So what’s the big deal about measles?


In a recent post (“Dear Anti-Vax Parents: We’re Not Mad At You“), I wrote about the critical need for better education and communication between doctors and vaccine-hesitant parents. It was far more popular than I would have imagined, and I appreciate all of you who shared it. And in the spirit of providing reliable information about vaccine-preventable illnesses, I wanted to take the time to write about why measles matters.

The measles vaccine was released in 1963. Before that time, nearly everybody got measles. And it usually didn’t matter. The most common symptoms are fever, cough, runny nose, and a rash. These symptoms last a few days and go away, usually leaving children with lifelong immunity. So what’s the big deal?

Prior to 1963, measles would affect between 300,000 and 700,000 children per year in the U.S. That’s a lot. It caused a lot of physical suffering. Affected children would miss several days of school. And a few hundred of them died … every year. That comes out to about 1 to 2 for every 1,000 children that got the disease. The fact that most children fully recovered from measles is not a legitimate argument that the virus is insignificant. As Dr. Roy Benaroch recently wrote, “Old cemeteries are littered with tiny little headstones for little dead children.” Measles is not “just a virus,” and it is a big deal.

1. Measles matters because it kills children. It can do this in a couple different ways. It can cause several neurologic complications including encephalitis — an inflammatory process of the brain that can lead to seizures, coma, permanent neurologic damage, or death. More commonly, it kills kids by causing severe pneumonia, either directly or by weakening the body’s defenses and leaving the lungs vulnerable to other infections. The measles virus can also cause lifelong paralysis, blindness, and epilepsy.

2. Measles matters because it’s very good at what it does. A few months ago, I wrote a post about Ebola — another virus that could kill you … but that you really shouldn’t worry about. I made the case that while Ebola is fatal in about 55 percent of cases (in Africa), it’s not very good at getting from one person to another — which is, after all, a virus’s only job. Measles, on the other hand, is a very good virus. As we have seen at Disneyland recently, it can spread rapidly without direct contact. It is infectious before symptoms appear. The number of cases in a measles outbreak grows exponentially. If our population were entirely unvaccinated, we would already have seen thousands of cases and probably a few deaths.

3. Measles matters because it is preventable. The number of cases of measles decreased by over 99 percent since 1963. Aside from a small outbreak in 1989 to 1991, we’ve seen maybe 1 or 2 measles-related deaths per year for the past couple decades. But it’s not gone. As we have recently seen, it doesn’t take much to start an outbreak — just one germy kid on It’s A Small World. And when a significant percentage of parents choose not to immunize their children, the outbreak spreads quickly, leaving behind a wake of destruction. I wonder how many children will have to die to make a point.

Chad Hayes is a pediatrician who blogs at his self-titled site, Chad Hayes, MD.


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