The United States is experiencing an alarming measles outbreak, with 626 cases in 22 states as of mid-April. The majority have been among residents of New York state, where the situation is so grave that it has prompted two separate public health emergency declarations this month in an attempt to curtail the spread of this highly infectious disease.
Thirty years ago, our country battled an outbreak of measles that sickened more than 55,000 people and caused over 11,000 hospitalizations. The 1989–91 epidemic ultimately killed up to 166 people, many of whom were young children. While that crisis and the latest one were both hastened by a lack of timely immunization of young children, the reasons for nonvaccination were quite different.