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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

The social media addiction bubble

Illustration: Annelise Capossela/Axios

Right now, everyone from Senate leaders to the makers of Netflix's popular "Social Dilemma" is promoting the idea that Facebook is addictive.

Yes, but: Human beings have raised fears about the addictive nature of every new media technology since the 18th century brought us the novel, yet the species has always seemed to recover its balance once the initial infatuation wears off.

Young people's next big COVID test

Illustration: Eniola Odetunde/Axios

Young, healthy people will be at the back of the line for coronavirus vaccines, and they'll have to maintain their sense of urgency as they wait their turn — otherwise, vaccinations won't be as effective in bringing the pandemic to a close.

The big picture: "It’s great young people are anticipating the vaccine," said Jewel Mullen, associate dean for health equity at the University of Texas. But the prospect of that enthusiasm waning is "a cause for concern," she said.

7 hours ago - World

New Zealand authorities charge 13 parties over deadly volcano eruption

Prime Minister Jacinda Ardern at New Zealand's parliament in Wellington. Photo: Mark Tantrum Photography via Getty Images

New Zealand authorities laid safety violation charges Monday against 10 organizations and three individuals over the fatal Whakaari/White Island volcanic disaster last December, per a statement from the agency WorksSafe.

Details: WorksSafe declined to name those charged as they may seek name suppression in court. But Prime Minister Jacinda Ardern said government agencies GNS Science, which monitors volcanic activity, and the National Emergency Management Agency were among those charged over the "horrific tragedy" that killed 22 people.