Science  /  Argument

The Public Health Community Must Tell the Whole Measles Story

The anti-vaccine movement has gained ground because the public health community has denied the truth about measles.

Measles outbreaks are back. And with each one in recent years, doctors and health officials have urged the public to get fully vaccinated against this “deadly” disease. Every time, however, the campaign produces a predictable response from vaccine skeptics: “Quit with the fear mongering,” as one recently put it on Instagram.

After all, one of the most common “anti-vaccine” views today is the idea that measles is nothing to worry about.

This argument has gained real currency despite public health campaigns, in part because the history of measles provides factual support for the claim. In the words of physician-historian Ann Carmichael, the disease has been a “chameleon” — a virulent and deadly plague in some contexts and a common childhood annoyance in others.

For decades, health and medical experts have denied that history. And that refusal has made it harder to get the public to buy into the need to get vaccinated against measles. Instead, it created an opening for vaccination opponents to accuse the public health community of distorting facts and lying about the past, and thereby to sow doubt about the need for vaccination. But the public health community can weaken anti-vaccine forces and boost public trust in medical authorities and vaccination campaigns if they can accept and communicate measles’ history, especially as it unfolded over the last century.

Records dating back over a millennium show that measles has had a duplicitous nature since humans began documenting it. In medieval Persia, a prolific hospital physician wrote about two kinds of measles: regular measles meant a fever and rash that could be treated. “Bad” measles, by contrast, meant death. 

Later, in Renaissance Europe, “bad” measles slipped from view, largely because plague took center stage. Then, during centuries of European conquest, fatal measles returned — in the Americas, where it combined with smallpox to devastate indigenous communities. In Europe, however, the disease developed a reputation for being mild, and confined to children. By the 19th century it had developed a similar reputation in the U.S. — even as it began to ravage island nations throughout the Pacific.

In the early 20th century, a small but growing number of scientists began to study measles’ ever-shifting epidemiology around the world. A boom in measles research erupted during World War II — in part because measles was one of a host of infectious diseases that had hobbled troops since the Civil War, and partly because wartime polio research had yielded new vaccine development techniques for scientists to test on other diseases. After the war, American scientists accelerated these efforts.