Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

“It could happen to you”


When talking with vaccine-hesitant patients, I bring up the recent measles outbreaks. It can be effective to use current events to motivate better compliance with immunization guidelines. 

While working at a hospital in South Africa during medical school, I saw my first and only patient with measles. She was a three-year-old girl with a full-body rash and bloodshot eyes. In the waiting room she had a seizure and we spent hours trying to stabilize her. She was so dehydrated we couldn’t place an IV and had to drill into her bone to give her medicine and fluids. Ultimately, she was admitted to the intensive care unit where we treated her for meningitis and pneumonia. She survived, but she was lucky.  


For many years, when working with vaccine-hesitant families in the U.S., this was the story I told about measles. Unfortunately, now I have stories closer to home. In 2000, the CDC declared that measles was eradicated in the U.S. However, with declining vaccination rates, in 2019 we saw over 1,000 measles cases, the most since 1992. In more recent years, we’ve continued to see cases across America. In 2024, we’ve already had over 20 cases in the U.S., with a school outbreak in Florida making the news as recently as last week. As of February 25, 2024, the cases reported from a single south Florida elementary school stood at seven.  


For many parents, the childhood vaccine schedule can feel overwhelming and excessive. I’ve found talking about breaking headlines is a useful tool—making an abstract illness more concrete and compelling. I also use these outbreaks to highlight the efficacy of our current vaccines. For example, in U.S. measles outbreaks since 2019, 90% of cases have been in those who are unvaccinated.  


I also lead with compassion. Virtually every parent is trying to make the best possible decisions for their children, and I try to recognize that, even when I disagree with them. Although I’ve seen the dangers of many of these diseases first-hand, most have not. Patients are also inundated with popular media where anti-vaccine influencers, most without medical backgrounds, minimize the danger of illnesses like measles and inflate the risks associated with vaccination.  


These outbreaks make that risk of not vaccinating tangible. Hopefully, we can use these unfortunate events to better inform patients and prevent them from being infected with vaccine-preventable illnesses.  









This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.