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QuickTake:
As federal leaders such as Robert F. Kennedy Jr. deliver mixed messages about evidence-based care for serious diseases, local doctors are providing clear guidance in support of both the COVID-19 vaccine and the measles, mumps, and rubella (MMR) vaccine. At the same time, they’re preparing to see measles in their clinics — for the first time.
Pilar Bradshaw, a doctor at Eugene Pediatric Associates, has never seen a case of measles in her long career. She expects that to change.
“We will see measles here, I’m sure,” Bradshaw said.
She and practitioners at clinics throughout the region are preparing for cases amid record-high vaccine exemptions in Lane County, where young children have fallen below the herd immunity threshold — the community protection that helps contain viruses to manageable levels.
The Centers for Disease Control and Prevention reports 1,088 measles cases across the country, outbreaks that coincide in an era of misinformation and mistrust about public health. Lately, much confusion has been coming from federal guidance, specifically when it comes to vaccines.
For months, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has delivered conflicting messaging about the measles. Last week, he took a stance against COVID vaccines for pregnant women and people under 65, a move that many doctors find unethical. The administration’s messaging about immunizations could affect some high-risk populations, according to the American Academy of Pediatrics.
“Those of us that have worked in [health] organizations for our entire career and dedicated ourselves to keeping people healthy, we are finding it difficult trusting the beacons and the landmarks that we’ve always had,” Bradshaw said. “For me as a human, a physician, a parent, and a community member, that’s been very sobering, very worrisome.”
In response, local public health leaders are doubling down on their commitment to evidence-based, preventative care like vaccines. But as vaccine exemptions rise in Lane County, physicians are now preparing for reactive measures if they see a measles case in their clinics for the first time.
Clinics brace for measles cases
Preparing for measles is a mix of education, logistics, and monitoring developments.
There hasn’t been a case of measles here since 2019, and so many practitioners have never seen a case before, they are learning the textbook signs to watch for: blotchy red rashes, triple-digit fevers, watery eyes. And then what to do if they see those symptoms in the clinics. That means figuring out how to keep everyone, both patients and staff, safe.
At Bradshaw’s clinic, staff are organizing their personal protective equipment — a flashback to the early days of the COVID pandemic in 2020. At that time, the clinic installed a specialized ventilation system that brings in fresh air and vents it outside to reduce the spread of airborne viruses. Now, with measles in mind, they’ve rearranged part of the building to create an isolated area built around that airflow system.
Isolation is also part of the plan at other clinics, like Pediatrics at PeaceHealth RiverBend Pavilion, in the event a patient with measles shows up.
“We will arrange to see them in a parking lot outside and do some testing, or bring them in through a back way to a room that has been shut down for the rest of the day,” said Dr. Leslie R. Pelinka of PeaceHealth.
Should Pelinka’s team see a case, her clinic will follow detailed testing and containment protocols from the Oregon Health Authority and Lane County Public Health. This includes collecting nasal swabs, urine samples, and blood tests to detect suspected cases and notifying public health officials immediately if a case is confirmed.
These workflows, which aim to limit exposure, have been around for years, but never implemented for measles at Pelinka’s office. Now, she worries about the disease showing up at her clinic, even though widespread vaccination against the disease nearly eradicated it in the United States.
“It’s heartbreaking,” Pelinka said.
Pelinka thinks about some of the most vulnerable people that herd immunity is supposed to protect — those who can’t be vaccinated for medical reasons, such as having a weakened immune system or certain underlying health conditions. She also thinks about people caught up in misinformation.
“I’m really sympathetic to parents who are just trying to make the best decision that they can for their children and protect them and keep them safe,” she said.
What do doctors say about vaccine hesitancy?
Since Robert F. Kennedy Jr.’s “Make America Healthy Again” movement gained momentum on the campaign trail last year, vaccine-skeptical content from non-peer-reviewed sources has increasingly entered mainstream media. Public health leaders believe it is eroding public trust in science and fueling a rise in preventable disease.
For example, Secretary Kennedy claimed the COVID-19 vaccine would be removed from the childhood immunization schedule. The CDC has made no such change.
Without formal CDC guidance, families could face insurance issues, including dropped coverage or higher out-of-pocket costs for the COVID-19 vaccine. Recognizing the financial and access implications tied to these recommendations, Lane County Public Health, which has the authority to make its own local guidance, continues to recommend the vaccine.
In an email to Lookout Eugene-Springfield, Senior Public Health Officer Dr. Patrick Luedtke advised that everyone 6 months and older stay up to date on COVID-19 vaccinations. That includes people who are pregnant, postpartum, breastfeeding, or planning a pregnancy.
He also supports the Centers for Disease Control and Prevention’s recommendation of two doses of the measles, mumps, and rubella (MMR) vaccine, which has been proven 97% effective. In rare cases where vaccinated individuals still get sick, the vaccine helps prevent the most severe complications of the disease — including brain swelling, blindness, and deafness.
These severe outcomes are why doctors strongly emphasize that the risks of measles far outweigh the risks of vaccination.
The greatest risk of measles arriving locally comes from travelers who are not fully vaccinated. It’s why Luedtke and Bradshaw are working together on public outreach and parent education on the precipice of summer vacation.
A widespread measles outbreak is unlikely in Lane County due to relatively high vaccination rates. However, small clusters could still emerge that make some people extremely sick.
Their approach centers on working with — not dismissing — families who are hesitant, whether due to cultural, political, or religious beliefs.
“The way we get through this is to be kind to one another and ask questions,” Bradshaw said.
