The Scary Things RFK Jr. Said — And Didn’t Say — About The Measles

Fewer people are getting measles shots. As a result, the level of protection is falling below the threshold necessary to prevent the virus from spreading in populations where — among other things — it can infect people (like cancer patients) with damaged or suppressed immune systems and young children who have not yet gotten the full, two-dose vaccine.

“This is what we see when vaccination rates drop,” Adam Ratner, a pediatric infectious diseases physician in New York City and the author of the book ”Booster Shots,” told me. “And unfortunately, I think that given the current trends in the U.S. and even globally, we’re going to see more and more outbreaks like this.”

Worries about the future of vaccination were the biggest reason Kennedy’s nomination aroused so much opposition. He has a long, well-established record of attacking vaccines with misleading and false claims about their supposed dangers. In the two weeks since Kennedy officially took over as HHS secretary, the agency already has postponed one key vaccine advisory committee indefinitely and canceled another without explanation, fueling fears he will use his leverage over HHS programs, personnel and regulations to deter vaccine use.

But it’s not just Kennedy’s potential to shape federal policy on vaccines that worries so many in the public health community. It’s also his potential to shape public perceptions with his rhetoric — and to reinforce the distrust that already exists — by downplaying the threat diseases like measles pose.

“He did not seem remorseful at all that a child had died in Texas of a vaccine-preventable disease,” Ratner said. “He did not encourage people to get vaccinated. He normalized the fact that we’re having a measles outbreak in Texas. This is not a normal thing.”

A Forgotten Lesson On Infectious Disease
Of course, there was a time when childhood deaths from diseases like the measles were a lot more common. And it wasn’t even that long ago, as Kathryn Edwards, a now-retired infectious disease physician from Vanderbilt University, reminded me in a phone interview this week.

She’s old enough to remember what it was like in the 1950s, when a bout of polio left the brother of a classmate with lifelong disabilities. Firsthand knowledge of those dangers is one reason the public not only accepted vaccines but embraced them ― something else Edwards said she saw firsthand as a researcher in the 1970s and 1980s working on the Hib (Haemophilus influenzae type B) vaccine.

Back then, she said, parents eagerly signed up their kids for trial studies because they knew the disease could lead to hearing loss, brain damage and death. And now? Vaccination, she says, has become a victim of its own success.

“We have such a great product that people have just forgotten the diseases,” Edwards said. “And that is a big problem, because if people don’t understand the diseases that you’re trying to protect against, they really don’t dread them, or they don’t fear them, and they don’t really worry about them.”

You can see the effects in polling, which has documented falling enthusiasm for vaccines over the last 25 years, with a particularly dramatic drop since COVID-19. (That’s also when attitudes about vaccines developed a sharp partisan divide, with Republican voters becoming far more skeptical than their Democratic counterparts).

Not coincidentally, vaccination rates have fallen too. And it is in those communities where vaccination rates have fallen most dramatically that the measles, one of the most easily communicable diseases on the planet, keeps finding a foothold.

“If people don’t understand the diseases that you’re trying to protect against, they really don’t dread them, or they don’t fear them.”

– Kathryn Edwards, Vanderbilt University
Gaines County is one of those places. Countywide more than 17% of schoolchildren received vaccine exemptions, according to public data; in one school it’s almost 50%. And although some of the people declining vaccination cite religious objection, a bigger factor is the misinformation parents are picking up online and from high-profile influencers, according to Jessica Gray, a board-certified family physician in Lubbock.

“There have been social media posts locally promoting hosting ‘measles parties’ to encourage natural immunity amongst their children,” Gray, who also hosts ”The Med Edit Podcast,” told me.

These “parties” are an improvised, uncontrolled way of doing the same task a vaccine does with safeguards that prevent actual illness. “As a physician with two young children of my own, and an infant who is under 12 months of age and too young to receive the MMR vaccine, the idea of having a measles party terrifies me. This is like playing roulette with your child’s health.”

Recent reports suggest that many parents are now rushing to get their kids vaccinated, to protect their children from what they now realize is such a real and serious threat. And that makes sense, given that the vast majority of parents really do want what is best for their kids. Those holding back on vaccines are doing so because they genuinely believe all of the misinformation in circulation.

State and local officials have been doing their best to combat those myths, making a loud, consistent case for vaccination. But one voice has been conspicuously absent from the chorus: Kennedy’s.

He said nothing about vaccination during those brief comments at the Cabinet meeting, nor has he made any other comments to that effect ― even though, as STAT News noted recently, his predecessors during the last Trump administration made strong pro-vaccination statements during a 2019 measles outbreak in New York.

Just how much effect Kennedy’s rhetoric ultimately has remains to be seen. The more people who get sick from this outbreak, and the more the public hears from other experts and officials that vaccination is important, the more parents are likely to get their kids the shots.

But it says something about the times — and the priorities of the presidential administration now in charge — that the best hope against diseases like the measles isn’t that the public listen to the nation’s top public health official.

It’s that they ignore him.