Philadelphia measles outbreak impacts unvaccinated children, raises ethical questions about vaccine enforcement

By Claire Wolters | Fact-checked by Jessica Wrubel
Published January 18, 2024

Key Takeaways

  • A recent measles outbreak in Philadelphia infected several unvaccinated people

  • The incident highlights the importance of getting vaccinated for personal and public health safety – and raises ethical questions about how far doctors can go to enforce vaccinations

A recent Philadelphia measles outbreak impacted several vulnerable individuals, some of whom refused vaccinations or disobeyed quarantine instructions. The incident raises public health concerns and revisits the early-pandemic question of to what extent doctors can ethically enforce vaccinations.

“We need to understand that measles has been controlled for decades in the United States due to public health campaigns and interventions,” says Dr. Ilan Shapiro, pediatrician and the chief health correspondent and medical affairs officer at AltaMed Health Services. “By not vaccinating for measles, we are opening the door for health complications that we haven't seen in decades.”

Dr. Shapiro advocates for encouraging vaccinations through honest conversations about the safety and efficacy of vaccines. He stresses the importance of being firm and honest with vaccine-hesitant patients while refraining from judgment, and “keeping our doors open to them.”

“We need to take into account other people's experiences and perspectives and have empathy,” Dr. Shapiro says. “It's important not to alienate parents and their children, otherwise we could open the door to complications from illnesses that we haven't seen in decades, like rubella, polio, and other conditions that have been eradicated in the US.”

In Philadelphia’s incident, a patient who reportedly contracted measles overseas was treated at the Children’s Hospital of Philadelphia (CHOP), where the infection spread to other patients and visitors — including an unvaccinated child and a parent who refused medication. Later, the child was sent to a daycare, despite instructions to quarantine, where the infection spread to four more people, NBC News reported.[]

Earlier, a measles outbreak in Ohio infected 85 children, 36 of whom were hospitalized as a result.[]

In a viewpoint published in the Journal of the American Medical Association (JAMA) this January, doctors Peter Marks, MD, PhD, and Robert Califf, MD, argue that vaccinations – and lack thereof – are reaching a “dangerous tipping point.”[]

In the paper, the doctors emphasize the need for doctors to encourage vaccinations among patients.

“We urge the clinical and biomedical community to redouble its efforts to provide accurate plain-language information regarding the individual and collective benefits and risks of vaccination,” they write. “Such information is now needed because vaccines have been so successful in achieving their intended effects that many people no longer see the disturbing morbidity and mortality from infections amenable to vaccines.”[]

Specifically to measles, they note that vaccine hesitancy is a contributor to recent outbreaks – and remind doctors that unvaccinated and immunocompromised patients – along with those in lower-income areas – are most at risk. 

“Regrettably, pediatric vaccine hesitancy now has been responsible for several measles outbreaks in the US,” write Dr. Marks and Dr. Califf. “Anyone doubting the benefits of vaccination needs only look to low-income parts of the world where measles vaccination is inaccessible, and many thousands of children continue to die each year due to preventable disease.[]

What this means for you

Encouraging vaccinations for measles and other infectious diseases is critical to keeping patients safe and healthy. But doctors say it's important to treat unvaccinated patients and to do so without judgment, too.

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