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Opinion
The
Editorial Board
Measles
Is Back. What Comes Next Will Be Worse.
April 25,
2026
By The
Editorial Board
The
editorial board is a group of opinion journalists whose views are informed by
expertise, research, debate and certain longstanding values. It is separate
from the newsroom.
https://www.nytimes.com/2026/04/25/opinion/measles-vaccines-rfk-jr.html
The
resurgence of measles — a terrible disease that can swell the brain and cause
permanent disabilities or death — is alarming enough on its own. There have
been more than 1,700 cases reported in the United States already this year, up
from about 70 per year in the early 2000s. Three children died last year.
The rise
of measles may also be a harbinger of something even worse, public officials
say. “Measles is basically a canary in the coal mine for our entire system,”
says Dr. Scott Harris, the state health officer in Alabama’s Department of
Public Health. “When it surges like this, it signals that our vaccination
programs are starting to fail, and that other diseases won’t be far behind.”
Already, cases of whooping cough have surged, too. And after two Florida
children died of Hib, a bacterial infection, epidemiologists worry that disease
is resurgent.
The most
maddening aspect of this situation is that it was almost certainly avoidable.
It stems in large part from a yearslong scare campaign by vaccine conspiracists
including Robert F. Kennedy Jr., who now serves as President Trump’s secretary
of health and human services. Since taking office, Mr. Kennedy has turned his
damaging ideas into federal policy. He has downplayed the seriousness of
measles outbreaks; promoted dubious treatments and prevention strategies;
replaced an expert panel that shaped federal vaccine recommendations with
people who share his views but, for the most part, lack relevant experience or
expertise; and made substantial changes to the childhood vaccine schedule
without even convening that same group.
There is
some reason to hope that the political climate is shifting against Mr. Kennedy.
In March, a federal judge blocked his changes to the childhood vaccine
schedule, calling them arbitrary, capricious and most likely illegal, and the
Trump administration has not yet appealed. Last week, Mr. Trump announced the
nomination of Dr. Erica Schwartz, a well-qualified Navy officer who supports
vaccines, to run the Centers for Disease Control and Prevention. Mr. Kennedy,
appearing at several congressional hearings over the past week, tried to
soft-pedal his views at times and even acknowledged that his department “has
advised every child” to get the measles shot.
But Mr.
Kennedy does not appear to have changed his actual views, and the threat to
vaccines remains substantial. The military recently eliminated its flu vaccine
requirement, for example. And the C.D.C. disingenuously canceled the
publication of a study documenting large, continuing benefits from the Covid-19
vaccines.
Reversing
the new vaccine skepticism will require a dedicated effort. State officials and
members of Congress, especially Republicans, should speak up. So should
doctors, religious leaders and corporate leaders. Protecting Americans from
deadly, preventable diseases should not be a partisan issue, despite the
attempts by opportunists like Mr. Kennedy to make it one.
Studies
have suggested that only a small share of parents are hardened anti-vaxxers who
refuse all shots. Many more are merely anxious and looking for trusted guides
or good information. The key is to meet these families where they are. Health
workers can listen empathetically and provide easily understandable
information. They can be careful to avoid using too many statistics and jargon
and instead tell human stories. Hearing about even one child who died from a
preventable disease can sometimes be persuasive.
Skepticism
about vaccinations began to grow in the early 2000s, in both the United States
and some other wealthy countries. It sprang partly from a 1998 study that
linked vaccines to autism and has since been discredited. The worries have been
part of a broader rise in conspiratorial politics, fueled by a combination of
partisan polarization, social media and other factors.
The Covid
pandemic once seemed as if it might reinstill confidence. The virus was a new
and terrifying pathogen for which scientists developed a safe, highly effective
vaccine in record time. It offered a case study in the power of vaccination.
But Covid, too, soon became subject to political polarization.
Many
conservatives questioned the vaccine in irrational and self-defeating ways.
Liberals rightly embraced the vaccine but sometimes went so far as to be
alienating — insisting that children needed annual boosters (which most
countries did not), calling for the firing of unvaccinated people and more. The
combination played into many Americans’ pre-existing uncertainty about how much
to trust public health experts. In the years since, vaccination rates for other
diseases have slipped further.
A vast
majority of American children — more than 90 percent by most estimates — are
still vaccinated for measles. But it takes a threshold of 95 percent to stop
the illness from spreading, and in too many communities, the rates are lower
than that already, or falling fast. In Idaho, just 78.5 percent of
kindergartners were vaccinated for measles last school year. Nationwide
vaccination rates for several other diseases, including flu, hepatitis B,
rotavirus, Hib, polio and whooping cough, are also down.
A policy
known as “shared clinical decision making,” which Mr. Kennedy put in place for
some shots in January and remains in effect, has proved pernicious. The
practice sounds innocuous. It involves doctors discussing options with their
patients and then allowing the patients to decide which course to pursue. But
doctors normally reserve it for cases in which a treatment’s benefits are
unclear, which is not the case with standard childhood vaccines. “It implies
that either decision, to take it or not to take it, is equally OK, and that’s
not the case with vaccines,” Dr. Harris said.
Doctors
now must spend more time rebutting misinformation and making the case for
vaccines. Doctors report that hesitancy is spreading from vaccines to other
medical staples. Last year, for instance, at least three infants died after
their parents opted out of a routine vitamin K injection meant to prevent
internal bleeding.
The
fallout from declining vaccination rates will not be confined to those who
choose not to get vaccinated. For one thing, newborns cannot be vaccinated
against most diseases and rely on the rest of society to provide herd immunity.
For another thing, no vaccine is perfect: About 3 percent of people vaccinated
against measles remain vulnerable to infection, often without realizing it.
Immunocompromised people, like those on chemotherapy, can also be vulnerable.
They, too, rely on herd immunity. A return of vaccine-preventable diseases
would also strain hospitals and doctors’ offices and require quarantines,
school closures and other disruptive safety protocols.
What can
be done? So long as Mr. Kennedy remains health secretary and insists on making
up his own facts, the options will be limited. The country needs vaccine
policies based on scientific consensus and federal investments in both vaccine
distribution and disease treatment.
Nonetheless,
other leaders can step forward to mitigate the damage. Governors and members of
Congress from both parties can issue clear messages about the benefits of
vaccines. As Dr. Paul Offit of the Vaccine Education Center at the Children’s
Hospital of Philadelphia puts it: “Vaccinate your children against measles. The
shots work and are safe, and nobody needs to die from this disease.”
States
and local governments can also adopt helpful policies that counteract the Trump
administration’s pseudoscience. One tangible step would be to make vaccines
easier to obtain by opening more pop-up clinics in schools and community
centers. It would also be useful to tighten the requirements for vaccine
exemptions. Several states require families to receive information about
vaccines before they can receive nonmedical exemptions, and more should follow.
Families should also have to apply individually for any exemption, rather than
being able to receive a blanket exemption covering all shots.
The
arguments against vaccines have been circulating for more than a century, even
if social media has allowed them to spread more easily. The claims can seem
compelling but can be debunked. Vaccines prevent three million to five million
deaths globally each year. They are not toxic and they do not cause autism,
full stop.
To some extent, vaccines have been a victim of their own success. They made many disease outbreaks a thing of the past, and people have forgotten how terrible those outbreaks were. We are at growing risk of experiencing that misery again.


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