“All you need is one case”: why vaccines are the best way to prevent negative health outcomes from measles and other diseases


On February 23, 2024, the Michigan Department of Health and Human Services reported the first case of measles, a highly contagious and vaccine-preventable disease, in the state of Michigan since 2019. Days later, TIME Magazine reported that in 2023, measles cases jumped by nearly 80 percent.

Peter Gulick, D.O., professor of Osteopathic Medical Specialties at the Michigan State University College of Osteopathic Medicine, is a vaccine expert. Here, he shares his insights about current vaccination trends and relates them to current concerns about measles.

How do vaccines work?

It depends on several things, such as vaccine type. To create traditional vaccines, scientists would take a specific, inactivated part of a virus, called an antigen, and attach it to an adjuvant, which is a compound that jars the immune system to get active! This is known as a killed, or inactivated, vaccine.

There’s two other kinds of vaccines–there’s what’s called a live, or attenuated, vaccine, which is made from a damaged virus. But the problem with the live vaccines, like the measles, mumps, rubella (MMR) vaccine, is that they’re not to be given to people with immunocompromised conditions.

The new mRNA vaccines use a specific gene to create an antigen. For example, with the COVID vaccines, they used the gene that makes the spike protein. So, if someone is exposed to COVID, the vaccine turns on antibodies to protect us from that protein. mRNA vaccines are faster to create than live vaccines because scientists can just modify a specific gene–that’s what’s so exciting about the mRNA vaccines!

And because mRNA vaccines aren’t live, anyone can have them. I can give an mRNA vaccine to an AIDS patient, to a transplant patient, a young patient, an old patient, a pregnant patient–any patient, and it’s not going to cause any harm. The same goes for the traditional, inactivated vaccines–as long as the antigen isn’t live, you can give it to anybody.

In 2022, the U.S. Centers for Disease Control and Prevention (CDC) reported that nearly 40 million children missed measles vaccine doses. In 2023, CDC and the World Health Organization estimated 9 million measles cases and 136,000 related deaths, most of which were among children. According to the National Institutes of Health, approximately 2-3 percent of the overall population, or 6.6-9.9 million people, are immunocompromised and unable to vaccinate against measles.

Why should people get vaccinated?

It can prevent or lessen the severity of the condition in question for everyone. You may be immunocompetent, but if you go home to your elderly parents or a child who is immunocompromised or disabled, you can transmit to them.

And this is for the future–we’re running out of antibiotics. We have C. difficile colitis that we’re treating with fecal transplants and other agents, and then we have Staph aureus that’s out of control–we’re running out of antibiotics to treat patients because these pathogens are becoming more and more resistant.

So, guess what? They’re looking at vaccines for C. difficile and Staph aureus and diseases like malaria to try and prevent them–because if you get it, what do you do? You don’t want to risk yourself getting a horrible infection.

What’s causing measles outbreaks?

There’s a lot of disinformation and fear that causes people to choose not to vaccinate themselves or their children. It’s the reduction in immunity over time, and then all you need is one case, and then if it hits other people who don’t have immunity, it spreads.

With the MMR vaccine that protects against measles, there was a completely disproven paper published that linked the MMR vaccine to autism. That was found to be a totally false article–it was retracted, and the publisher said there is no evidence, the data was put together wrong. But people still bring it up.

Read more about vaccination hesitancy from Sean Valles, director and professor for the Center for Bioethics and Social Justice.

Are children and adults who are immunocompromised able to receive the MMR vaccine, which is a live vaccine?

No, and it’s unfortunate–they’re the most vulnerable, and they’re unable to protect themselves.

With measles, that’s never been a problem since we’ve had the vaccine, which was developed in the 60s. Historically, we’ve always had good herd immunity–everyone who’s been able to vaccinate would get vaccinated and have immunity, so there was very little chance of the virus being active. There’s no host to infect–that’s how viruses die off.

According to CDC, measles symptoms, such as fever, cough, and runny nose, don’t emerge for 7-14 days after infection; however, infected people can spread the virus as soon as 4 days before they develop measles’ signature rash, possibly before they realize they have measles, instead of just a cold or flu.

How can immunocompromised people protect themselves from measles?

Not all immunocompromised patients are restricted from ever getting the MMR and other live vaccines. For example, if a patient is receiving chemotherapy, as long as they recover their immunity, then that’s the time to get vaccines–you’ll get the best response, and live vaccines wouldn’t be contraindicated because your immunity would be more substantial.

In my clinic, where I work with HIV patients, we’re checking all our patients for their antibodies, and we’ve been giving the MMR vaccines like crazy to anyone with T cell counts above 200. AIDS is defined as having a T cell count below 200, but with all these magical drugs we have, we can bring those T cells back above 200, and as long as they’re above 200, we can give them the MMR.


By E. LaClear