The Centers for Disease Control and Prevention (CDC) warned on May 30, 2019 that, if the current measles outbreak continues, the U.S. could lose its measles elimination status that has been in effect since 2000. According to the agency: “If these outbreaks continue through summer and fall, the United States may lose its measles elimination status. That loss would be a huge blow for the nation and erase the hard work done by all levels of public health.”1 2 3
In a press release, the CDC stated, “We were able to eliminate measles in the United States for two main reasons: Availability and widespread use of a safe and highly effective measles vaccine and strong public health infrastructure to detect and contain measles.” It added, “The measles elimination goal, first announced in 1966 and accomplished in 2000, was a monumental task.3
The CDC did not elaborate on the consequences of losing its status as a country that has eliminated measles. Neither did it explain the apparent inconsistency in its remarks, given that there were 86 cases of measles in the U.S. in 2000, followed by cases of measles cases in every year since, including 211 cases in 2011, 187 in 2013, 667 in 2014, 120 in 2017, 372 in 2018 and 971 in 2019 (as of May 30).4 5 6
One indication of the significance of losing this status may have been offered by epidemiologist Robert Kezaala, MD. According to Dr. Kezaala, who is a senior health adviser to the United Nations Children’s Fund, or UNICEF, a country stands to lose its elimination status if the spread of an infectious disease lasts for a year.7
This would appear to suggest a loss of national prestige in the eyes of the international community with regard to the fight against infectious diseases through vaccination programs. As part of the World Health Organization’s (WHO) Global Vaccine Action Plan (GVAP), one of the key goals set forth is elimination of vaccine-preventable infectious diseases, including measles.
Under the GVAP, the framework for measles elimination includes verification of “the absence of endemic measles transmission in a defined geographical area (e.g. region or country) for ≥ 12 months in the presence of a well-performing surveillance system.”
Failure to meet this framework would place the U.S. alongside many developing countries where measles remains endemic.8 That seems to be the main concern, given the reality that measles may never really have been eliminated from the U.S. in the first place.
This article or commentary provides referenced information and perspective on a topic related to vaccine science, policy, law or ethics being discussed in public forums and by U.S. lawmakers. The websites of the U.S. Department of Health and Human Services (DHHS) provide information and perspective of federal agencies responsible for vaccine research, development, regulation and policymaking.
1 Blumberg A. Measles Cases Reach Highest Level In U.S. In 25 Years. HuffPost May 30, 2019.
2 El-Bawab N. CDC warns US could lose measles elimination status if outbreak continues. CNBC May 30, 2019.
3 Press Release. U.S. measles cases in first five months of 2019 surpass total cases per year for past 25 years. Centers for Disease Control and Prevention May 30, 2019.
4 Cáceres M. Was Measles Really Eliminated in the U.S. in 2000? The Vaccine Reaction May 22, 2019.
5 CDC. Measles Cases and Outbreaks. CDC.gov.
6 Allyn B. New U.S. Measles Cases Break 25-Year-Old Record, Health Officials Say. NPR May 30, 2019.
7 Wu Tan S. Public health experts fear U.S. may lose measles elimination status. The Washington Times May 30, 2019.
8 World Health Organization. Global Vaccine Action Plan: Monitoring, Evaluation & Accountability. Secretariat Annual Report 2018.