Measles kills: a short history

He knows nothing and thinks he knows everything. That points clearly to a political career.
—George Bernard Shaw

In 1962, about 500,000 American kids got measles, with fever and spots made by the immune system reacting with the virus. Many of us remember it as relatively benign and I have heard people say, ‘I had it, and it wasn’t so bad’. But we are not all the same; we are not inbred white mice. Some people respond differently; immune systems are complex and vary from one person to the next.

About 20% of affected children had complications, usually encephalitis, an inflammation of the brain. Or they had diarrhea and dehydration. Many were hospitalized and about four hundred died. Year after year. That is hard to imagine now, because in 1963, a vaccine was produced by the legendary Dr. Sidney Hillman and his team at Merck. The Merck team made many vaccines and saved millions of lives.

After 1963, measles was one less thing for parents to worry about, along with polio, mumps, rubella, and then chickenpox. Whooping cough, diphtheria, and tetanus had been dealt with through earlier vaccines. Measles virus did not disappear, it was not eradicated like smallpox; It still stalks unvaccinated communities.

The measles virus is very contagious, more than SARS-CoV-2. Measles has another insidious property — it wrecks existing immune responses and not just a person’s response to measles. Imagine a child in Africa, whose immune system is just managing to keep the malaria parasite at bay. A case of measles will depress the immune system, unleash the malaria parasite, and may kill the child. Measles virus is one of the great killers in Africa with 47,000 deaths in 2022. Most viruses have ways to suppress immune systems, but measles is a champion of immune suppression and contagion.

The vaccine is exceptionally effective. And measles returns when vaccination stops. In an under-vaccinated community, a single tourist shedding measles virus can start an epidemic. That is what happened in September 2019, in American Samoa, in the months before the Covid pandemic.

The ground had been prepared by Robert F. Kennedy Jr., who had visited Samoa, met with government officials, and told them and other people that the vaccine caused autism. In 2017, 74% of babies were vaccinated, which was already low, but by January 6, 2020, only 31 to 34% of newborns were being vaccinated. Before the outbreak there were almost no cases of measles. A single infected tourist introduced the virus and by the 6th of January 2020 there were 5,700 cases and 83 deaths. The population is about 200,000 and about 100,000 doses of vaccine — measles, mumps and rubella — were administered. Schools were closed, and sports teams were idle — Samoans play rugby. People stayed home and hung out a red flag to summon the vaccination teams. Other islands in the region had 99% vaccination rates and no measles or noticeable increases in autism. Wikipedia has a lengthy article on the American Samoa measles outbreak, well as others in the South Pacific.

An emergency response by Samoan health workers converted to vaccinators with help from the Centers for Disease Control and Prevention and the public health agencies of New Zealand, Australia, Israel and French Polynesia and many other countries, and health agencies stamped out the measles epidemic by Jan. 22, 2020.

I do not know if there were any cases of autism among the thousands of children who were vaccinated, as Mr. Kennedy’s theory predicts there would be. Did Mr. Kennedy even ask if autism had increased after thousands of kids got measles vaccine? There should have been a wave, according to his theory, but if you don’t ask, the theory remains intact.

Raw data say no increase in autism occurred. The American Samoa Public Health website does not mention autism as a problem. I called the American Samoan Health Authorities. They were very cooperative and have not noticed anything of concern, but being competent officials said that they will do a deeper investigation. Numbers count. We will let you know the results.

The message from these events is simple: Be skeptical of people who never admit that they are wrong. Do not trust people whose message is meant to instill fear. Don’t believe people who think they know, but don’t. Do not put Robert F. Kennedy in charge of any American health agency, let alone all of them. Genial skepticism is a virtue that keeps people healthy, even alive.

Richard Kessin, PhD, is Professor Emeritus of Pathology and Cell Biology at the Columbia University Irving Medical Center.