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Illustration: Sarah Grillo/Axios

The federal government may try to take action if states don't tighten their vaccine exemption laws and measles continues to spread in sections of the U.S., FDA Commissioner Scott Gottlieb tells Axios.

Driving the news: Overall case numbers of measles remain low in the U.S. but the disease is growing in areas of high non-vaccination rates. Some states like Washington are considering tightening their exemptions even as they continue to face a more organized anti-vaccination movement.

"It's an avoidable tragedy," Gottlieb, who says he's usually a proponent of state rights, tells Axios. "Too many states have lax laws."

Background: The highly contagious disease can only be controlled if there's a large vaccination rate in the population, which the World Health Organization says should be 93%–95% of people.

  • States are allowed to adopt their own rules over what types of exemptions are allowed for vaccines. All of them allow exemptions for medical reasons, but many also provide exemptions on religious and/or philosophical grounds.
  • These pockets of unvaccinated people are transmitting measles in the U.S., which is particularly dangerous to those who can't get vaccinated, including babies under 12 months and people with susceptible immune systems.
  • Gottlieb says the vaccine is one of the most effective ones (97% with 2 doses) created so far, and for one of the most contagious viruses.
  • Measles can cause various complications, including pneumonia, brain damage and sometimes death, and it has been linked to longer term immune problems.
What's happening now

WHO reported last week that measles cases tripled globally in 2018 from the prior year, and current reports show multiple deadly outbreaks in the Philippines, Ukraine, Israel and Madagascar.

In Washington state, the number of confirmed cases has more than doubled since Gov. Jay Inslee declared a state of emergency on Jan. 25, to 54 as of Feb. 13.

In New York, there is an outbreak in Rockland County, Monroe County and New York City, and Texas reported 8 cases in 5 different counties as of Feb. 14.

The debate

"It's a self-inflicted wound," says Peter Hotez, dean at Baylor College of Medicine who published a study last year showing possible U.S. "hotspots" of measles due to vaccine exemptions, that he says is already proving to be true.

  • Pro-vaccination groups are "losing the battle" to anti-vaccination groups, who've been very active on social media and forming at least one PAC to promote their message, he says.

The other side: Barbara Loe Fisher, co-founder and president of the nonprofit National Vaccine Information Center often labeled as anti-vaccination, tells Axios that 100 cases of measles in a population of 320 million "is not a public health emergency."

  • "[It] should not be used to justify eliminating the legal right to exercise informed consent to vaccination, which is protected by the inclusion of flexible medical, religious and conscientious-belief vaccine exemptions in public health laws," she says.

Go deeper:

Go deeper

"Neanderthal thinking": Biden slams states lifting mask mandates

States that are relaxing coronavirus restrictions are making "a big mistake," President Biden told reporters on Wednesday, adding: "The last thing we need is Neanderthal thinking."

Driving the news: Texas Gov. Greg Abbott (R) said Wednesday he will end all coronavirus restrictions via executive order, although some businesses are continuing to ask patrons to wear face masks. Mississippi is lifting its mask mandate for all counties Wednesday, per Gov. Tate Reeves (R).

Cuomo: "I am not going to resign"

New York Gov. Andrew Cuomo apologized Wednesday for acting in a way that made women feel "uncomfortable," but insisted that he has "never touched anyone inappropriately" and said he will not resign.

Driving the news: Cuomo reiterated in his first public appearance since sexual harassment allegations surfaced that he will fully cooperate with a team of independent investigators appointed by New York Attorney General Letitia James, but suggested that demands for his resignation from were simply "politics."

Facebook to lift political ad ban imposed after November election

Photo Illustration by Omar Marques/SOPA Images/LightRocket via Getty Images

Facebook will finally allow advertisers to resume running political and social issue ads in the U.S. on Thursday, according to a company update.

The big picture: Facebook and rival Google instituted political ad bans to slow the spread of misinformation and curb confusion around the presidential election and its aftermath.