Declining vaccination rates in the U.S. could lead to a dramatic resurgence of measles and other preventable diseases over the next 25 years, according to a new simulation model published in JAMA. Researchers at Stanford University paint a grim picture of potential public health consequences if immunization levels continue to fall.
The study explored the impact of declining vaccination rates on measles, rubella, poliomyelitis, and diphtheria. In a worst-case scenario, a 50% drop in childhood vaccinations could result in a staggering 51.2 million measles cases over 25 years. This decline would also lead to 9.9 million rubella cases, 4.3 million polio cases, and 197 diphtheria cases. The model estimates this would cause 10.3 million hospitalizations and 159,200 deaths.
Even Maintaining Current Rates Poses a Threat
Even if vaccination rates remain at 2025 levels, the model projects over 850,000 measles cases in the next 25 years. A more moderate 10% drop in MMR (measles, mumps, and rubella) immunization rates could still result in 11.1 million measles cases. Conversely, a 5% increase in vaccination rates could drastically reduce cases to just 5,800. Herd immunity for measles requires approximately 95% vaccination coverage, and researchers estimate current coverage at between 87.7% and 95.6%.
Immunization rates vary significantly by state. Data from the CDC shows that New York had a childhood vaccination rate of 97.7% for the 2023-24 school year, while Idaho lagged behind at just 79.6%.
Childhood MMR vaccination rates by state for the 2023-24 school year
Measles: A Resurgent Threat with Serious Consequences
Before the measles vaccine in 1963, the CDC estimates 3 to 4 million Americans contracted measles annually, resulting in tens of thousands of hospitalizations and 400-500 deaths. Beyond mortality, measles can cause “immune amnesia,” weakening the immune system and increasing susceptibility to other infections.
The U.S. is currently grappling with its worst measles outbreak in 25 years, with at least 800 cases reported across 25 states, according to the CDC. Tragically, three deaths have been attributed to measles this year, including two children in Texas and an adult in New Mexico.
Vaccine Hesitancy and its Impact
The parents of the deceased children have expressed no regret about not vaccinating their children, even attributing one death to unrelated causes and poor hospital care. Both families have communicated with Children’s Health Defense, an anti-vaccine organization that falsely links vaccines to autism. Robert F. Kennedy Jr., head of the Department of Health and Human Services, chaired this organization until 2023.
RFK Jr.
Concerning Statements from Health Officials
Kennedy has publicly stated his intention to reveal the “cause” of autism and has referred to it as an “epidemic.” Reports suggest he is compiling a database of autism cases, raising concerns about privacy. Kennedy’s recent public statements, including linking autism to declining testosterone levels and claiming many diseases are new phenomena, have sparked alarm.
He has also expressed concern about the number of Americans unable to qualify for military service due to health issues. He attributes the rising costs of treating chronic diseases to unspecified causes. These statements ignore the historical context of undiagnosed or misdiagnosed conditions and the societal practices of institutionalizing individuals with these conditions, including members of his own family.
The Future of Public Health
The current landscape of public health raises serious concerns. The prevalence of anti-science views among top health officials and their focus on unsubstantiated claims could have devastating consequences for public health in the coming decades. If allowed to continue, these anti-vaccine sentiments could lead to millions of preventable illnesses. With the potential for continued political instability, the outlook for improving vaccination rates and protecting public health remains uncertain.
