After virtually eliminating the highly contagious virus in the United States at the turn of the century, measles is back thanks to anti-vaccination misinformation.
So far, more than 150 people, mostly children in 10 states, have been infected with measles in 2019. These outbreaks are mostly related to travelers from other countries, such as the United Kingdom, who have introduced measles into communities where vaccination rates are low.
The public health crisis is widely perceived as a political failure: legislators have over-simplified the choice of parents to vaccinate their children. Two doses of measles vaccine are 97% effective, but to protect everyone – including infants and those who can not be vaccinated for medical reasons – a high percentage of people need to be vaccinated. This concept is called "herd immunity".
All states require that students be vaccinated to a certain extent and grant all exemptions to children for medical reasons. But 47 states grant religious exemptions. Seventeen of them also allow personal or philosophical exemptions. Experts are less interested in religious exemptions than in personal or philosophical reasons, because parents who withdraw nowadays usually do so because they are suspicious of the government or simply misinformed.
The question now is, what are the legislators going to do about it?
Dr. Scott Gottlieb, Commissioner in charge of the Food and Drug Administration, has garnered a lot of attention after telling CNN that he was skeptical about vaccine exemptions outside of medical reasons, and whether "some states continue on the path that they follow, I think that they will force the hand of the federal health agencies. "
Dorit Reiss, a law professor at Hastings College of the Law at the University of California, vaccine policy specialist and affiliate of the Immunization Action Coalition, is pleased that Gottlieb has used his program to attract the Pay attention to the public health crisis, especially because President Donald Trump does not have it.
"It would be nice to see other federal government actors make this statement," Reiss told ThinkProgress. "IPresident Trump said epidemics were a problem – that would be good, but I do not think that will happen. "
But Reiss also pointed out that what the federal government could do beyond the public interest messages is not clear. She suggested that Centers for Disease Control and Prevention (CDC) could put pressure on states by, for example, addingThe federally funded Childhood Vaccine Program (VFC) provides free vaccines to children in underserved areas. But she warned that state health departments could simply abandon the program, which could worsen the existing problem.
"It makes sense for the federal government to positively encourage states to adopt policies that improve immunization rates … you do not need very coercive policies to improve immunization rates. For example, a policy that makes it very easy to obtain a waiver can prevent people who are reluctant to vaccinate from vaccinating from not vaccinating for practical reasons, "she added.
The former FDA Commissioner, Robert Califf, told ThinkProgress by email that "the FDA has no real authority over medical practice. This is a matter of national law unless an additional federal law is passed. It is possible that CDC or CMS has control over the distribution organizations that could force the problem, but it would be difficult. "
ThinkProgress contacted the Department of Health and Human Services (HHS) for comments but did not receive an immediate response.
Congress is also examining the issue. The House and Senate hold hearings on measles outbreaks on Wednesday and early March, respectively.
A Democratic Assistant to the Senate Committee on Health, Education, Workers and Retreats, which is hearing "The vaccine saves lives," told ThinkProgress that it was important to "Understand what was happening before taking other measures," adding that the federal government "simply can not override states". At present, the Congress is only collecting information; For example, the Senate sent a letter to HHS asking what measures they were already taking to address vaccine hesitation.
That said, vaccine laws are primarily a matter of government policy. Until now, lawmakers from New Jersey, New York, Iowa, Maine and Vermont have proposed eliminating religious exemptions for vaccines and the state of Washington seeks to eliminate personal and philosophical exemptions. Meanwhile, lawmakers in Arizona are seeking to expand exemptions for children.
In addition, technology companies are trying to remedy anti-vaccination misinformation. More recently, Pinterest has blocked anti-vaccine content. Try to look for "vaccine" and nothing should happen.
Youtube has recently demonetized such videos.
Rapid action is needed because there is no cure for measles, a disease that is easy to contract and spread. Before the measles vaccine, a child with measles infected about 12 to 18 other children. Doctors can try to help infected people avoid extreme complications, such as pneumonia or blindness, and may prescribe antibiotics for less severe cases, such as ear infections and eye infections.
But doctors say that the best way to defeat measles is to avoid contracting it, that is to say to get vaccinated.
This piece has been updated to replace a National Vaccine Information Center card with a map of the National Conference of State Legislatures.