Photo credit: CDC Measles (Rubeola)
By Irwin Redlener, MD
Forgive me for stretching a metaphor. But it’s painfully clear that HHS Secretary Robert F. Kennedy, Jr’s misinformed conspiratorial chickens are now coming home to roost.
The accelerating measles outbreak in South Carolina is not an inexplicable natural phenomenon. Nor is it any more inevitable than the ongoing outbreak of pertussis, better known as whooping cough. These are epidemics of choice, generated by anti-vaccine zealots who choose to reject proven public health science, turn back progress, and put Americans – especially children – at entirely unnecessary risk.
As of mid-December, more than 111 measles cases have been confirmed in South Carolina’s Upstate region, the largest U.S. outbreak since 2019. Over 70% of those infected are unvaccinated children, and hundreds of exposed students and adults are now in quarantine. One church community alone has been linked to at least 16 cases.
Yes, “outbreak” is the technically correct term. But what we’re seeing looks a lot like an emerging epidemic. The U.S. declared measles eliminated in 2000—meaning there was no sustained, year-round transmission. Yet active chains of infection in South Carolina, Arkansas, New Jersey, and Minnesota are putting that hard-won status at real risk. In 2019, we came within weeks of losing elimination altogether during an 11-month surge that sickened more than a thousand people. We are perilously close to replaying that scenario.
What changed? Not the virus. Measles has always been ferociously contagious, capable of infecting 12 to 18 people for every one case. It lingers in the air long after a sick person leaves the room. Before vaccination, the U.S. saw millions of infections and hundreds of deaths annually.
The trends are headed in the wrong direction – and we are paying a steep price.
National childhood immunization has been slipping for years. Since 2019, kindergarten measles vaccination has dropped from 95% to 93%, leaving roughly a quarter-million children in a single year’s cohort unprotected. Vaccine exemptions—often framed as “philosophical choices”—are now at the highest levels ever recorded. Several states report exemption rates above 5%, which is incompatible with containing measles. Anti-vaccine activists are trying to ban states from eliminating religious exemptions for vaccine requirements.
And measles is just the latest alarm, a concern since days after RFK took office. Pertussis, or whooping cough, surged to nearly 20,000 U.S. cases last year, especially in communities where adolescent booster uptake has lagged.
Hepatitis B vaccination—once a routine, unquestioned protection for infants—has become a flashpoint for newly emboldened anti-vaccine activists. I fully expect to see a resurgence of early onset of untreatable chronic liver disease, including cancer, as a result of policies concocted by unqualified advisers who reject clear evidence that the Hepatitis B vaccine given at birth is effective and safe.
Deliberate promulgation of misinformation by our most senior health officials has become an ideological weapon for MAGA and MAHA extremists.
Kennedy apologists will point out that measles and pertussis outbreaks began a year before he was confirmed as Secretary. Yes, but JFK has been the world’s most influential anti-vaccine conspiracist for years, personally contributing to the public’s loss of confidence that has steadily eroded vaccine levels nationally.
How he got confirmed is a study in how politics can devastate appropriate policy decision-making. Kennedy has built a national following by promoting long-discredited claims linking vaccines to autism and immune disorders. His views have no support in the scientific literature or among legitimate medical organizations, yet their political impact is unmistakable.
The consequences of ill-advised, unsubstantiated medical messages show up in polling as surely as they do in hospital wards. A quarter of Americans now believe vaccines cause autism—a dramatic rise from a decade ago. Trust in key public-health institutions has sharply eroded. The number of parents who describe themselves as vaccine-hesitant has more than doubled.
So when measles erupts in South Carolina, it’s not an isolated public-health failure. It's the direct result of the cultural and political space we’ve created for anti-science ideology to flourish.
We know exactly how to stop measles and pertussis – and prevent Hepatitis B liver disease: widespread vaccination, clear communication, and leadership grounded in evidence rather than conspiracy. What we lack right now is the political courage to say unequivocally that public-health protections are not optional. They are foundational for a civilized nation to protect the health and well-being of its citizens.
I have to ask: Why is Robert F. Kennedy still running the biggest, most powerful health agency on the planet? The damage he’s doing has just begun. It may just be a matter of time until the polio vaccine finds itself in the crosshairs of MAHA extremists.
