Measles was first identified as a virus in the early 20th century. This disease caused significant morbidity and mortality. A measles vaccine was first introduced in 1963, using a live virus strain developed from a child who had measles.

In the 1970s and 1980s, many countries began implementing widespread measles vaccination programs as part of their childhood immunization schedules. The measles vaccine is usually administered as a combination vaccine, such as the MMR (measles, mumps, rubella) vaccine.

The impact of that program was dramatic—the incidence of measles in the U.S. plummeted from 500,000 annual cases before the vaccine’s introduction to around 100 cases per year by the early 2000s. The World Health Organization launched initiatives to eliminate measles globally, highlighting the importance of vaccination in preventing outbreaks.

Despite the huge success of the measles vaccine, vaccine hesitancy has emerged as a significant challenge in recent years. This hesitancy has caused outbreaks of measles in certain communities with low vaccination rates, such as Texas recently.

I am a family medicine doctor who practiced for 42 years in the Seattle area. When I first started practicing in the early 1970s, I saw a lot of sick kids. During my first ten years, it seemed like I was always admitting children with various infectious diseases such as meningitis, Haemophilus influenzae, and whooping cough.

Some other infectious diseases

• Diphtheria – A serious disease that can lead to heart complications.
• Measles – A disease targeted for elimination by the CDC in 1978; causes birth defects in pregnant mothers.
• Mumps – A disease that was combined with the MMR vaccine in 1971.
• Polio – A disease that was targeted for eradication by Rotary International in 1985.
• Whooping cough – A highly contagious disease.

As time went on and we gave children more vaccines, I started noticing that I rarely saw a really sick child. These vaccines have drastically reduced the burden of disease for children. In 1900, twenty percent of children died before the age of five, generally from a preventable infectious disease.

For vaccines to really work, a large segment of the population—generally around 80 percent—must be immune to a virus or disease to stop its spread.

Measles was declared eliminated from the United States in 2000 by the World Health Organization due to the success of vaccination efforts. However, it continues to be reintroduced by international travelers, and in recent years, anti-vaccination sentiment has allowed for the reemergence of measles outbreaks.

Vaccines have, in many ways, become a victim of their own success. They have been so effective in wiping out diseases that most people today have never seen someone with that disease, so they assume the risk is not very great. If too many people think this way, herd immunity vanishes, and more people are at risk of getting the disease.

Robert Bettis is a family physician with over four decades of experience in patient care, medical research, and education. As the founder of a clinic that grew to employ more than 100 staff members, Dr. Bettis has provided dedicated health care services for over 42 years. In addition to his clinical practice, he has contributed extensively to medical research, co-authoring numerous studies published in JAMA, Clinical Therapeutics, and The Journal of Antimicrobial Chemotherapy. His research has focused on antibiotic efficacy, respiratory infections, and chronic disease management. Dr. Bettis has also shared his expertise as a part-time faculty member at the University of Washington in the Department of Family Medicine. Through his commitment to patient care, medical advancement, and education, Dr. Bettis continues to make a lasting impact in the field of medicine.