Confidence Commentary: Blog archive

Article of the week: Measles in 2019 — Going Backward

Heidi Larson | 19 Apr, 2019

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PERSPECTIVE By Catharine I. Paules, M.D.,  Hilary D. Marston, M.D., MP.H.,  and Anthony S. Fauci, M.D.

New England Journal of Medicine (published on April 17, 2019, at NEJM.org )

Measles vaccination has prevented an estimated 21 million deaths worldwide since 2000.³ Despite these substantial gains, global elimination goals have not been met, and previous strides are now being threatened by a 31% increase in the number of measles cases reported globally between 2016 and 2017.³

The resurgence in measles cases is all the more frustrating since the disease is entirely preventable through vaccination. Measles has all the components of an eradicable disease: there is a safe and highly effective vaccine, it has a readily diagnosable clinical syndrome, and it has no animal reservoir to maintain circulation.¹ But because of the highly contagious nature of the virus, near-perfect vaccination coverage (herd immunity of 93 to 95%) is needed to effectively protect against a measles resurgence. Although there are valid reasons why some people might not be vaccinated, such as a medical contraindication due to marked immunosuppression, the failure to vaccinate too often stems from misconceptions about vaccine safety, especially those resulting from a now-debunked claim that posited a connection between the vaccine and autism. The growing anti-vaccination movement, based heavily on philosophical objections to vaccinations, poses a threat to public health. Vaccine hesitancy has been identified by the WHO as one of the top 10 threats to global health and is a serious hurdle to the global elimination and eradication of measles.

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