Teddy Rosenbluth
Appearances
The Daily
The Growing Danger of Measles
So if you look at the graphs of rates of vaccination nationally, it's gone from 95 to 93 percent, which doesn't sound like a big deal. But you have to think that this isn't evenly distributed. You know, you have some pockets like in Gaines County where you're closer to 80 percent, which is a real danger zone.
The Daily
The Growing Danger of Measles
And, you know, the more of these pockets that you get, the more likely that these outbreaks are going to hop from group to group. And those falling rates go hand in hand with the mistrust in the system that we talked about. You know, it was always there to some extent, but really ramped up during COVID.
The Daily
The Growing Danger of Measles
So for the most part, during outbreaks like this, state and local officials are managing the on-the-ground response. And what the CDC typically does is they are out front encouraging everyone to get vaccinated. But several experts I spoke to thought that the reaction from federal health officials this time around has been really muted.
The Daily
The Growing Danger of Measles
The CDC only posted their first significant notice about the outbreak almost a month after the first cases in Texas started popping up. One epidemiologist I spoke to said they've been, quote, shouting with a whisper.
The Daily
The Growing Danger of Measles
He falsely claimed that many of the people hospitalized from this outbreak were there for quarantine, which is not true. They were there because they were sick. And, you know, after he faced pushback from these comments, he changed his tune a little bit.
The Daily
The Growing Danger of Measles
And so in some pockets of the United States, what we're seeing is that vaccination rates for the measles, mumps, rubella vaccine, the MMR shot, have fallen far below where experts would want them to be. And those pockets have multiplied and gotten bigger, really raising concerns that these once-isolated outbreaks are going to travel further and infect more people.
The Daily
The Growing Danger of Measles
And he actually comes out and says that, you know, health officials recommend the vaccine for people in Gaines County.
The Daily
The Growing Danger of Measles
He starts talking about some of the risks of getting vaccinated. He says that there are people in the Mennonite community who are, quote-unquote, vaccine injured. You know, again, the risks of getting the MMR vaccine are very low. He even goes so far as to say at one point... We're going to return to the Hippocratic Oath.
The Daily
The Growing Danger of Measles
That's the only way that... That, you know, medicine should be focused on individual health versus, you know, what he says is theoretically good for the community.
The Daily
The Growing Danger of Measles
And so ultimately, he's making a pretty weak recommendation for vaccines and emphasizing this idea of personal choice.
The Daily
The Growing Danger of Measles
So I think a lot of experts are really looking at what's happening in Gaines County as a warning sign. If vaccines rates dip any lower, we are at serious risk of these outbreaks sort of igniting on a national scale. And, you know, it might not happen with this outbreak, but it might happen next year. And they're not just worried about this one virus.
The Daily
The Growing Danger of Measles
You know, you can think about measles sort of like a canary in the coal mine. When you see an outbreak of measles, it's likely that other vaccine-preventable infections are not so far behind.
The Daily
The Growing Danger of Measles
You know, I think we might be at a turning point. Even on the ground, at the heart of this outbreak, I talked to a public health official in Seminole who said he recognizes that measles is an awful virus and he wants people to get the vaccine because he knows it can prevent so many of these cases and hospitalizations.
The Daily
The Growing Danger of Measles
But he also said, you know, this is Texas and people have the right to do what they want with their bodies. And so if people continue to make that choice and stay unvaccinated, we know what happens. This is an incredibly contagious virus. And we know what viruses do when they have enough oxygen. Teddy, thank you. Thanks for having me.
The Daily
The Growing Danger of Measles
So the first couple cases started popping up at the end of January. And they were these kids who belonged to a very large Mennonite population that settled in West Texas in the 1970s. In this population, there is no religious doctrine that says that they cannot be vaccinated.
The Daily
The Growing Danger of Measles
But historically, they have had low vaccine uptake just because they don't interact with the medical system as often as the broader community.
The Daily
The Growing Danger of Measles
Yes, a long tradition of holistic medicine, that sort of thing. Okay. But the lack of vaccination uptake in that area sort of gives measles the oxygen that it needs to spread rapidly through the community. And so by the end of February, we saw more than 120 cases, right? And then two months later, we're now up to more than 200 cases.
The Daily
The Growing Danger of Measles
And now we're also seeing a separate but likely related outbreak in New Mexico, in a county that borders where this outbreak has been happening in Texas. And unfortunately, we've seen two deaths related to these outbreaks. So I was really interested in seeing what an outbreak of measles looks like. This is a virus that many people have never seen in their lifetimes.
The Daily
The Growing Danger of Measles
So I started to call some doctors, call some public health officials, and ultimately decided to travel down there myself.
The Daily
The Growing Danger of Measles
Sure. So maybe just at the scene a little bit, what West Texas is known for is, you know, four things. Cotton, peanuts, oil, and this big Mennonite community.
The Daily
The Growing Danger of Measles
So I spent time at the hospital that serves this community, Seminole Memorial Hospital in Gaines County, Texas, which is the epicenter of this big measles outbreak.
The Daily
The Growing Danger of Measles
And at the clinic, they have divided their day into two. In the morning, they do all the wellness visits. They see the pregnant women. They do checks to make sure infants are healthy. And then at 1 p.m., sort of everything shifts. Everyone puts on N95 masks, and that's when they start seeing the measles cases.
The Daily
The Growing Danger of Measles
And Dr. Parkey, who has worked in the area for almost three decades, he has not seen a measles case before this year. He'd only seen it in medical textbooks.
The Daily
The Growing Danger of Measles
But he has become very good at spotting these cases. And it's not because of the rash, which you might think.
The Daily
The Growing Danger of Measles
It's because all of these kids come in with this very distinctive look. It looks like they're staring, you know, a hundred miles away. Very vacant expression. These kids are sick. And so I got to see this for myself with one patient, this eight-year-old girl in the room with her mom. And this little girl did not speak any English.
The Daily
The Growing Danger of Measles
She spoke Low German, which is a regional dialect that many Mennonites speak.
The Daily
The Growing Danger of Measles
recovering from a really nasty case of measles and she had that thousand yard stare and what is she usually like is she usually energetic oh yeah this is a little kid that you would expect to be bouncing around the room and of course bothering her mother and she was you know really not feeling well and not responding i'm gonna can you lay down Thank you.
The Daily
The Growing Danger of Measles
And at one point, they go and give her this injection in her thigh, which Dr. Parkey prescribed to help manage some of her symptoms. And I'm looking at this needle, and, you know, it's like two or three inches long.
The Daily
The Growing Danger of Measles
And she just stares straight ahead, doesn't even flinch as that needle goes into her leg.
The Daily
The Growing Danger of Measles
So the first symptoms that they'll probably experience is a runny nose, a cough, a fever. You know, they get these crusty eyes that look a little red and irritated. And then you start to develop that iconic measles rash, which is these bruises. flat red spots that start at the top of your body and spread downwards to cover your arms, your neck, your entire trunk.
The Daily
The Growing Danger of Measles
And for most kids and adults, these symptoms will resolve within a few weeks. But for some kids, measles can be really dangerous. About one in 20 kids develop pneumonia, which makes it really difficult to get oxygen into the lungs. You know, some kids have to be hospitalized, maybe even put on a ventilator.
The Daily
The Growing Danger of Measles
One in a thousand kids get encephalitis, you know, swelling of the brain, which can cause permanent damage, blindness, deafness, intellectual disability. And then, of course, in rare cases, children can die.
The Daily
The Growing Danger of Measles
So this is a woman who had vaccinated three of her children.
The Daily
The Growing Danger of Measles
And after that, you know, combined with things that she had heard from the community about the risks of the vaccine, she decided that she wasn't going to vaccinate any more of her children. And as a result, several of her children fell ill with measles during this outbreak, and she was just exhausted.
The Daily
The Growing Danger of Measles
That must be awful. But I asked her whether this changed anything for her, whether she regretted not getting her younger kids vaccinated. Like, did you think about maybe I should get the vaccine for measles? No, no. And she basically said no. So I really wanted to go deeper to understand more fully how people are making these decisions.
The Daily
The Growing Danger of Measles
I met her at a park just a few blocks away from the hospital. And, you know, this is a mom who is really scared of her kids getting measles. You know, she's pregnant herself. She understands the risks to pregnant women, to young kids.
The Daily
The Growing Danger of Measles
And are her kids vaccinated? She has vaccinated one of her kids up to one year.
The Daily
The Growing Danger of Measles
But around that time is when the COVID-19 pandemic started. And that is when a lot of misinformation around vaccines, around the medical system started swirling around on social media. And she decided not to get any of her other kids vaccinated.
The Daily
The Growing Danger of Measles
And when this outbreak first started, she considered getting the MMR vaccine for her kids. Like I said, she knows that it's a serious disease.
The Daily
The Growing Danger of Measles
But she had seen these scary stories on her mom groups, on social media, on TikTok, of kids suddenly dying after getting shots, which is not something that happens or is common at all. Ultimately, she and her husband preyed on it and decided not to get her kids vaccinated.
The Daily
The Growing Danger of Measles
Yes. So part of the reason that you probably don't think very much about measles, even though it's an incredibly contagious virus, is because it's vaccine-preventable. It's been eliminated in the United States since 2000, which means there'll be cases here and there, but it's not continuously spreading. And so we've seen these other outbreaks. You know, we saw one in New York.
The Daily
The Growing Danger of Measles
Right. And, you know, there are lots of vulnerable people in the community that are impacted by a virus as contagious as measles. You know, there are babies who are too young to get the vaccine. There are pregnant people who aren't eligible to get the shot. And people who are immunocompromised, who can't build up that immunity themselves.
The Daily
The Growing Danger of Measles
I saw a patient of Dr. Parkey's, a teacher, who had gotten the MMR vaccine, but she was immunocompromised. So she ended up getting just this really nasty case of measles. You know, the rash was covering her torso. It had spread under her hair. Her scalp was really sore. She was bedridden for a week. And this is sort of the point of public health. It's to protect everyone.
The Daily
The Growing Danger of Measles
And when you're talking about a disease as contagious as measles, this is what can happen. It can spread beyond the people who just choose for themselves not to get vaccinated.
The Daily
The Growing Danger of Measles
Yeah, so I think what a lot of people don't appreciate when it comes to the elimination of measles is just how widespread it was before the vaccine. So before it became available in the early 1960s, almost all children got measles by the time they were 15. And about, you know, 500 people died every year. So this is everywhere.
The Daily
The Growing Danger of Measles
Eliminating measles was a really hard-fought victory that took about four decades.
The Daily
The Growing Danger of Measles
And when you think of the COVID vaccine, that's something that was developed really quickly. But that's not what normally happens. They had isolated the measles virus in 1954. They had started doing trials to check the efficacy, the side effects. And they didn't have a usable vaccine until 1963. And then they had to get people to take the vaccine.
The Daily
The Growing Danger of Measles
They had to launch these massive campaigns to get the vaccination rate as high as possible.
The Daily
The Growing Danger of Measles
They poured funding into making vaccines available and accessible. They made the vaccines a requirement for public schools. The goal was to get as many people as possible vaccinated to starve this virus of oxygen.
The Daily
The Growing Danger of Measles
We saw one in Washington. But experts are looking at this outbreak a little bit differently. And that's because, one, a child has died. And two, because childhood vaccination rates have been falling for some time. And that fall really accelerated during the pandemic and just hasn't rebounded.
The Daily
The Growing Danger of Measles
So for a virus as contagious as measles... And it's really contagious, right? The most contagious. One person infected with measles can spread it to 18 other people. Oof. Yes. So the idea is you get as many people as possible protected against measles so that if one person in the community becomes infected, it has nowhere to go. You've starved it of oxygen, essentially, until it simmers down.
The Daily
The Growing Danger of Measles
Exactly. So the result of this big public campaign to get people vaccinated, the requirements, the funding investment, was essentially that by 2000, vaccination rates were above 95%. And as a country, the U.S. had eliminated this disease. It went from something that pretty much everyone gets as a child to something unheard of. That is until vaccination rates started coming down.