Original article in (in Croatian) was published on 3/17/2025; Author: Marta Kolarić
Ten years before the introduction of the vaccine, an average of 440 people died from measles each year in the U.S. Recently, the first death since 2015 was recorded.
Once an almost inevitable childhood disease, measles is now rare in countries with high vaccination rates. New outbreaks of measles in the U.S. have sparked the spread of disinformation on social media about the importance of vaccination.
Recently, a Facebook post appeared featuring a video claiming that the decline in measles mortality is not connected to the introduction of the vaccine.
“Did you know that the measles mortality rate decreased by 98% BEFORE the measles vaccine was introduced? This is all featured on the CDC website. That drop in mortality has nothing to do with vaccines.
The drop in mortality happened thanks to better nutrition, improved hygiene, clean water, etc. That declining mortality rate – it was a trend that existed even before the introduction of the measles vaccine (which was introduced in the U.S. in 1963). So, those 400 measles deaths [per year], which have now fallen, how much of that can be attributed to the measles vaccine? How much credit goes to the efforts of health institutions?
This could be debated forever. But we don’t need to. What matters is that when you listen to public health authorities today, they’ll tell you: The measles vaccine is what caused the drop in mortality”, states the Facebook post shared along with a video on March 8 (archived here).
The key thesis that is indirectly suggested through the post is that better living conditions, rather than the vaccine, are responsible for the drop in measles mortality. While it’s true that mortality began to decline before the introduction of the measles vaccine, data show that it was the vaccination program that led to the elimination of the disease in the U.S. in the year 2000. However, due to vaccine opposition, outbreaks have occurred again in recent years.
What is measles?
According to the European Vaccination Information Portal, measles is a highly contagious viral disease that can affect people of any age.
Measles symptoms include high fever, cough, runny nose, and a full-body rash. Complications caused by measles can be lifelong and develop in about 30% of infected children and adults. Pneumonia is the most common complication, affecting 1% to 6% of infected individuals. One in 1,000 people develops inflammation of the brain (encephalitis), a disease that can result in permanent neurological disability.
The death rate due to measles is one to three people per 1,000 cases, and it is highest among children under five years old and immunocompromised individuals. The measles virus spreads through the air in droplets coughed or exhaled by an infected person. These droplets can remain in the air for several hours, and the virus can stay infectious on contaminated surfaces for up to two hours.
Drop in infections and deaths after the introduction of the vaccine
As explained by the Infectious Diseases Society of America, improved sanitation conditions reduced the incidence of diseases transmitted through food and water, such as cholera and typhoid, but their impact on measles was negligible. Measles spreads through direct human contact and airborne transmission, so hygiene did not play a key role in controlling it.
After the introduction of the measles vaccine in the U.S. in 1963, the number of reported cases fell by more than 97% between 1965 and 1968, while hygienic and sanitary conditions during that period did not change significantly.
Although measles mortality had been gradually declining before the vaccine was introduced, the disease was still widespread in the population. The major change came only with the introduction of the vaccine, which drastically reduced the number of infections – and consequently, the mortality. This prevented the virus from spreading within the population and reduced the risk of complications, hospitalizations, and long-term health effects.
According to a 2007 report by the American Medical Association, which compared infection and mortality rates before and after the widespread implementation of national vaccination recommendations for vaccine-preventable diseases, between 1953 and 1962, before the first measles vaccine was licensed, an average of just over 530,000 people contracted measles annually in the United States, and an average of 440 people died from it each year. The highest number of cases in that period was recorded in 1958, when there were 763,094 infected individuals and 552 deaths.
Since the scientific report was published in 2007, the figures are compared with 2006 data. In that year, the number of measles cases in the U.S. was 55 – a 99.9% decrease compared to the pre-vaccine period. The number of deaths was compared to 2004, when not a single person in the U.S. died from measles, representing a 100% decrease in mortality compared to the pre-vaccine period.
Recent data from the U.S. Centers for Disease Control and Prevention (CDC) show that as of March 13 this year, 301 cases of measles had been recorded in the U.S. of which 95% were unvaccinated or had unknown vaccination status. Two people have died (one confirmed from measles, the other still under investigation). Last year, 285 measles cases were reported in the U.S. with 89% being unvaccinated or having unknown status, and no deaths in 2024. Looking at the age of those infected, in 2025, 34% of patients were under five years old, and 42% were aged five to nineteen. In 2024, 42% were under five years old, and 31% were in the five-to-nineteen age group. This year saw the first measles-related death in the U.S. since 2015.
Historical data published on the “Our World in Data” website also show a decline in measles infections and mortality only after the broader application of the measles vaccine.
Also, the CDC website features a map showing the drastic decline in the number of cases after the introduction of the vaccine in the U.S.
The decline in the mortality rate that occurred in the U.S. after the introduction of the vaccine is best seen on the map from the web portal Statista.com. It shows measles mortality rates from 1940 to 2019. It is clear that a drastic drop occurred after 1963.
Measles epidemic in the U.S.
Measles was officially eliminated in the U.S. in 2000. This means that measles no longer spreads within the country and that new cases only appear when someone gets infected abroad and then brings the virus into the U.S. In 2016, an independent expert body declared both American continents free of endemic measles, making it the first WHO region to achieve such success. However, that status was lost two years later due to a measles outbreak caused by a social and political crisis in one country on the American continents as a result of low vaccination coverage and a delayed response to the outbreak, which led to the virus spreading to neighboring countries.
Vaccination rates in the U.S. have been declining, especially after the COVID-19 pandemic, which fueled the spread of disinformation about vaccines. According to the CDC, vaccination coverage among preschool children fell to 92.7% during the 2023-2024 period.
Current U.S. Secretary of Health Robert F. Kennedy Jr. has for years spread unfounded claims about a link between the MMR vaccine and autism, although these claims have been completely debunked by scientific studies. After the outbreak of the new epidemic, he somewhat softened his stance, expressing support for vaccination while also promoting alternative treatments such as vitamin A and steroids. Although these treatments have medical applications, experts warn that emphasizing them can shift focus away from the crucial importance of vaccination in preventing the spread of disease.
In the most recent epidemic, mostly in the U.S. states of Texas and New Mexico, nearly 300 measles cases have been recorded, including two deaths. The epicenter of the current outbreak is Gaines County in western Texas, which has a large Mennonite community. According to data from the Texas health department, 174 measles cases have been confirmed in that county, and the rate of vaccine refusal among children has drastically increased in recent years. In 2013, around 7.5% of preschool children in the county had parents or guardians who requested exemptions from at least one vaccine. Ten years later, that number rose to over 17.5%, the highest in Texas.
How do vaccines work?
As Faktograf has previously written, vaccines have been one of the main tools of public health for decades and save millions of lives each year. Vaccines, as part of immunization, reduce the risk of various diseases such as tetanus, whooping cough, and measles by working together with the body’s natural defenses to build stronger protection.
A vaccine essentially “teaches” the immune system how to fight off a disease if it comes into contact with it. Most vaccines contain a weakened or inactivated form of a virus or bacteria, or a small part of it, known as an antigen. When a person receives a vaccine, their immune system recognizes the antigen as a foreign substance. This activates immune cells that produce antibodies and create a “memory” of the virus or bacteria, according to the European Vaccination Information Portal.
By maintaining measles vaccination rates above 95 percent, the likelihood of measles spreading among unvaccinated individuals is reduced – this is known as herd immunity. It provides protection for those who cannot receive the vaccine, such as infants who are too young or individuals with weakened immune systems, like people with HIV or cancer. When local vaccination rates fall below the level needed for herd immunity, those areas can experience outbreaks if measles is introduced into the community, according to the Infectious Diseases Society of America.
The MMR vaccine
Vaccination is the only protection against measles. The MMR vaccine is a safe and effective combination vaccine that protects against measles, mumps, and rubella. Two doses of the MMR vaccine provide long-term protection from infection and potentially serious consequences of the diseases. According to the World Health Organization’s web portal, before the introduction of the measles vaccine and widespread vaccination, large outbreaks occurred every two to three years and caused an estimated 2.6 million deaths annually.
Accelerated immunization efforts by countries, the WHO, the Measles and Rubella Partnership, and other international partners successfully prevented an estimated 60 million deaths between 2000 and 2023. Vaccination reduced the estimated measles mortality from 800,000 in 2000 to just over 100,000 in 2022, according to the U.S. Centers for Disease Control and Prevention.
In conclusion, measles is a highly contagious viral disease with serious potential complications, and vaccination is the most effective means of protection. Historical data clearly shows that vaccines are a key factor in reducing measles cases and deaths. Despite scientific evidence, vaccine disinformation has contributed to declining vaccination rates, which has enabled the reemergence of outbreaks – including the current epidemic in the U.S. Therefore, we find that the post – indirectly suggesting that improved sanitation, rather than vaccines, was responsible for the decline in measles mortality – lacks important context.
