Ellen Davis
Chapel Hill, North Carolina, United States

In 1949, before there was a vaccine, my thirteen-year-old brother Freddie died from encephalitis, a direct complication of measles.

A person with measles (rubeola or “standard” measles) develops a fever and redness of the eyes, nose, and throat about seven to ten days after exposure to the virus. White spots appear in the mouth, and a rash spreads quickly. People are contagious from five days before the rash appears to four days after the rash goes away.¹ It is the most contagious of childhood diseases. There is no treatment for measles, only supportive care to manage symptoms. The only protection against measles is the vaccine, which is 93–97% effective.² The measles vaccine is given in a combination either as the MMR (measles, mumps, rubella) or, for children aged between one and twelve years old, the MMRV (measles, mumps, rubella, varicella) vaccine.³

Measles can cause serious health complications, especially in young children. Otitis media, pneumonia, and diarrhea occur in about 1 in 10 patients. Encephalitis, a severe neurologic complication, can result in deafness, intellectual disability, and death. As many as three of every 1,000 children who become infected will die from complications. A very rare but fatal complication, subacute sclerosing panencephalitis, can develop seven to ten years after measles, resulting in brain damage, coma, and death.⁴ Unfortunately, measles is not the only common childhood illness that can bring dire complications: the diseases represented by the other M and the R in the MMR vaccine are also dangerous. Mumps can bring on braininflammation, deafness, and infertility in males; rubella (“German measles”) in a pregnant woman can result in miscarriage, stillbirth, and severe birth defects, including deafness and heart anomalies.⁵

Prior to the introduction of the measles vaccine by Dr. John F. Enders in 1963 and the improved vaccine by Dr. Maurice Hilleman in 1968, there were 135 million cases of measles worldwide, resulting in over 2.6 million deaths annually. In the US, there were 3–4 million cases and 400–500 deaths attributed to measles each year.⁶ Measles was officially eradicated in the US in 2004. Now it has returned, enabled by communities with low vaccination rates. As of August 13, 2026, 2,566 confirmed measles cases were reported in the US, the largest number in a single year since measles was eradicated. Of these cases, 93% occurred in people who were unvaccinated or had an unknown vaccination status. Studies of large outbreaks in 2025 and 2026 show cases of encephalitis and sepsis among those hospitalized.^8-10 Three people in the US died from measles in 2025.⁷

Recent data suggest that outbreaks in some areas of the US have precipitated a surge in titer testing in adults born before the vaccine became available. To check their immunity status, more than 74,000 US adults over the age of fifty had the testing done between January 2025 and March 2026, followed by vaccination if needed, because they did not want to get measles or rubella and put infants and children at risk.¹¹ This unexpected increase in titer testing might be a glimmer of hope toward eradication.

Worldwide, the increase in measles is much worse. In many countries where measles is endemic, access to and delivery of the two-dose protocol is a challenge, and implementing effective vaccine campaigns requires extensive funds.In 2024, an estimated eleven million children worldwide were infected with measles, with 100,000 deaths.¹² These deaths occurred despite decades of evidence showing that the measles vaccine is extremely safe and effective. It is far safer than getting measles. A large body of research consistently shows that the MMR vaccine does not cause autism. However, vaccine skeptics, including some in high government positions, still promote this myth.¹³

The death of a child is a difficult and painful experience, often causing an overwhelming family crisis. Studies show that grief following the death of a child is the worst experience a parent can endure. Child death damages core beliefs about the world and how life should unfold. It has been associated with declines in the physical and mental health of the parents and with first-time psychiatric hospitalizations. Divorce rates may also increase, but it is unclear by how much.^14,15

How parents cope with the death of a child correlates to how well their other children fare, both immediately and in the long term. Survivor guilt is common.¹⁴ Since the publication of a 1981 article, “Siblings: The Forgotten Grievers,”¹⁶ clinical and research attention has progressed to include a significant body of knowledge. Analyses of sibling experiences highlight themes for interventions: 1) Loss of affection, attention, and stability due to the parents’ own distress; 2) Lack of validation of siblings’ grief and lack of knowledge about how to respond; 3) Surviving children’s perception of not being good enough.¹⁴ If parents later have a “replacement child,” the family reorganizes again.¹⁵

Before Freddie and I got measles, our family was content and complete with a father, a mother, a son, and a daughter. I was six years younger than Freddie, and I recovered. But one morning our parents rushed Freddie to the university children’s hospital, and within days he died of encephalitis. Freddie’s classmates formed two lines for people to walk through into the church for his funeral. Sadness, as it does in families that experience such tragedy, crushed everyone. Before then, our father read Mark Twain every night, like some people read religious texts. That habit, along with his laughter, ended when Freddie died. The depth of our parents’ broken heartedness was beyond comprehension to little me.

My parents wanted another child, and a second daughter was born the next year. Happiness returned and our family did not experience the overt severe difficulties often seen when a child dies. We sisters were fortunate to each have two sons, and my sister also had a daughter. And yet the memory of our family tragedy lived on. Many years later, my sister and I shared with each other that when our sons were thirteen years old, we found ourselves checking on them often. We each had watched our sons’ chests rise and fall in their sleep, as parents do with newborns. When our sons reached age fourteen, our lives returned to normal.

In the US, vaccine skepticism has increased measles cases. Misinformation, public distrust in experts and public health institutions, and a growing use of personal belief exemptions have all played a role in lowering vaccination rates. Measles poses a risk to all countries and communities where vaccination coverage is below 95%, the rate needed to reach herd immunity. In 2024, only 92.4% of kindergarteners had been fully vaccinated for measles.⁷ In some communities, that number is much lower.

If I were asked whether or not I believe in vaccines, I would answer that I believe in kindness, in love, in God. I do not believe in a vaccine, as though it is a feeling. I trust scientific data. Data is based on reliable, valid information obtained after careful investigation. During the COVID-19 pandemic, some vaccine skeptics said they were doing their own research and subsequently had decided not to get vaccinated. It is unclear what that “research” involved. They were not conducting biomedical research at home. Instead, they seemed to have embraced the opinions and conspiracy theories of people without sound scientific knowledge.

Some vaccine skeptics said that the first COVID vaccines were developed too fast, and therefore, were dangerous. The rapid development of the COVID vaccine was based on decades of research on viruses, allowing for faster development of vaccines for COVID, and now also for influenza.^18,19 Currently, research on mRNA-based vaccines has been slowed to a near halt in the US. This governmental neglect has only downsides. We are not ready for the next pandemic. Some people say they are in favor of childhood vaccinations, but there are just too many of them. They will simply decline some. Since the pandemic, others say they feel like pincushions and will not get more immunizations. Science is not mentioned in these scenarios.

In 2024, my sister, who was born after Freddie died, responded online to published anti-measles vaccine statements. She spoke to an article that cited Florida’s surgeon general saying that vaccines are bad and that mandates for people to have them are like slavery. He said that people should not live in fear. (Similar remarks were made in other venues.²⁰) Almost 15,000 people wrote data-filled oppositional comments to the anti-vaccine article. But my sister, who taught math and statistics, focused her letter on the impact of serious side effects, writing, “My brother died from the measles complication encephalitis at age 13. I will never forget the look of fear on my parents’ faces when I contracted measles some years later—also at age 13. How anyone can think, ‘It’s just measles,’ is beyond comprehension. Thank goodness for the MMR vaccine. My own family has benefitted from it.”²¹ My younger sister’s touching story was powerful, telling of the broader, long-range personal effects. Freddie’s family will not stop letting people know that measles is preventable.

References

1. Pearce, JMS. “Measles again.” Hektoen International. Winter 2024.
2. Centers for Disease Control (CDC). “Measles Vaccination.” April 29, 2026. https://www.cdc.gov/measles/vaccines/index.html. Accessed August 10, 2026.
3. CDC. “Measles, Mumps, Rubella, Varicella (MMRV) Vaccine Safety.” September 4, 2025. https://www.cdc.gov/vaccine-safety/vaccines/mmrv.html. Accessed August 10, 2026.
4. CDC. “Measles Symptoms and Complications.” August 5, 2026. https://www.cdc.gov/measles/signs-symptoms/index.html. Accessed August 10, 2026.
5. CDC. “Clinical Overview of Rubella.” July 15, 2024. https://www.cdc.gov/rubella/hcp/clinical-overview/index.html. Accessed August 10, 2026.
6. CDC. “History of Measles.” April 29, 2026. https://www.cdc.gov/measles/about/history.html. Accessed August 10, 2026.
7. CDC. “Measles Cases and Outbreaks.” September 4, 2026. https://www.cdc.gov/measles/data-research/index.html. Accessed August 10, 2026.
8. Chovatiya R, Silverberg JI (2020). “Inpatient morbidity and mortality of measles in the United States.” PLoS ONE 15(4): e0231329. https://doi.org/10.1371/journal.pone.0231329.
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13. “MMR vaccine does not cause autism.” www.immunize.org/catg.d/p4026.pdf / Item #P4026(4/17/2026.
14. Christ G, Bonanno G, Malkinson R, Rubin S. Appendix E: Bereavement experiences after the death of a child, When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families by MJ Field and Richard E. Behrman RE, Editors. National Academies of Sciences, Engineering, and Medicine. The National Academies Press, Washington, DC, 2003.
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17. McKee C, Bohannon K. “Exploring the Reasons Behind Parental Refusal of Vaccines.” J Pediatr Pharmacol Ther. 2016 Mar-Apr;21(2):104-9. doi: 10.5863/1551-6776-21.2.104. PMID: 27199617; PMCID: PMC4869767.
18. Bowden-Reid E, Moles E, Kelleher A, Ahlenstiel C. “Harnessing antiviral RNAi therapeutics for pandemic viruses: SARS-CoV-2 and HIV.” Drug Deliv Transl Res 2025 Jul;15(7):2301-2322. doi: 10.1007/s13346-025-01788-x. Epub 2025 Jan 20.
19. Jewett, C. “F.D.A. Approves Moderna’s mRNA Flu Vaccine.” New York Times, Aug 5, 2026. Accessed August 5, 2026.
20. Sun L, Weber L. “Florida surgeon general defies science amid measles outbreaks.” Washington Post, February 23, 2024.
21. Blackford A. Letter to the editor responding to “Florida surgeon general defies science amid measles outbreaks.” Washington Post, February 23, 2024.