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Illustration: Aïda Amer/Axios

After having practically eradicated measles from the U.S. almost two decades ago, a growing anti-vaccination movement has led to a resurgence of cases, currently focused in the Pacific Northwest and New York.

Why it matters: Unless doctors and the public step up to counteract the vocal opposition to vaccines with evidence-based facts, there is a serious concern that infectious diseases like measles could return full-force, public health officials and scientists tell Axios.

Driving the news: Washington state Gov. Jay Inslee declared a state of emergency Jan. 25 after multi-county cases caused a "public disaster." There were 36 cases reported on Monday.

  • The nearby city of Portland in Oregon is also concerned, as there have been dozens of possible exposure locations, ranging from a Portland Trail Blazers game to a children's museum.
  • In 2018, there were 349 cases reported in 26 states and D.C., including outbreaks in New York and New Jersey where many were unvaccinated people in Orthodox Jewish communities.
  • Several of these outbreaks (defined as 3 or more cases) are continuing into 2019, including in NYC and Rockland County, N.Y.

Public health officials are concerned the pro-vaccination message isn't getting through, they tell Axios.

"When we see outbreaks of measles like this one, it’s a reminder to parents that many diseases rarely seen in the United States can affect their unvaccinated children.  In some cases, children with measles may go on to develop serious complications, like pneumonia.”
— Nancy Messionnier, director, CDC's National Center for Immunization and Respiratory Diseases
"There's incorrect information about the safety of the MMR vaccine, and its association with autism, which is 100% false. ... This is one of the most highly contagious diseases out there, but it's balanced against one of the most effective vaccines out there, [which is] 97% effective."
— Anthony Fauci, director, National Institute of Allergy and Infectious Diseases

Between the lines: Some of the main factors behind the anti-vaxxer movement are disbelief that measles is such a bad disease, anti-government sentiment, a misguided sense that the vaccine can be harmful, and lack of accessibility.

1. Disbelief in its seriousness.

  • "This is a very dangerous situation, and I don't think people fully appreciate how difficult and dangerous it is," Fauci says.
  • Pre-vaccine, measles was the cause of deafness, encephalitis or death for some children. People have forgotten how they "were clamoring" for a vaccine, he adds.

2. Anti-government and fear.

  • "Anti-vaccinism often goes hand in hand with suspicion of experts, government and Big Pharma and with conspiracy theories and scepticism about science generally," Helen Bedford, children's health professor at the University College London, tells Axios.
  • Part of this is due to fear the vaccine causes autism, which spiked when a small 1998 study linked the measles vaccine and autism (a study later found fraudulent and retracted), Fauci says.
  • For instance, Ukraine's current large outbreak (already 8,500 in 2019) is mainly due to unsubstantiated fears over safety, Bedford says.

3. Social media optimization.

  • "[Anti-vaxxers'] voice is loud and they have powerful influencers such as celebrities who attract media coverage. Messages can also spread in seconds around the world via social media (perhaps even faster than measles can spread!)," Bedford says.

4. Accessibility issues.

  • "Overall, it is factors such as difficulties accessing services that play an important role in under-immunisation, as a result of large families, poverty, [and] social disadvantage," Bedford adds.

What's next: Fauci says evidence-based science must be consistently promoted by clinicians and public health officials. Bedford agrees, "Science has demonstrated repeatedly that vaccines are highly effective and very safe. We don’t say this loudly or frequently enough!"

Go deeper:

Go deeper

Updated 8 hours ago - Politics & Policy

Omicron dashboard

Illustration: Brendan Lynch/Axios

  1. Health: Pfizer and Moderna boosters overwhelmingly prevent Omicron hospitalizations, CDC finds — Omicron pushes COVID deaths toward 2,000 per day — The pandemic-proof health care giant.
  2. Vaccines: The case for Operation Warp Speed 2.0 — Starbucks drops worker vaccine or test requirement after SCOTUS ruling — Kids' COVID vaccination rates are particularly low in rural America.
  3. Politics: Biden concedes U.S. should have done more testing — Arizona says it "will not be intimidated" by Biden on anti-mask school policies — Federal judge blocks Biden's vaccine mandate for federal workers.
  4. World: American Airlines flight to London forced to turn around over mask dispute — WHO: COVID health emergency could end this year — Greece imposes vaccine mandate for people 60 and older — Austria approves COVID vaccine mandate for adults.
  5. Variant tracker

Arizona governor sues Biden administration over COVID funds tied to mandates

A teacher prepares a hallway barrier to help students maintain social distancing at John B. Wright Elementary School in Tucson, Arizona, on Aug. 14, 2020. Photo: Cheney Orr/Bloomberg via Getty Images

Arizona Gov. Doug Ducey (R) filed a lawsuit Friday against the Biden administration for ordering the state to stop allocating federal COVID relief funds to schools that don't comply with public health recommendations such as masking, the Arizona Republic reports.

Why it matters: The Treasury Department said last week that the state would have to pay back the money if Ducey does not redesignate the $173 million programs to ensure they don't "undermine efforts to stop the spread of COVID-19."

Federal judge blocks Biden's vaccine mandate for federal workers

President Biden speaking from Eisenhower Executive Office Building on Jan. 21. Photo: Yuri Gripas/Abaca/Bloomberg via Getty Images

A federal judge in Texas blocked the Biden administration from enforcing its coronavirus vaccine mandate for federal workers on Friday, citing the outcome of last week's Supreme Court ruling that nullified the administration's vaccine-or-test requirement for large employers.

Why it matters: It's a blow to President Biden's efforts to increase the U.S.' vaccination rates, though much of the federal workforce has already been vaccinated against the virus.