Remember the Before Times, when America's public healthcare system was a well-oiled altruistic machine that effortlessly served a rational nation? If so, you should get a professional head examination that somehow costs $57,000, or consult your cousin who thinks vaccines are part of a nefarious government plot to sterilize him, thus ending a line of threatening freethinkers who are great at Hearthstone and complaining about the Packers. Back in the halcyon year of 2019, the United States was dealing with a measles resurgence, and while out of sight may mean out of mind it doesn't mean out of body.
Let's start with a quick recap, if for some crazy reason other events have been on your mind recently. In 2019, America's 1,282 measles cases were the most the country had seen in 25 years, and while that number looks downright quaint compared to COVID, it was enough for New York and Washington to declare public health emergencies. The outbreak was linked to "vaccine hesitancy," otherwise known as "selfish gibbering conspiracy theory idiocy," and so mandatory vaccinations were backed by the threat of fines, laws eliminating "personal and philosophical" vaccination exemptions were pushed forward, and the anti-vaxx courting Trump administration flipped to encouraging parents to get their children vaccinated.
While the White House unfortunately threw out their bold "We should probably do what medical professionals suggest" stance when the clock struck midnight on New Year's Eve as though their brains had reverted to pumpkins, the measles problem was still solved, right? Well... yes and no. While those 2019 outbreaks were quashed, the CDC has warned of another possible outbreak thanks to COVID preventing parents from taking their children to be vaccinated. 76.1% of 16-month-olds were vaccinated in May 2019, but that dropped to 70.9% in May of 2020, and 90% is the benchmark cited to achieve herd immunity.
That doesn't mean we'll all emerge from our COVID bunkers and immediately turn into spotted, feverish messes, but a statistic already hurt by anti-vaxxers is trending in the wrong direction. Worldwide in 2018, 353,236 measles cases were confirmed, and it killed over 140,000. Most of those fatalities were children under five who, even if they survive, can be left with brain and spinal cord damage, among other serious disabilities. In 2019, cases spiked to over 500,000 and, thanks to COVID, 2020 might end up even worse.
Between the fact that a vaccine has been readily available in the developed world since 1963 and the disease sounding like a rejected Muppet, it's easy to forget that measles is one of the most contagious viruses on the planet. In its heyday, it was killing more American children than polio. Today, it's primarily a problem in developing countries where access to modern medicine is limited and the symptoms can be exacerbated by malnutrition, war, and other fun challenges created by cranking up life's difficulty sliders. Doctors Without Borders has dubbed it a "silent, steady killer among COVID-19," as vaccination efforts in countries including Chad, the Central African Republic, and the Democratic Republic of Congo have been suspended or otherwise, shall we say, challenged by the whole global pandemic thing. 117 million children across 37 developing countries were estimated to miss vaccinations and, as of April, the DRC's outbreak has killed 6,500 children, in what is believed to be the worst outbreak since the vaccine first became available.
So now that we've established the fact that people are risking their lives to vaccinate countries desperately trying to scrape up every last penny for immunization efforts that will prevent parents from watching their children suffer slow and agonizing deaths, let's return to the western world, where people reject free and safe vaccinations because of something Novak Djokovic told freedompatriot.ru. "Vaccine hesitancy" is considered a major threat to global health, and while America is stereotyped as the epicenter it's actually France and Ukraine that lead the way. In a staggering coincidence, France and Ukraine also led the way in 2019 European measles cases, which had tripled from 2018. Care to guess what countries most trust vaccines? It's developing states like Bangladesh, Rwanda, and Ethiopia, where people have been able to watch vaccination campaigns wipe out deadly epidemics firsthand. Scaremongering YouTube videos are less effective if you've just had to bury a child.
Anti-vaccination is essentially its own disease, one that ravages the brains of people who don't know how good they have it. They might be forced to find out: as pointed out by Vox back in ye olde 2019, America's measles outbreak augured the larger problem of under-immunization. If America had managed to let measles reboot itself like a bad horror villain, what other eradicated diseases could make a return?
If COVID has a silver lining it's that it's been a reminder that medical professionals and NarutoLuverNeedleHater are not equally qualified authorities. The White House may be sleeping through the wake-up call, but polls have found that America's trust in medical science has climbed while 88% of Americans retain their trust in the measles vaccination. Will that be enough? 83 American Samoans died in a 2019 outbreak that was linked to social media misinformation dangerous enough for a prominent anti-vaxxer to be arrested for incitement against a government order. Those who still ignore the scientific consensus are driven by the partisan rhetoric of Trump-loving Republicans and, worryingly, a positive attitude towards the measles vaccine is less common among those with children.
An August 2019 Atlantic article asked, with all the foreshadowing that would be cut from a movie script for being too blunt, "If Americans won't take expert advice about something as scientifically proven as the benefits of vaccinating their children, what other life-and-death advice will they ignore?" That's a question we'll have to ask again once COVID is over, when the consequences of ignoring life-and-death advice is fresh on our minds.
What makes measles so nefarious is that, for many victims, it's an inconvenience that knocks them on their ass for a week. For children who don't even understand what a vaccine is, it's deadly. In the west, horror stories about measles ravaging families are fading out of living memory, and anyone with an internet connection can create their own truth. If, even after COVID, those problems keep the lunatics on social media convincing to enough people that everyone is put at risk, we might get enough new horror stories to last us a few more decades.