By now, you’ve seen the news: after being declared eliminated in the U.S. in 2000, measles cases have reached record highs and already claimed four lives. We are only halfway through the year. Public health officials are raising alarms. Physicians are relearning what it means to treat these rare diseases. Parents have questions.
But many are wondering: we’ve had sporadic outbreaks before, why the panic? Is public health overreacting?
After all, measles hasn’t claimed nearly as many lives this year as the flu or the opioid crisis. Compared to those, a few hundred cases—and even a few tragic deaths—might seem like an overreaction. And the number of measles cases in the U.S. isn’t even close to what Europe experienced last year—more than 127,000 cases.
The answer: the alarm isn’t just about the risk of measles. (93% of Americans are at low risk because of immunity.) It’s about what measles represents.
For those of us in public health and medicine, this outbreak is more than an infectious disease flare-up. It’s a symbol of broken trust, eroded progress, rise of individualism replacing collective good, and a system that is cracking under the weight of disinvestment and distrust. The urgency you’re seeing from health officials isn’t just about the virus’s high transmissibility (though measles is one of the most contagious diseases known) or the risk of serious outcomes in populations without immunity. It’s about the deeper warning signal this resurgence sends.
Measles is a canary in the coal mine. When measles reappears in a country like the U.S., it signals that something has gone seriously wrong. This is a disease we had essentially eliminated—thanks to one of the safest and most effective vaccines in the history of medicine. But the way things are heading, the U.S. is at risk of losing its elimination status this year. This is not just a failure to move forward—it’s the unraveling of decades of progress, representing one of the greatest public health achievements of our era.
That progress was built on public confidence in science and medicine. When parents now refuse the MMR (measles, mumps, rubella) vaccine, it’s not because the science has changed. It’s because trust has, both due to failures of public health to reach communities and due to well-organized efforts to spread inaccurate information about vaccination, leaving many Americans’ heads spinning as they sort through the noise and figure out who to trust.
For many in medicine, the resurgence of measles, along with declining rates of routine childhood vaccination, is a concerning sign of what’s to come. If we’re losing ground on measles, we may soon be vulnerable to other vaccine-preventable diseases. Whooping cough cases are already rising. Polio, Hib, or even diphtheria may soon appear in our emergency rooms. Unlike most of human history, childhood deaths from infectious diseases are now relatively rare (at least in high-income countries like the U.S.), and we’d like to keep it that way.
For people working in public health departments, this outbreak is revealing the cracks in our fragile public health system, cracks that are only going to get bigger as resources and personnel are actively being defunded. Local health departments—understaffed and underfunded—are scrambling to contain something that should have been preventable. Many are still recovering from Covid-19 burnout, and the prospect of trying to contain more outbreaks with even fewer resources is demoralizing.
This is why the medical and public health communities are so alarmed. It’s not just a clinical reaction—it’s an emotional one. It’s about decades of progress being unraveled, and the foreboding prospect of what’s to come. It’s grief. Frustration. Exhaustion. And, yes, anger.
But these deeper concerns haven’t always been communicated clearly. Instead, the alarm comes out as loud repetition of technical warnings and statistics: transmission rates, hospitalization data, mortality estimates. That information is important, but it doesn’t explain why the alarm feels so intense. To many Americans, this mismatch between tone and scale creates confusion. “Why are we freaking out over a few hundred cases? Why is every measles death front page news?” Covid-19 created alarm fatigue, and many are tired of constant updates on case and death counts. If the deeper reasons behind the alarm aren’t communicated, the public health response can seem like hype.
Even worse, for some, this deep frustration over the unraveling of one of modern medicine’s greatest achievements is driving doctors and scientists to shame those who don’t vaccinate. This may seem like an understandable reaction, but unfortunately it is making the problem worse. While higher vaccination rates would certainly help fix this problem, shame will not get us there. The evidence-based path to restoring trust in evidence-based medicine is the exact opposite: empathy. Shame destroys trust, empathy rebuilds it.
So, where do we go from here?
If you’re in public health or medicine, one answer is to help people understand what’s fueling this emotion. It isn’t elitism or alarmism—it’s heartbreak. We’re watching preventable diseases kill healthy children. We’re being asked to contain outbreaks with fewer tools and fewer allies. We’re watching years of trust-building dissolve.
The answer isn’t just to be louder or show people more data. It’s to be better communicators who are more transparent, more empathetic, and more grounded in the human stakes. Our academic training taught us to take emotion out of it. But right now, genuine emotion—articulated with kindness and compassion—is exactly what’s needed.
And if you’re a parent, neighbor, or community member trying to make sense of all this: your curiosity is welcome. Ask questions. Don’t assume bad intentions. Lead with empathy, not judgment. That may be a surprising place to start a conversation, but it’s a start.
Bottom line
Measles is at an all-time high, but it remains very rare, and more than 93% of Americans are protected. However, the road back to a world where this isn’t a challenge will not be paved with more facts, fear, or finger-wagging. It will be built, as it always has, through stories and relationships—one respectful, genuine, evidence-based conversation at a time.
Love, YLE and KP
Kristen Panthagani, MD, PhD is an emergency medicine physician completing a combined residency and research fellowship focusing on health literacy and communication. She is the creator of the newsletter You Can Know Things and author of YLE’s section on Health (Mis)communication. Views expressed belong to KP, not her employer.
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE is a public health newsletter that reaches over 380,000 people in more than 132 countries, with one goal: to translate the ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below
Imagine you are an artist, a painter or sculptor. After many years of study and practice, you create the best portrait you can possibly make of the person you most admire in all of history. Maybe it's a portrait of a great political leader. Maybe it's a portrait of a great religious leader. Maybe it's somebody less famous who did unsung acts of great heroism. Whoever the subject may be, you have poured all that you know and all that you are into creating the best possible version of what you cherish most deeply.
And then somebody deliberately defecates on your creation. Not accidentally, they intentionally destroy your life's work.
I am a scientist. My most cherished works are the antiviral drugs that I helped put on the market, for Hepatitis B, Hepatitis C, and HIV.
The deliberate destruction of medical research and public health now being wreaked in the service of lies feels to me like they are deliberately defecating on everything I value.
Bravo! Well said with a good balance between detail and emotions. As a family doc and epidemiologist, and as a person who has had polio and been in medicine long enough to have treated measles, and many cases of preventable whooping cough, as well as HIV and COVID, thanks for a terrific essay.
While you cite " broken trust, eroded progress, rise of individualism replacing collective good, and a system that is cracking under the weight of disinvestment and distrust," the current problem really boils down to a huge, pervasive, passionate, cultural, societal over-commitment to AUTONOMOUS INDIVIDUALISM, nurtured by many years of protected, comfortable, relative security, prosperity, and peace and fueled by neoliberal, commercialized consumerism. Public health is the archetypical "public good." It is not produced by individuals, nor companies; it requires collective effort; it usually is systemic; it requires government agency; it should be anticipatory; it is best when its return on investment (in dollar bill terms) is zero; it gives free benefits to people who did not participate or buy it. Our society lauds the free market of Adam Smith, but has forgotten he wrote a companion volume on "moral sentiments" dealing with these issues.
In this sense the problem with measles, vaccines, and public health is a massive culture wide blindness and insensitivity. The magnitude of all possible remedial solutions to this situation re-enforces the wisdom that all public health is, and will remain, political.