This winter, measles outbreaks have surfaced across the United States, leaving pediatricians waiting for an important communication from the country’s public health agency aimed at aiding in the prevention of the disease’s spread.
Not until last week did the Centers for Disease Control and Prevention (CDC) issue such a letter, by which time the number of cases had exceeded 700, and a second young child in Texas had succumbed to the infection.
While the delay might appear insignificant, it is a part of a series of mistakes that a number of healthcare professionals and public health officials noted in the current administration’s response to the measles outbreak.
In an effort to control the situation within a close-knit, religious community in West Texas, Health Secretary Robert F. Kennedy Jr.’s actions have diverged from traditional public health methods that have been successful in containing previous epidemics.
“What we need now is a strong, unified voice from the federal level down to the local level, emphasizing that vaccination is the key to preventing measles,” stated Patricia Stinchfield, an infectious disease expert and nurse practitioner who was instrumental in halting a measles outbreak in Minnesota’s Somali community back in 2017.
Behind the scenes, Kennedy had reportedly not been consistently briefed in person on the outbreak by CDC specialists leading up to March 21. Kevin Griffis, who was the communication director at the CDC until his resignation on that day, revealed that even after the first young Texas victim’s death in late February, Kennedy still lacked a direct briefing from CDC staff. This account was verified by another former federal health official.
A spokesperson for Kennedy did not respond to inquiries regarding his communication with the CDC staff; however, it was stated that the CDC initiated an Atlanta-based response in early February to offer overarching guidance on measles testing and vaccination strategies. An on-the-ground team was sent to West Texas in March and withdrew on April 1, a decision made jointly by state and federal officials. Another team of seven was sent to the region this week.
Historically, health secretaries have maintained weekly briefings with CDC staff during infectious disease outbreaks, but Kennedy received updates through paper or email instead. This approach was described as “extremely unusual” by Griffis. Furthermore, the CDC has not collaborated with the American Academy of Pediatrics, the nation’s largest pediatric network, despite past precedent.
So far, only a health alert network update released on March 7 and a recent delayed letter have been the CDC’s primary means of informing pediatricians.
During a recent event, Kennedy commended the CDC for controlling the measles outbreak, but his mixed messages regarding vaccine safety have added complexity to handling the situation, experts suggest.
Despite occasionally acknowledging the effectiveness of the measles, mumps, and rubella vaccine, Kennedy raised safety concerns in other statements, casting doubt among the public.
Previously, during outbreaks, health secretaries have provided clear messages urging vaccinations, supported by past healthcare leaders like Dr. Anne Schuchat. Past presidents and health secretaries, including President Donald Trump and Alex Azar, called for public inoculation actively, offering consistent guidance during earlier measles outbreaks.
Local leaders, including Texas Governor Greg Abbott, have not been vocal about encouraging vaccinations, leaving public persuasion to aides and other officials. This contrasts with the approach of governors like Hawaii’s Josh Green and Nebraska’s Jim Pillen, who have been proactive in urging vaccinations as a preventive measure.
For public health experts like Dr. Oxiris Barbot, a consistent and clear message from top officials is crucial for promoting local efforts, emphasizing how crucial high-level endorsements can be in supporting their initiatives.