Here’s the lowdown on measles in the U.S., and whether you should get a measles booster.

Robert F. Kennedy Jr. has only been health secretary for a few weeks, but already he’s facing a test that reveals his approach to infectious diseases.

A measles outbreak is spiraling in the American Southwest, with a total of 159 cases in Texas and nine cases in New Mexico. Twenty-two patients have been hospitalized, and one child has died.

The vast majority of cases have been among unvaccinated children and teens, many of whom are Mennonite. But there isn’t an ideological push among Mennonites against vaccines. In fact, amid news of the outbreak, people who previously hadn’t vaccinated their kids are rushing to do so now.

Rather, the community hasn’t had regular access to health care—and in this area of West Texas, it’s a common story. Medical care can be an hour’s drive or more away. There are immense structural and logistical barriers to reaching people at risk: Only 90 percent of Texans are vaccinated—below the 95 percent threshold recommended for community immunity (also called herd immunity).

–RFK Jr.’s Policies Could Spread Measles Far Beyond Texas, The New Republic

Despite the risks, Kennedy is taking a pretty hands-off approach to the outbreak. Initially, as I reported, the CDC wasn’t even sending a team to help address the outbreak. The CDC now says they have a team on the ground.

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But Kennedy, a longtime anti-vaccine activist, is still seeding messages that could damage trust in vaccines — making outbreaks like these far more common.

And he’s doing so in a pretty sly way.

“Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote on Monday. Fellow anti-vaxxers were furious at the suggestion that vaccines might be a good idea. But on closer review, it’s not so clear that Kennedy has actually changed his tune.

“I think he’s playing the long game,” said Dorit Reiss, professor of law at U.C. Law San Francisco. And some anti-vaxxers engaging in a close reading of Kennedy’s piece agreed—even seeing the piece as an encouraging sign that the anti-vax agenda is proceeding in this administration.

Kennedy does not seem to be changing his stance on vaccines so much as cloaking it in code words. Sleights of hand like this are a good indicator of how he intends to transform health agencies, the recommendations they make, and the availability of—and trust in—vaccines in the United States.

–How to Decode RFK Jr.’s Dog Whistle Messages on the Measles Vaccine, The New Republic

Does the Texas measles outbreak mean you should get a booster shot?

One dose of the measles vaccine is 93% effective, and two doses are 97% effective, which is amazing.

But there are a few reasons you might consider a booster shot.

For some people, immunity fades. Until now, that hasn’t been a big problem in the U.S., because there’s not much measles around — but the more it spreads, the more risky that 3% becomes.

You can ask your doctor to check your titers — measuring whether your immune system still mounts a strong response.

I had this test done before I had kids, because my doctor didn’t want me to get sick during pregnancy. It turns out, my protection against rubella had faded, so I got another shot. The good news is, the MMR shot covers measles, mumps, and rubella, so I should be in good shape for all three.

If you were born before 1989, you may have only received the first measles shot, and you could be due for a second one.

If you’re not able to afford the blood work to check titers or you don’t have access to your childhood immunization records, you could also talk to your doctor or pharmacist about getting a booster straight away — especially if you live in an area with low vaccination rates or cases of measles. (I am Not a Doctor™ and do not offer medical advice.)

There are also people who can’t get vaccinated or might not have a good immune response, including babies, people on cancer treatments, and organ transplant recipients. If that’s you or someone you love, I would certainly consider additional precautions like wearing a face mask in crowded areas (which is a good idea anyway with lots of Covid and flu circulating now).

It’s worrying to see outbreaks like the one in the Southwest, especially because this could happen anywhere with vaccination rates under 95%.

And I can’t put into words how tragic it is that a child died from a preventable illness.

But we have very very effective vaccines, which is nothing short of a miracle. It can protect you and everyone around you. I hope we’re able to bring this outbreak under control and stay safe in the years ahead.

Got a tip? Message me on Signal at melodyschreiber.06 from a non-work device.

Top image: Pan American Health Organization (PAHO)