Measles is killing children in Texas. We can, and should, stop it in its tracks here

Increased vaccine hesitancy means we are on the brink of measles making a return. We need to act now, writes Afif El Khuffash

A sign outside Seminole Hospital District offering measles testing in Texas last month. Once vaccination rates drop below around 95%, measles has a prime opportunity to come roaring back. Photo: AP/Julio Cortez

Let’s face it: if you’ve ever been on social media, you’ve probably stumbled across conflicting opinions about measles, the MMR vaccine, and whether you’re being secretly bankrolled by “Big Pharma” just for considering immunisation. (For the record, I’m still waiting on my gold coins.) 

In all seriousness, though, Ireland has been doing a good job of keeping children safe from measles — until recently, when our vaccination rates started slipping under that crucial 95% herd immunity threshold. And trust me, this is no time to get lax. Here’s why.

Measles isn’t just a rash with a fancy name; it’s a serious and incredibly contagious viral illness that can spread like wildfire in communities with lower vaccination rates. A single infected person can pass it on to 90% of non-immune people around them. 

Picture that in a crowded environment like a school, a busy waiting room, a family gathering, or on a plane — one case can spark an outbreak before you can say “achoo”. The internet often portrays measles as a harmless rite of passage, something every child “just gets over”, with our natural immunity more than capable of handling it. Unfortunately, that’s not the case. 

Measles can lead to pneumonia, seizures, deafness, and in rare but devastating cases, encephalitis (inflammation of the brain). Even more chilling is the risk of SSPE (subacute sclerosing panencephalitis), a fatal brain disorder that can appear years after the initial measles infection. 

It’s a ticking time bomb nobody wants to face that can occur in up to 1 in 700 unvaccinated individuals who contract measles before the age of one.

Yet the pushback on the MMR vaccine continues, fuelled by everything from worries about autism (which science has thoroughly debunked) to conspiracy theories about what goes into these shots. That noise can drown out the facts.

Over the past couple of years, there’s been a noticeable dip in childhood vaccinations — MMR included. Some public health experts suspect “vaccine fatigue”. others point to misinformation on social media, and still others point to the disruption of normal healthcare routines during the pandemic. 

The reasons vary, but the upshot is the same: we’re inching closer to herd immunity failure (we may be already there). Once vaccination rates drop below around 95%, measles has a prime opportunity to come roaring back. 

MMR vaccine

We’ve fought tooth and nail to keep measles out of Ireland, hitting elimination targets in the past. But those gains didn’t happen by magic; they came from consistent vaccination policies and parents making informed decisions.

The MMR vaccine protects against Measles, Mumps, and Rubella — three diseases that can all be serious, although measles stands out due to its extremely high contagion rate and potential for severe complications. 

It’s a "live attenuated" vaccine, which means it uses weakened forms of the viruses to teach your immune system how to recognise and fight them effectively. For optimal protection, two doses are recommended: the first at around 12 months of age, and a booster between ages four and six, though exact timing can vary slightly. 

Like any vaccine, the MMR can occasionally cause mild side-effects such as fever or rash, but importantly, overwhelming scientific evidence has thoroughly debunked any alleged link between MMR and autism. 

That persistent myth originated from a discredited and retracted study that has long since been proven false. Achieving at least a 95% vaccination rate is critical—this threshold ensures herd immunity, meaning the virus can’t easily spread because there simply aren’t enough unvaccinated hosts. 

Herd immunity protects those who can’t be vaccinated, like newborns and people with compromised immune systems, who depend on the wider community to remain healthy. The biggest risk is thinking it won’t happen to you.

Measles in Texas

Take a sobering look at what's unfolding in Texas, where vaccine complacency has directly resulted in a significant outbreak. Due to falling immunisation rates, driven largely by misinformation and vaccine hesitancy, Texas is now battling its largest measles outbreak in years. 

Tragically, this complacency has already claimed its first victim — a young, unvaccinated child whose death marks the first recorded measles fatality in the state in over a decade. 

This devastating scenario underscores exactly how dangerous it is to let vaccination rates slip. It isn't alarmist to say that Ireland risks facing similar tragedies if we become complacent about the MMR vaccine.

Measles is the type of disease that loves an opening. All it needs is a modest drop in vaccination rates — and that’s exactly where complacency could land us. Even if you think, “My child is healthy; they can handle it,” remember that measles complications don’t care if you’re otherwise robust.

Plus, someone else’s toddler, an elderly grandparent, or an immunocompromised neighbour might pay the price if the virus starts making the rounds. For parents of new babies, it’s particularly worrying. Infants rely on adults and older siblings to be vaccinated, because they’re too young to receive the full course themselves.

Debunking the myths

“It’s just a rash — kids bounce back!” Some do, sure. But measles can also mean hospital admissions, high fevers, ear infections, pneumonia, and very real life-threatening complications.

“MMR causes autism.” It doesn’t. That theory has been disproven by countless studies involving millions of children across multiple countries. The medical community has slammed the door on this rumour for decades.

“We’re better off getting natural immunity.” Getting natural immunity to measles means risking a severe infection with complications like pneumonia or encephalitis — and that’s if you survive unscathed. Compare that to a safe, effective vaccine that prevents the illness. The choice is clear.

“We can just treat it if it shows up.” Measles can’t be zapped away with antibiotics. Treatment is mainly supportive care, and once complications set in, it can be a harrowing experience for a child — and their frantic parents.

So here we are, teetering on the line where measles could sneak back in and wreak havoc on our communities. The simple solution? Make sure children get the MMR vaccine on schedule. Talk to your GP, community nurse, or paediatrician if you have concerns — they’re far more reliable than the friend of a friend on social media with a viral conspiracy video.

Ireland has managed to keep measles in check before, but the only reason we’re safe from major outbreaks is because of vaccination.

It’s crucial for parents to keep up with their child’s routine medical appointments, as these visits help ensure babies and toddlers are reaching developmental milestones — vaccinations play an essential role in this broader picture of health, so don’t let them slip. 

If you're feeling anxious or uncertain about potential side-effects or vaccine schedules, make sure to reach out to healthcare professionals who work with real-life data and patient outcomes every day, rather than relying solely on online information — stick to reputable, expert-backed sources. 

Lastly, when you encounter misinformation about vaccines circulating in WhatsApp groups or on social media, step up and share evidence-based resources; it's everyone's responsibility to prevent misleading information from spreading.

Ireland has managed to keep measles in check before, but the only reason we’re safe from major outbreaks is because of vaccination. If too many people start believing measles is “no big deal”, or that MMR is dangerous, we could easily lose that protection and nobody wants to see hospital wards filling up with sick children.

So yes, you can call me a proud “puppet” of science if it means encouraging parents to protect their kids (and the rest of us!) from a very real, very preventable threat. A moment’s pinch from a vaccine needle beats weeks of high fevers and hospital visits any day. 

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Let’s not give measles any breathing room in Ireland, because when it comes to children’s health, “good enough” is never enough. We owe it to ourselves, our neighbours, and future generations to keep that MMR coverage sky-high.

Stay safe, stay informed, and if you’re wondering whether to vaccinate — well, the data couldn’t be clearer.

• Professor Afif EL-Khuffash is Consultant Neonatologist at the Rotunda Hospital and host of The Baby Tribe podcast