The Urgent Lessons of Measles and the Uncertain Future of Children's Health
January 1, 2025
A pediatrician examines the rise of once-contained and nearly extirpated diseases, especially measles. Thanks to widespread vaccination programs in the 1950s and 1960s, writes Ratner, diseases such as rotavirus and strep largely disappeared, so much so that pediatric residents often "go through years of training without ever seeing a child with either of these infections." Just so, polio had almost disappeared until recently. This describes the situation in the developed, wealthy world, Ratner hastens to add: There is a strong differential in childhood diseases between rich and poor communities, and this should not be so. "Every single child diagnosed with measles anywhere in the world represents a system failure--an inexcusable unforced error," he urges. That system failure has to do with money: Ratner examines the disease patterns in rich and poor neighborhoods in Texarkana, where "living on the wrong side of State Line Avenue can be hazardous to your health." Money is one issue, and so is the anti-vaccine movement, which fearfully depicts vaccinations as instruments of government control. The result: Whereas in 1994 the world "was on its way to being measles-free," we see frequent outbreaks in the U.S. alone, particularly in schools. Much of the anti-vaccine, anti-masking, anti-lockdown mentality draws on misinformation and disinformation, Ratner holds, to say nothing of activists such as Robert F. Kennedy Jr., who has been in the habit of "ghoulishly spreading unfounded anti-vaccine messages in an attempt to ensure that no tragedy would go to waste." Noting that "the time to secure furniture to the wall isbefore a child starts pulling up on it," Ratner closes by arguing that good science-based education should be put to work to supplant bad information and bad intentions--which, sadly, would seem to be wishful thinking. An intriguing look at the costs to children's health wrought by bad information and poor parenting.
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Starred review from December 2, 2024
“Measles is a biological agent that preys on human inequity,” according to this penetrating debut analysis. Ratner, a professor of pediatrics at NYU, contends that the virus’s history illustrates how social factors determine who gets sick. For example, he describes how in the late 19th century, poor children in England died from measles at significantly higher rates than their wealthier peers because malnutrition and cramped tenements increased their vulnerability. Protection from viruses depends on much more than vaccine efficacy, Ratner argues, discussing how the rollout of the first measles vaccines in the early 1960s was hampered by the lack of a centralized distribution plan, confusion over which of the two options was better for which patients, and inadequate messaging from health experts on the vaccines’ benefits. Elsewhere, Ratner covers how a recall of a 1992 measles, mumps, and rubella vaccine in England and a fraudulent 1998 scientific article positing a link between MMR vaccines and autism spurred an anti-vaccine movement that contributed to measles outbreaks in California and New York in the 2010s. Ratner provides fascinating scientific insight into measles, explaining how the virus induces a kind of immunological amnesia by targeting immune cells responsible for remembering how to counteract previously encountered viruses, and he makes a strong case that health depends on much more than biology. This will open readers’ eyes. Agent: Michelle Tessler, Tessler Agency.