Vaccine misinformation makes measles an even deadlier threat to youth

As the grandparent of a 2-year-old and an infectious disease doctor, I’ve thought a lot about the current controversy around measles vaccine and its supposed dangers, including autism, as promoted by Robert Kennedy Jr. and other vaccine skeptics. Parents of young children are understandably concerned and confused about conflicting information they hear. What are the facts?

Measles can be dangerous and more than a simple rash. Before measles vaccine became available, more than half a million measles cases and more than 400 deaths occurred in this country every year. One in every 10 children with measles develops ear infections, and one in 20 develops pneumonia, the most common cause of measles deaths in young children. One in 1,000 children with measles develop brain swelling that can lead to seizures, deafness or intellectual disabilities, something no parent wants.

If an unprotected child has day care or classroom contact with another child with measles, it is almost guaranteed they will also become infected. Measles is one of the world’s most contagious diseases, spread by coughing, sneezing or breathing the air of someone with measles. One person infected by measles can infect nine out of 10 unprotected close contacts, and the measles virus can remain in the air for up to two hours even after an infected person has left. After an unvaccinated 11-year-old child with measles visited Disneyland, 125 cases ultimately occurred that were connected with this one outbreak.

Measles cases have surged both worldwide and in this country. According to the Centers for Disease Control and Prevention, to date in 2024 measles cases have occurred in 32 states including Washington, with the largest numbers in children. The great majority of measles cases (89%) are among those who have not been vaccinated, and another 7% are in those who are only partially vaccinated.

The good news is that children can be protected by receiving two doses of a measles vaccine, given at 12-15 months, and 4-6 years. The vaccine typically used is called MMR, because it also confers protection against rubella (German measles) and mumps. Two doses of the vaccine are 97% effective in preventing measles for the child’s lifetime, and the remaining 3% generally have milder disease.

The measles vaccine contains a special weakened strain of the measles virus, which primes the immune system to develop protection against measles. Besides soreness or redness where the shot is given, some children have a fever and a mild rash afterward. A small number of children with fevers from any cause may develop a seizure which, although frightening, does not cause any permanent harm. (Note: I was one such child!)

Very rarely, children can develop a decrease in a blood cell that helps with clotting; this is temporary. For some teenagers or adult women, there may be swelling of certain glands after vaccination or temporary joint stiffness. To be safe, the vaccine is not recommended for those with serious immune system problems, for whom even a weakened strain of the measles vaccine can potentially cause significant problems.

What about autism? An alleged connection between measles vaccine and autism first came from Andrew Wakefield, a British physician who subsequently had his medical license revoked. Follow-up investigations failed to confirm medical information he reported, and it was revealed that Dr. Wakefield was trying to develop his own for-profit business based on a supposed vaccine-autism association. An alleged relationship between measles vaccine and autism has also been blamed on thimerosal, a preservative in some products to prevent contamination with bacteria and fungi.

Not only have studies found no evidence that thimerosal causes autism, but measles vaccine has never contained thimerosal, which for more than two decades has not been in any childhood vaccine. In addition, the measles-autism link has been proven false in multiple studies, such as a Danish study of more than half a million children that compared children who did and didn’t receive MMR and found no significant difference in the risk of autism between the two groups.

As both a physician and from personal experience, I recognize what a serious concern autism is, and the need to understand why and how it occurs. However, falsely attributing autism to a vaccine causes real harm by tragically diverting our attention from finding the true causes of autism, to the detriment of parents and pediatricians who want the best correct information to prevent and treat this condition.

In making an informed decision about vaccinating their child, parents need to balance these risks and benefits. The next time you walk through an old cemetery, see the headstones from children who died from diseases we can now prevent. Parents should not be swayed by politicians and internet bloggers who cast doubts and dangerous falsehoods on vaccines and other public health measures that have saved millions of lives. Our children deserve better than that.

Alan Lifson, MD, MPH is an infectious disease physician and retired Professor of Epidemiology and Community Health. He lives in Bellingham and has devoted over 40 years to public health at the local, state, national and international levels.