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March 21, 2024

Michigan is seeing a rise in measles: MSU experts can comment on related health issues

Earlier this week, the Centers for Disease Control and Prevention, or CDC, issued an advisory to inform clinicians and public health officials of an increase in global and U.S. measles cases. The Michigan Department of Health and Human Services reported the first case of measles, a highly contagious and vaccine-preventable disease, on Feb. 23 — the first case in the state since 2019. Days later, TIME magazine reported that in 2023, measles cases jumped by nearly 80%. Although vaccines make this disease — and many others — preventable, cases are on the rise.  
About the impact of measles: 
Prior to the introduction of the measles vaccine in 1963, approximately 3 to 4 million people in the United States were infected with measles virus every year. 
Measles is one of the most contagious diseases known to man, with a single case leading to as many as 20 additional cases in susceptible populations. 
The World Health Organization estimates that the measles vaccine prevented 20.4 million deaths worldwide between 2000 and 2016 (measles is much more dangerous in malnourished children). 
In 2022, the CDC reported that nearly 40 million children missed measles vaccine doses.  
In 2023, the CDC and the World Health Organization estimated 9 million measles cases and 136,000 related deaths, most of which were among children.  
According to the National Institutes of Health, approximately 2% to 3% of the overall population, or 6.6 to 9.9 million people, are immunocompromised and unable to vaccinate against measles. 
Michian State University experts are available to comment on many issues associated with measles, related diseases, and vaccinations, including: the resurgence of measles and the rise of cases in Michigan, vaccine efficacy, vaccine types, risks of not vaccinating, why we need new vaccines, cultural aspects of vaccinations, parental rights and making vaccines more widely accepted.  
Peter Gulick is a professor of osteopathic medical specialties in the MSU College of Osteopathic Medicine and serves as adjunct faculty in the College of Human Medicine and the College of Nursing. Gulick is an expert on vaccines and communicable diseases. 
“Measles has not been a problem since we’ve had the vaccine, which was developed in the ‘60s. Historically, we’ve always had good herd immunity — everyone who’s been able to vaccinate would get vaccinated and have immunity, so there was very little chance of the virus being active. There’s no host to infect — that’s how viruses die off. But when there’s reduction in immunity over time, then all you need is one case. If that hits people who don’t have immunity, it spreads.”   
Sean Valles is director of the MSU Center for Bioethics and Social Justice in the College of Human Medicine and interim director of the Office of Medical Education and Research Development. He can comment on the ethical and evidentiary complexities of health disparities and ways that biomedicine meshes with public and population health. and ways that biomedicine meshes with public and population health. 
“A common opinion among vaccine experts in public health is that vaccines are their own worst enemy. When they work, nothing happens . . . so people think vaccines aren’t important. They think they don’t need a measles vaccine because no one has measles. But if you try to show people what measles looks like or share statistics about how many kids ended up in the hospital with measles, you can get a boomerang effect and make people more afraid of vaccines.” 
Angela Chia-Chen Chen is the McLaren Greater Lansing Endowed Chair for Behavioral Mental Health Nursing Education and a professor in the MSU College of Nursing. She is currently conducting pilot testing of a game-based intervention to promote HPV, or human papillomavirus, vaccination in families with unvaccinated children.  
“The findings of my research about vaccination suggest the increased vaccine hesitancy that has arisen since the COVID-19 pandemic has been generalized to other vaccines such as measles, flu and HPV. For years, parents have had the same concerns about vaccines, including whether or not the vaccine works, safety and side effects, perceived lack of need for vaccinations due to zero risk of getting infection or no symptoms. Parental concerns are closely related to misinformation about vaccines circulated in social media which has increased their hesitancy and led to mistrust.” 
B. Keith English is a professor and chair of the Department of Pediatrics and Human Development in the MSU College of Human Medicine. He specializes in pediatric infectious diseases and is working to expand statewide partnerships in pediatrics and to expand pediatric research. 
“I know vaccines work — I’ve watched their success throughout my career. When I was a pediatric resident Haemophilus influenzae type b, or Hib, was the leading cause of serious bacterial infections in children in the United States. As many as 20,000 children developed severe Hib disease and about 1,000 of those children died each year. After the development of the Hib conjugate vaccines, this disease has become extremely rare in the U.S. I think we’ve had one case in Lansing in the past 10 years.”  
Rhonda Conner-Warren is an assistant professor in the MSU College of Nursing and a pediatric nurse practitioner for MSU Health Care. 
“The measles outbreak is a result of multiple factors, including vaccine hesitancy and families’ lack of access to health care, be it due to financial or transportation issues. Many families also may not elect to vaccinate their children due to a lack of information or an abundance of misinformation. The best way for healthcare providers to address this has been through face-to-face conversation. We must address parents’ concerns and clarify the misinformation. This can impower the parent to make an informed decision.” 
Heatherlun Uphold is an assistant professor in the C.S. Mott Department of Public Health and MSU Department of Translational Neuroscience. Her interests include dissemination and implementation science, community engaged research, vaccine equity and health outcomes data. 
“Advancing vaccine equity and creating vaccine-confident individuals begins with community. We need to build from what already exists, starting with established organizations and trusted credible messengers who are familiar with community needs. Then, together, we can address the community-specific factors that create challenges to vaccination access and acceptance.” 
Robert Root is an associate chief medical officer and board-certified pediatrician with MSU Health Care and assistant professor in the Department of Pediatrics at the MSU College of Osteopathic Medicine. He is an expert on measles symptoms in children and measles vaccine education for parents and caregivers. 
“Amidst recent outbreaks across the country, parents are understandably raising more questions and concerns about their children’s health. We urge families to connect with their pediatrician or primary care providers when they have questions or concerns and ensure their child is up to date on vaccinations, particularly the MMR vaccine administered at 12 months and four years. Fortunately, the MMR vaccine is highly effective. As a pediatrician, I remain vigilant for any signs or symptoms of measles, which can initially mimic a cold but may progress to include distinctive features such as white/gray spots in the mouth and a characteristic rash. Protecting our children through vaccination is paramount in safeguarding against preventable diseases.” 
Rebecca Schein is a board-certified pediatric infectious disease physician at MSU Health Care and assistant professor in the Department of Pediatrics and Human Development at the MSU College of Human Medicine. 
“Recent events underscore the importance of vaccination against measles, as declining rates pose a risk for outbreaks. Vaccinated individuals are generally protected, but additional MMR doses in adulthood may be necessary. Recognizing measles symptoms in unvaccinated children is critical for prompt isolation and testing. Comprehensive testing protocols and vigilance are important in preventing and managing measles outbreaks.” 

By: Dalin Clark

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