HHS Is Fucking Up America’s Measles Elimination Status
As we unfortunately have to keep reiterating, the current measles outbreak in America is not going away. While we have suffered from outbreaks ranging from mild to slightly worse than that since the disease was officially declared eliminated in 2000 due to a concentrated vaccination effort, the current outbreak is putting that elimination status at risk. We are four months into the year and transmission cases have occurred, and are indeed trending upwards, in each of those months. If we get 12 months of ongoing infections via transmission, we lose the elimination status.
The cause of this is plain to see for everyone: MMR vaccination rates dropping below 95% in certain geographies. Above that threshold, we all benefit from herd immunity. Below that threshold we start to lose that herd immunity, which puts at risk not only those who are unvaccinated by choice, but also those who are unvaccinated as a result of immunodeficiency or who have not yet been vaccinated due to age. It’s no surprise to see, then, that the vast majority of the infected, the hospitalized, and the deceased are both unvaccinated and are children. Add to all of this the unhappy fact that a measles infection carries the risk of immune amnesia for a whole host of other infectious diseases and we have a recipe for a miserable healthcare meal being constructed as I type this.
RFK Jr. had a heavy hand in getting us here. Before he was stupidly put in a position of government healthcare oversight, he promoted all kinds of batshit vaccine skepticism, helping spur on these lower vaccination rates. Now in charge of the Department of Health and Human Services, Kennedy’s inability to be clear on the need for vaccination, and indeed his pushing of several other theories about how to handle the outbreak, has resulted in government inaction.
Add to all of this the massive cuts in budgets and staff at HHS and we are primed for yet another major health concern in a second consecutive Trump presidency.
“We are scrapping to find the resources and personnel needed to provide support to Texas and other jurisdictions,” said David Sugerman, the CDC’s lead on its measles team. The agency has been devastated by brutal cuts to CDC staff and funding, including a clawback of more than $11 billion in public health funds that largely went to state health departments.
Sugerman noted that the response to measles outbreaks is generally expensive. “The estimates are that each measles case can be $30,000 to $50,000 for public health response work—and that adds up quite quickly.” The costs go to various responses, including on-the-ground response teams, vaccine doses and vaccination clinics, case reporting, contact tracing, mitigation plans, infection prevention, data systems, and other technical assistance to state health departments.
In the past, the CDC would provide media briefings and other public comments on the responses to such an extraordinarily large and fast-moving outbreak. However, Sugerman’s comments are among the first publicly made by CDC experts under the current administration. He spoke about the outbreak at the very end of an all-day public meeting of the agency’s Advisory Committee on Immunization Practices (ACIP), which discussed a broad range of vaccine and vaccine-preventable diseases over the course of the day.
I wouldn’t be surprised to learn in the near future that Sugerman has been terminated or disciplined for such clear-eyed comments. The measles outbreak is expensive to combat and the budget cuts are making it harder. Sugerman has to “scrap” to find resources to combat the outbreak. Some of the clinics he mentioned being involved are being closed due to the budget cuts. And HHS is led by a man who, despite having the last name Kennedy, might instead be most famous for having a portion of his brain eaten by a worm and for strapping marine mammals to the hood of his family car.
As for why we aren’t getting more press briefings from HHS or the CDC on the outbreak, that one is fairly obvious. Kennedy and the administration are unlikely to want the public to be hearing about this any more than they already are. Put another way, the government would rather put more people at risk by being under-informed than endure any embarrassment that would come along with actually informing the public. Were there a more perfect antithesis to the mission of HHS to be had, I can’t find one.
And so we’re at risk for losing our elimination status for measles. The pace with which cases are growing should concern everyone, especially when you consider how likely it is that these cases are severely underreported.
With at least 673 documented cases linked to the Texas outbreak and other smaller outbreaks and imported cases around the country, the CDC tallies at least 712 cases as of April 10 (which is already out of date). This number is already more than double the total in 2024, when the country saw 285 cases.
Given that there have already been three deaths in the outbreak—and measles is estimated to have a fatality rate of 1 to 3 in 1,000—some experts expect a significant number of cases are being missed. Sugerman confirmed that the CDC also thinks this. “We do believe that there is quite a large amount of cases that are not reported,” he said. Health responders on the ground have reported families mentioning prior cases that recovered and were never tested or treated, leading to undertesting, underdiagnosis, and underreporting, Sugerman said. This is not uncommon in communities like this that tend to have “lower healthcare-seeking behavior at baseline.”
At the start of April, we were at 483 confirmed reported measles cases. Roughly two weeks later, we sit at 712. That’s something like a 50% increase in cases over the course of two weeks. Doubling cases ever month would cause us to easily eclipse 2019’s measles cases, the year in which we had the most cases since 2000, totaling 1,249 cases. Unless HHS and the CDC do something drastic, we could reach that number in a month or two.
Sadly, for all of us, the government appears to be unwilling to do much of anything at all. And because of that, all of us, and especially our children, are at increased risk.