Measles Is Back

A measles outbreak in Philadelphia in the early 1990s might be a window into the future.

On February 13, 2024, National Geographic published a book I wrote called, TELL ME WHEN IT’S OVER: AN INSIDER’S GUIDE TO DECIPHERING COVID MYTHS AND NAVIGATING OUR POST-PANDEMIC WORLD. For the next few months, I will be writing about various issues discussed in that book.

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On April 4, 2024, the CDC reported 113 cases of measles in 18 states and jurisdictions. These outbreaks were consistent with a CDC survey showing that more parents are choosing religious exemptions for their children. Because measles is the most contagious of the vaccine-preventable diseases, it’s always the first to come back. It’s the “canary in the coal mine” for fraying vaccine rates.

A single-dose measles vaccine was first introduced in the United States in 1963. Before that, every year measles would infect 3-4 million people causing 48,000 hospitalizations and 500 deaths. With the enforcement of school vaccine mandates and the recommendation for two doses of measles vaccine in the early 1990s, we eliminated measles from the United States in 2000. A remarkable accomplishment for such a highly contagious disease. But measles has come back. One can only hope that an outbreak in Philadelphia in the winter of 1990-1991 isn’t a window into the future.

In Philadelphia, by November 29, 1990, measles had infected 96 children; by December 7, the number had risen to 124; and by December 31, to 258. The 1990 outbreak was larger than anything the city had seen in more than a decade. Then an 18-month-old unimmunized boy from North Philadelphia died from measles pneumonia. It was the first time a Philadelphia resident had died from measles in 20 years. Then another unimmunized child in North Philadelphia died from measles. In response, city health officials asked parents to vaccinate children beginning at six-months of age.

The measles outbreak centered on two fundamentalist churches in the city: Faith Tabernacle and First Century Gospel, both of which refused vaccines on religious grounds. After another unimmunized child in the church school died, Dr. Robert Ross, Commissioner of Health for the City of Philadelphia asked Reverend Charles Reinert of the Faith Tabernacle Church to immunize his students. Reinert refused. Ross had no choice but to close the school, which did nothing to slow the advancing epidemic. 

By Friday, February 15, 1991, five children had died in ten days. Philadelphia was the center of the worst measles epidemic in the United States. At Children’s Hospital of Philadelphia, 82 children had been treated in the emergency department and 28 had been hospitalized. At St. Christopher’s Hospital, which was closer to the homes of church members, 250 children had been treated in the emergency department and three were being hospitalized every week. Philadelphia had become a feared destination. Two nearby schools cancelled trips to the city.

On Wednesday, February 27, 1991, Mayor Wilson Goode directed the City Solicitor’s office to obtain a court order to forcibly vaccinate children against their parents’ will. Goode had crossed the line from mandatory vaccination to compulsory vaccination. With mandatory vaccination, people are asked to receive a vaccine or pay some sort of societal price, such as being excluded from work or school. In compulsory vaccination, people are vaccinated whether they want to be or not. In the history of the United States, children had never been forcibly vaccinated against their parents’ will.

On Friday, March 1, 1991, Charles Reinert asked lawyers from the American Civil Liberties Union (ACLU) to represent his church in its fight against compulsory vaccination. Because a right to refuse vaccines based on religious beliefs was afforded by state law, everyone assumed that ACLU lawyers would rush to his church’s defense. But the ACLU declined. “There is certainly a free exercise of religion claim by the parents,” said Deborah Levy, executive director of the Philadelphia chapter of the ACLU, “but there is also a competing claim that parents don’t have the right to martyr their children.”

By Friday, June 7, 1991, the Philadelphia measles epidemic had subsided. Among church members, 486 people had been infected and 6 killed by measles. Among non-church members, as measles spread into the surrounding communities, 938 people had been infected and 3 killed. All nine deaths were in children. Because they hadn’t been vaccinated, the attack rate among church members was a thousand times higher than that in the surrounding community.

Forty-five states now grant religious exemptions to vaccination. In July 2023, Mississippi became the most recent state to offer a religious exemption. In response, more than 2,000 parents in the state immediately chose to exempt their children from vaccination. It’s a dangerous game we play.