50 Years Ago in TheJournalofPediatrics: The Status of Measles and Rubella Immunization in the United States

Abstract

Krugman S. Present status of measles and rubella immunization in the United States: a medical progress report. J Pediatr 1971;78:1-16. In 1971, the challenge with the relatively new measles and rubella vaccines was determining “which one” was best. Multiple strains of both live attenuated and inactivated vaccines were being trialed. Thus, Dr Saul Krugman reviewed the state of the vaccines less than 10 years after the first measles vaccine and 2 years after the first rubella vaccine. After assessing the data from numerous serologic studies from as far away as the Faroe Islands, Krugman concluded that the 2 measles vaccines (Edmonston B and Schwartz) were effective and that one dose should provide long-term immunity to measles for 98% of children. At the time, Krugman could not have predicted how health disparities and antiscience beliefs would impact vaccine delivery. Between 1989 and 1990, measles cases surged from 3700 to 18 193, with outbreaks fueled by unvaccinated preschool-aged children of racial and ethnic minority groups living in inner-city areas.1Atkinson W.L. Orenstein W.A. Krugman S. The resurgence of measles in the US: 1989-1990.Annu Rev Med. 1992; 43: 451-463Crossref PubMed Scopus (100) Google Scholar In addition, that year an outbreak with high fatality rates occurred in Philadelphia in an unvaccinated church community.2Rodgers D.V. Gindler J.S. Atkinson W.L. Markowitz L.E. High attack rates and case fatality during a measles outbreak in groups with religious exemption to vaccination.Pediatr Infect Dis J. 1993; 12: 288-292Crossref PubMed Scopus (37) Google Scholar These outbreaks led to the current 2-dose series of the measles, mumps, and rubella vaccine (MMR) and a decline in the incidence of measles. Unfortunately, over the past decade with the promulgation of a discredited study linking MMR to autism and the growing social media presence of antivaccine misinformation, the US incidence rose from 43 cases in 2007 to 1282 cases in 2019.3Centers for Disease Control and PreventionMeasles Cases and Outbreaks.https://www.cdc.gov/measles/cases-outbreaks.htmlDate accessed: July 6, 2020Google Scholar The pediatric community is faced with again combating a once-vanquished, deadly disease, but in the midst of a pandemic and a climate of disinformation and antiscience sentiment. Dr. Scott Krugman is Dr. Saul Krugman's eldest grandson and is a third generation pediatrician.