The Dose: Measles slowing? Flu deaths, water safety, and lots of talk in vaccines
May 6
Keeping up with public health developments—both policy and health events—is like drinking from a firehose these days. While all YLE content remains free, we need financial support to keep the team sustainable (and sane). If you can, please consider upgrading to a paid subscription below.
Good morning! This is coming a day late—I was in New York over the weekend for a graduation, and there's truly nothing more energizing than being around students.
Here’s your dose: the context behind this week’s public health headlines. From shifting disease trends and overlooked drowning risks to the latest in vaccine falsehoods and messy talking points—here’s what you need to know, and why it matters.
Infectious disease alerts
Flu and Covid activity remain very low nationwide—normal for this time of year. But we’re now seeing final tallies from this past winter, and the U.S. just recorded the highest number of pediatric flu deaths in recent years.
Flu vaccination rates continue to decline—year after year since 2019. This may be our new normal, and it’s hard to swallow.
Measles
As of Sunday, the U.S. had 967 confirmed cases. We are getting closer and closer to reaching the record high (1,200) since we eliminated measles in 2000.
Of that, 817 cases are from the Southwest outbreak. The good news is that it may be slowing down in West Texas. We know this from three soft data points:
This is the first week with no hospitalized children in West Texas for measles.
A downward trend in reported weekly cases (a promising “epi curve” below). Ultimately, we want a bell-shaped curve, which may be starting to take shape.
Fewer new cases are reported anecdotally by clinicians on the ground.
Transmission continues, just at a slower pace. While any case could still spark a new outbreak in communities with low vaccination rates (for example, all eyes are on El Paso right now), big thanks to the public health workers working to contain.
Other sporadic cases continue to pop up in the past week. Also, a small outbreak in Montana continues to grow, and a new outbreak in North Dakota:
Illinois: +2 (unrelated cases)
Montana: 7 (+2: household cluster)
Ohio: +1
Arkansas: +1
California: +1
North Dakota +4
Missouri +1
For the latest full SITREP report, go here:
What this means for you: You are very well protected if you’re up-to-date on vaccines. Here are the top 10 FAQ about your measles protection. If you have a child under 12 months and there is an outbreak (3+ cases) near you, they can get a vaccine as early as 6 months. Be sure to talk to your pediatrician.
HPV vaccine: Is one dose enough?
We already know the HPV vaccine is one of the most powerful tools in cancer prevention—protecting against cervical, penile, anal, and some head and neck cancers.
The standard schedule is two (or three) doses, depending on age.
But a large clinical trial from the National Cancer Institute just reported something great: In a study of 20,000 girls in Costa Rica, a single dose of the HPV vaccine provided protection that was just as strong—even 4.5 years later. This could expand access globally—especially in places where getting two doses is hard.
What it means for you: Not much, as the dosage recommendation hasn’t changed. Stick with the two/three dose series as we still have many unanswered questions. For example, these results apply specifically to cervical cancer. We don’t yet know if they apply to other HPV-related cancers.
Vaccines & placebos: Let’s clear the air
RFK Jr. recently claimed that “none of the vaccines on the CDC’s childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products.” That’s not true—but it’s also more nuanced than a soundbite allows.
A lot of our vaccines have been tested against placebos, like saline. (Here is a running list a few infectious disease doctors put together.) When we have a brand new pathogen, like Covid-19 or RSV, this is important in evaluating safety and efficacy.
However, some vaccines haven’t been tested against a saline placebo but rather against another vaccine. Scientists do this when they combine vaccines, change strains, or develop a next-generation vaccine. These “bridge studies” allow scientists to see if the new vaccine (or drug) is as good or better than the original vaccine (that went through a placebo clinical trial). If not, they don’t go to market. This is like building blocks, advancing from a foundation rooted in randomized placebo trials.
Two reasons why we do it this way:
Ethics: We can’t withhold known protection. In other words, we cannot give someone a placebo vaccine if there’s already a better alternative to getting the disease. Imagine testing a better car seat by giving half the kids no seat.
Feasibility: Some vaccines (like flu) are updated yearly to match circulating strains. These are tweaks—not new products. In this case, we don’t have a randomized control trial because the virus mutates too quickly.
What it means for you: Vaccine science is complex, but our current processes are top of the line. Falsehoods, half-truths, or messy talking points—especially when amplified by the highest health office in the U.S.—can be confusing and do real harm.
State legislation targeting mRNA vaccines
Falsehoods can turn into policy changes. Several states are considering bills that would restrict or even criminalize mRNA vaccines:
Iowa: Providers could face fines of up to $500 for administering mRNA vaccines (approved by a Senate subcommittee).
Idaho: Would ban mRNA vaccines for ten years; six counties already restrict the health department from distributing Covid vaccines.
Montana: Considered a similar action, but was defeated in the House.
Minnesota: A bill to label mRNA vaccines “weapons of mass destruction” (unlikely to pass).
These bills build upon false claims that mRNA technology is gene-editing and/or gene-based, a falsehood we debunked as early as 2020.
Why would this be bad? Beyond Covid-19, mRNA technology is revolutionizing treatments for cancer and other diseases. Early clinical trials show dramatic survival improvements in pancreatic cancer (overall survival, which was previously 10%, has increased to 50% in a Phase 1 clinical trial) and kidney cancer (in a Phase 1 trial, the vaccine appeared to be essentially curative), with the potential to transform outcomes for some of the hardest-to-treat illnesses. Cutting off this technology would be devastating for patients—and medical progress.
Happy National Water Safety Month!
If you ask my husband the number one thing I worry about with my 4- and 5-year-olds, you’ll always get the same answer: drowning. (That episode on The Pitt TV show wrecked me.)
The number one killer for children aged 1-4 is drowning. Unfortunately, rates have remained relatively steady over the past 30 years because it’s a neglected public health area. It will likely not get better, either: the CDC’s drowning prevention team and program were cut dramatically impacting capacity for local education, such as through the YMCA.
While a lot of communication on drowning has centered around adult supervision (which is important!), that’s not when the majority of drownings happen. Around 70-90% are during non-swimming times when no one expected the child to be anywhere near the pool.
What it means for you: Multiple layers of protection are important, like fences, but early, consistent water familiarization and aquatic competency will get kids exposed and comfortable with water from an early age. In two words: back float. (Yes, there’s a lot more to it, but if you have to boil it down to one needed skill, it’s this.)
Big thanks to Acacia Clark, an injury/drowning prevention researcher, for helping the YLE team provide context here.
Question grab bag: “Are immigrants bringing in measles?”
This narrative resurfaces every outbreak. So what do the data say?
Measles was eliminated in the U.S. in 2000, which means it isn’t just randomly floating around the community. It has to be imported, find an unvaccinated pocket, and spread. However, most measles cases are among U.S. citizens who traveled abroad and brought the virus home. Thus far, in 2025, 92% of index measles cases were among U.S. residents who traveled abroad.
Here’s a deep dive from our archives:
Where is measles coming from?
As measles cases increase, online rumors follow. Encased in some recent rumors is the underlying assumption immigrants— especially illegal immigrants from the Southern border— are fueling U.S. measles outbreaks.
Bottom line
You’re all caught up! Have a great week.
Love, the YLE team
Your Local Epidemiologist (YLE) is a public health newsletter with one goal: to “translate” the ever-evolving public health science so that people feel well-equipped to make evidence-based decisions. This newsletter is owned and operated by Dr. Katelyn Jetelina— an epidemiologist and mom. This is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
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The audacity for someone to believe that Measles is coming from the immigrant population and not from their own unvaccinated neighbors will always be astounding to me. So easy to dehumanize and blame the "other" for something they themselves (or their peers) are responsible for.
Bummer bummer bummer. BUT the mrna vaccines helping to cure cancer is very exciting, and perhaps our current indulgence in stupidity will change for the better. Thanks for this update!