Texas and Its Measles Epidemics

Prior to the introduction of measles vaccine in the early 1960's, serious measles epidemics among school-aged children occurred in the United States every 2-3 years, typically peaking in winter or spring During that era, an estimated 50,000 hospitalizations occurred annually, together with 500 deaths and 4,000 cases of measles encephalitis, leading to permanent neurologic complications, deafness, or both, as well as billions of dollars in lost productivity and medical costs (Fig 1) 1,2. Globally, the situation was even worse. Measles was one of the leading killers of children, causing millions of deaths annually. Building on the successes of the World Health Organization (WHO)'s smallpox eradication campaign, in 1974, the Expanded Program on Immunization (EPI) was launched, followed by Gavi, The Vaccine Alliance in 2000. Global measles death rates began to decline precipitously. According to the Global Burden of Disease Study 2013, measles deaths decreased 83%, from 544,500 measles deaths in 1990 to 95,600 deaths in 2013 3. In the US, measles deaths disappeared 2.