Another Risk Factor: Parental Psychiatric Disorders

 In The Politics of Autism, I discuss various ideas about what causes the condition. Studies have ruled out vaccines as a cause of autism, but there is a very long and growing list of other correlates, risk factors, and possible causes that have been the subject of serious studies.  This blog has identified at least 41 such items.  Here is yet another:

Weiyao Yin et al., "Association between parental psychiatric disorders and risk of offspring autism spectrum disorder: a Swedish and Finnish population-based cohort study," Lancet Regional Health, Open AccessPublished:April 23, 2024DOI:https://doi.org/10.1016/j.lanepe.2024.100902.  Summary:

Background
Roughly more than one in six adults worldwide suffer from psychiatric conditions. Sporadic studies have associated parental psychiatric disorders with autism spectrum disorder in offspring. Comprehensively examining the association between parental psychiatric disorders and offspring autism spectrum disorder is needed to guide health policies, and to inform etiologic studies.

Methods
We included all children born in Sweden and Finland 1997–2016. Diagnoses were clinically ascertained from National Registers through 2017. We calculated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for autism spectrum disorder in offspring of fathers and mothers with psychiatric disorders, in both parents jointly and across co-occurring conditions.

Findings
Among 2,505,842 children, 33,612 were diagnosed with autism spectrum disorder, of which 20% had a parent with psychiatric disorders. The risk of autism spectrum disorder was increased across all psychiatric disorders in fathers (Sweden: aHR = 2.02, 95% CI = 1.92–2.12; Finland: aHR = 1.63, 95% CI = 1.50–1.77), mothers (Sweden: aHR = 2.34, 95% CI = 2.24–2.43; Finland aHR = 2.12, 95% CI = 1.92–2.28), or both parents (Sweden: aHR = 3.76, 95% CI = 3.48–4.07; Finland aHR = 3.61, 95% CI = 3.20–4.07), compared to neither parents. Co-occurrence of parental psychiatric disorders further increased risk (e.g., Sweden: for one, two or ≥three different diagnostic categories compared to no diagnosis, in fathers aHR = 1.81, 2.07, 2.52; in mothers aHR = 2.05, 2.63, 3.57).

Interpretation
Psychiatric disorders in both parents conveyed the highest risk of offspring autism spectrum disorder, followed by mothers and then fathers. The risk increased with number of co-occurring disorders. All parental psychiatric disorders were associated with increased the risk of autism spectrum disorder. To reliably assess the risk of autism spectrum disorder in children, a comprehensive history incorporating the full range of parental psychiatric disorders is needed beyond solely focusing on familial autism spectrum disorders.

The very long. growing, and probably incomplete list of other correlates, risk factors, and possible causes that have been the subject of serious studies: 

1. Inflammatory bowel disease;
2. Pesticides;
3. Air pollution and proximity to freeways;
4. Maternal thyroid issues;
5. Autoimmune disorders;
6. Induced labor;
7. Preterm birth;
8. Fever;  
9. Birth by cesarean section;
10. Anesthesia during cesarean sections;
11. Maternal and paternal obesity;
12. Maternal diabetes;
13. Maternal and paternal age;
14. Grandparental age;
15. Maternal post-traumatic stress disorder;
16. Maternal anorexia;
17. Smoking during pregnancy;
18. Cannabis use during pregnancy;
19. Antidepressant use during pregnancy;
20. Polycystic ovary syndrome;
21. Infant opioid withdrawal;
22. Zinc deficiency;
23. Sulfate deficiency;
24. Processed foods;
25. Maternal occupational exposure to solvents;
26. Congenital heart disease;
27. Insufficient placental allopregnanolone.
28. Estrogen in the womb;
29. Morning sickness;
30. Paternal family history;
31. Parental preterm birth;
32. Antiseizure meds
33. Location of forebears
34. Lithium
35. Aspartame
36. BPA
37. Brain inflammation
38. Maternal asthma
39. Infertility
40. Ultraprocessed foods
41. Household chemicals

 

Access to Home and Community-Based Services

The Politics of Autism includes an extensive discussion of insurance and  Medicaid services for adults with intellectual and developmental disabilities. Home and Community-Based Services (HCBS) are particularly important.

From HHS:

“Ensuring Access to Medicaid Services” (“Access Rule”) creates historic national standards that will allow people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) to better access care when they need it and also strengthens home and community-based services (HCBS), which millions of older adults and people with disabilities rely upon to live in the community. This landmark final rule will set minimum threshold standards for payments to the direct care workforce, create meaningful engagement with Medicaid consumers, and advance provider rate transparency.
...

The Access Rule strengthens HCBS by requiring that at least 80 percent of Medicaid HCBS payments directly compensate direct care workers rather than cover “administrative overhead.” The rule also requires states to report how they establish and maintain HCBS wait lists, assess wait times, and report on quality measures. This policy would allow states to take into account small providers and providers in rural areas, promote training and quality, and ensure smooth implementation with additional data collection prior to full phase-in.

It protects the health and safety of people who receive HCBS by improving states’ incident management systems and requires states to have a grievance process for all HCBS participants.

See here for a full description of the final rule and a link to the rule text. 

Autism Cards in Suffolk County, New York

In The Politics of Autism, I write:

[M]any police departments have trained officers and other first responders how to spot signs of autism and respond accordingly.  Some organizations have also published identification cards that ASD adults can carry in order to defuse potential conflicts. Virginia provides for an autism designation on driver licenses and other state-issued identification cards. Once again, however, the dilemma of difference comes into play. One autistic Virginian worries: “Great, so if I get into an accident, who’s the cop going to believe, the guy with the autistic label or the guy without it?” Clinical psychologist Michael Oberschneider is concerned about the understanding level of first responders: “I think many people still think of Rain Man or, more recently, the Sandy Hook Shooter, when they think of autism even though very few people on the autistic spectrum are savants or are homicidal and dangerous.”

Jennifer McLogan at WCBS-TV in New York:

Suffolk County law enforcement officers are now equipped with a tool to help people on the autism spectrum during potentially stressful encounters. It was designed by a young man from Long Island, who is on the spectrum himself.

Christopher Cortale, a receptionist at the Winters Center for Autism in West Babylon, helped design an emergency card to foster communication in stressful situations.

At the top, the card reads, "Please be patient. I have autism. Please point to the pictures to help me understand what you want." Underneath are photos of a driver's license, registration, insurance and weapons.

The card also includes photos and captions violations for officers to indicate if the individual with autism is being warned, ticketed or arrested, and reasons, such as license plate, tail light, speed limit, stop sign or several others.

The bottom of the card has a section titled "I need help" with photos indicating low fuel, flat tire, hospital, emergency contact, tow truck and lost.

 

RFK Jr. Might Be Hurting Trump

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong. A leading anti-vaxxer is presidential candidate Robert F. Kennedy, Jr.  He has repeatedly compared vaccine mandates to the Holocaust.  Rolling Stone and Salon retracted an RFK article linking vaccines to autism.

He is now running for president as an independent.  A big question in the campaign is whether he will draw Democratic votes from Biden (because his name is Kennedy) or draw Republican votes from Trump (because he is an antivaxxer).

Lisa Kashinsky et al. at Politico:

Republicans are waking up to the reality that Robert F. Kennedy Jr. could sink their standard-bearer just as easily as he could hurt President Joe Biden, after a pair of new polls showed the presence of third-party candidates on the ballot might not necessarily benefit former President Donald Trump.
...

In two polls released so far this week, from NBC News and Marist College, Biden actually gained relative to Trump in matchups featuring Kennedy and other third-party candidates, though the differences were well within the margins of error in each survey and represented a break from previous polling.

In the NBC News poll, a negligible 2-point Trump lead in a head-to-head matchup became a 2-point Biden advantage when Kennedy, Cornel West and Jill Stein were added as options. That’s because 15 percent of respondents who picked Trump against Biden defected to Kennedy in the five-way matchup, compared to 7 percent of those who chose Biden initially.

The Marist poll showed Kennedy winning equal shares of respondents who reported voting for Biden (12 percent) and Trump (12 percent) in 2020, and roughly the same percentages of self-identified Democrats (8 percent) and Republicans (10 percent) — mostly in line with other polls that show Kennedy drawing evenly from both major-party candidates.

...

The overlap in potential support for Trump and Kennedy is evident in more than just policy. Of the $22.7 million that Kennedy’s campaign has reported raising from donors giving at least $200 — the threshold at which the Federal Election Committee requires campaigns to itemize donations — since his launch last summer, nearly $1.6 million comes from more than 1,700 donors who gave to Trump’s campaign during the 2020 cycle, according to a POLITICO analysis.

By contrast, Kennedy has raised only $850,000 from about 980 donors with a record of giving to Biden’s 2020 campaign. Both totals represent a small overall share of Kennedy’s fundraising. But they are one data point suggesting his appeal may be stronger among those once interested in Trump.

Colorado Closures

 The Politics of Autism includes an extensive discussion of autism service providers.

Some are closing.

Nick Coltrain, The Denver Post:

Since 2021, at least 13 companies—operating about 35 clinics of different sizes—have closed or left the state over reimbursement rates that haven't kept up with rising costs, according to research by the Colorado Association for Behavior Analysis. Those closures have affected treatment for some 1,380 patients, and an estimated 1,000 Coloradans lost their jobs, according to the group.

"Colorado is relatively unique in the Medicaid landscape right now because of the number of programs that have closed and/or exited the state," said Mariel Cremonie-Fernandez, the vice president of government affairs for the national Council of Autism Service Providers.

..

Rebecca Urbano Powell, executive director of Seven Dimensions Behavioral Health, said she watched her waitlist balloon from two months to six months as the industry contracted in recent years. And with low reimbursement rates, she's lost entry-level staff to Starbucks and Walmart, she said, effectively cutting off entry into the behavioral health workforce before workers can get their feet under them.

"They could choose to work with kids with very severe, dangerous behaviors, or go work at Starbucks as a barista, and make the same—if not more—as a barista," said Urbano Powell, who also is board president of the Colorado Association for Behavior Analysis.

 ...

The growing role of private equity investment firms also complicates matters, HCPF warned, as firms buy up providers and close down autism services when they don't hit profit goals.

HCPF cited a national report from the Center for Economic Policy and Research that found private equity firms "move in and skim funds to pay high salaries to executives and outsized returns to private equity partners." The study did not cite any Colorado-specific impacts but noted that many of the firms it looked at operate in dozens of states.

While some budget committee members were "agnostic" to ownership structures of autism providers, as one put it, Sen. Jeff Bridges was more skeptical. While the Arapahoe County Democrat ultimately voted to increase funding, he worried it would set a precedent that investment firms could demand money to pad profits to their liking—and hold autism services hostage to do so.

"To me, it feels like a monopoly," Bridges said. "There's a real problem here if private equity is coming in here and doing what they did to other markets to autism providers. If those folks are getting in the way, then we absolutely have to take the fight to them."

Independence and Interdependence

 In The Politics of Autism, I write:

Many analyses of autism speak as if it were only a childhood ailment and assume that parents are the main stakeholders. But most children with autism grow up to be adults with autism, and they suffer uniquely high levels of social isolation. Almost 40 percent of youth with an autism spectrum disorder never get together with friends, and 50 percent of never receive phone calls from friends. These figures are higher than for peers with intellectual disability, emotional disturbance, or learning disability. When school ends, many adults with autism have grim prospects. Though evidence is sparse, it seems that most do not find full-time jobs. Compared with other people their age, they have higher rates of depression, anxiety, bipolar disorder, and suicide attempts.

Moser, C., Smith DaWalt, L., Burke, M. M., & Taylor, J. L. (2024). Emerging adulthood in autism: Striving for independence or interdependence? Autism, 0(0). https://doi.org/10.1177/13623613241245647

While some autistic youth have attitudes consistent with Arnett’s conceptualization of emerging adulthood, feeling as though they need more time to gradually move toward adulthood (Cribb et al., 2019), others consider themselves to be adults immediately after adolescence (e.g. 18 years of age; Anderson et al., 2016). This belief may lead to unattainable expectations, as most people achieve more traditional milestones of adulthood later in life (e.g. 29 years of age; Arnett, 2014). Like their non-autistic peers, it is also unclear to what extent independence should be considered a marker of adulthood in this group—particularly given the varied opinions autistic emerging adults have about the importance of self-sufficiency. For instance, although some autistic youth hope to live on their own, others report no desire to move out of the parental home (Anderson et al., 2016). Moreover, autistic emerging adults who desire greater independence can find it challenging to achieve this goal without support (Cribb et al., 2019; Sosnowy et al., 2018).

Thus, to support autistic youth in reaching their maximum potential and achieving their goals during emerging adulthood and beyond, it may be helpful to widen our focus from promoting independence, to promoting independence and interdependence. While the term interdependence has been used in various contexts, here we conceptualize interdependence as a mutual dependency between two or more people and is underscored by the notion that support should not stifle autonomy (Condeluci, 1995). Drawing from other scholars (e.g. Settersten et al., 2015), we argue that no one acts entirely independently, and thus, independence and interdependence co-occur within all people (autistic or not). Furthermore, individuals demonstrate varying degrees of independence and interdependence across domains of life and stages of development. For instance, while some emerging adults may prefer a high degree of interdependence throughout their lifespan, others may desire some degree of interdependence to gain more self-sufficiency in later adulthood (e.g. living independently).

Pro-Polio Legislation in NH

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures. 

The anti-vax movement has a great deal of overlap with MAGA, QAnon, and old-school conspiracy theory.

Julia Metraux at Mother Jones:

New Hampshire could soon beat Florida—known for its anti-vaccine Surgeon General—when it comes to loosening vaccine requirements. A first-in-the-nation bill that’s already passed New Hampshire’s state House, sponsored only by Republican legislators, would end the requirement for parents enrolling kids in childcare to provide documentation of polio and measles vaccination. New Hampshire would be the only state in the US to have such a law, although many states allow religious exemptions to vaccine requirements.

Currently, Republicans control New Hampshire’s state House, Senate and governor’s office—but that isn’t a guarantee that the bill will be signed into law, with GOP Gov. Chris Sununu seemingly flip-flopping when it comes to disease control. Sununu did sign a bill in 2021 allowing people to use public places and services even if they did not receive the Covid-19 vaccine. But the next year, the governor vetoed a bill that would bar schools from implementing mask mandates.
...

Rises in anti-vaccine sentiments have largely been linked to concerns that vaccines cause health issues, like the debunked claim that the MMR vaccine leads to kids being autistic. What parents may want to keep in mind is that polio and measles themselves are disabling conditions: according to the World Health Organization, 1 in 200 polio infections leads to irreversible paralysis. Children who get measles can experience symptoms including swelling of the brain. Death is always a possibility, too.

...

The bill would strike language requiring that immunization records be submitted to childcare agencies, but would keep those requirements for students enrolling in kindergarten through 12th grade. As of 2022, according to the nonprofit ChildCare Aware of America, there are some 700 licensed childcare centers and homes in New Hampshire (which doesn’t require the Covid-19 vaccine for enrollment in childcare, either, despite its efficiency in reducing both death rates and acute symptoms).

The Need for Autism-Specific Programs in School

In The Politics of Autism, I write:

But what is equal treatment? This question raises the “dilemma of difference,” as legal scholar Martha Minow explains. “When does treating people differently emphasize their differences and stigmatize or hinder them on that basis? And when does treating people the same become insensitive to their difference and likely to stigmatize or hinder them on that basis?”[i]

---

[i] Martha Minow, Making All the Difference (Ithaca: Cornell University Press, 1990), 20.

Jamie Mihoiko Doyle at Newsweek:

Frustratingly, autism programs are being emaciated under the veil of equity and efficiency: That by combining kids with autism who were receiving the support they needed with other children with various learning disabilities with less specialized support means that all needs will be met.

Why have all these children drink from specialized cups of autism support when they can drink from a special education trough instead?

Diluting support for these kids under the veil of equity and efficiency is dishonest. These actions are ableist.

"Equity" would be expanding these autism-specific programs across the county and the nation. Every child with my son's autism phenotype deserves the program that my son is enrolled in today.

Touting autism awareness while silently pulling the rug of support from under them are incongruous acts.

The assassination of autism-specific programs is a national issue. Just last year, schools in Houston, Texas eliminated their "autism services team", which was described by an educator as a "lifeline" for teachers.

Instead, the school district generalized the support into a "special education unit." Buffalo Public Schools in New York eliminated classes with the lowest student-to-teacher ratios for elementary school students with autism to "maximize resources."

...

 There is both a current and future demand for autism-specific services, suggesting a need to expand specialized programs and enhance the recruitment and retention of autism-trained paraeducators. Diluting autism support is short-sighted and jeopardizes their chances of achieving independence as adults.

Blue Envelopes in Arizona

 In The Politics of Autism, I discuss interactions between first responders and autistic people.  Some jurisdictions allow autistic drivers to ask for a blue envelope to disclose the driver's diagnosis in case of an accident or traffic stop .

From Arizona DOT:

Arizona is launching a program through which drivers on the autism spectrum can place their credentials in special blue envelopes to enhance communication with law enforcement officers during traffic stops.

This voluntary program, which includes education for law enforcement officers, follows a model used successfully in Connecticut. The envelope will have instructions for the driver and law enforcement officer to follow and advise the officer that the driver may respond differently to instructions in situations that can increase anxiety.

To provide the necessary groundwork and training, the Arizona Department of Transportation Motor Vehicle Division is partnering with the Arizona Department of Public Safety (AZDPS) and the University of Arizona’s Police Department, Department of Speech, Language and Hearing Sciences, and Leadership Education in Neurodevelopmental and Related Disabilities (ArizonaLEND) training program.

“When I heard about this program in Connecticut, I was extremely fascinated and intrigued to see if we could incorporate it here in Arizona,“ ADOT MVD Director Eric Jorgensen said. “MVD is thrilled to be partnering with DPS and the University of Arizona Police Department to help calm what can otherwise be potentially stressful situations.”

This program will function similarly to the one Connecticut established in 2020. The blue envelope is a voluntary way to hold important vehicle documents such as insurance and registration, while also being a communication tool between the driver and law enforcement during an interaction.

"This program provides explicit support for drivers who choose to participate," said Jennifer Casteix, UArizona Clinical Professor and ArizonaLEND faculty member. "Better understanding of communication differences should positively impact these interactions."

After his interim appointment at the University of Arizona in May 2023, Police Chief Chris Olson shared his desire to bring the Blue Envelope Program to the university. Creating partnerships with University of Arizona units that specialize in autism research and caring for the community have been key in laying the groundwork for this program at the University of Arizona.

According to Chief Olson, “The Blue Envelope program is an outstanding public safety initiative that seeks to improve communication between police officers and autistic drivers during traffic stops.”

Director Jeffrey Glover of the Arizona Department of Public Safety said, “The AZDPS is proud to support and be a part of the Blue Envelope Program. A program like this, seeking to enhance safety for both members of the public as well as all law enforcement officers in the State of Arizona, is absolutely invaluable.”

"We are implementing this program with an evidence-based approach to better support law enforcement and autistic drivers to improve safety outcomes," said Dr. Nell Maltman, UArizona Assistant Professor with the Department of Speech, Language and Hearing Sciences.

Training with officers and volunteer drivers to simulate a traffic stop with the blue envelopes will be happening next week at the University of Arizona’s Tucson campus.

The envelopes are expected to be available through ADOT MVD offices, various law enforcement locations as well as other locations across the state starting in May.

For additional information about this program, please visit azdot.gov/BlueEnvelope.

Antivax Bucks

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong. A leading anti-vaxxer is presidential candidate Robert F. Kennedy, Jr.  He has repeatedly compared vaccine mandates to the Holocaust.  Rolling Stone and Salon retracted an RFK article linking vaccines to autism.

He is now running for president as an independent

 Rob Lever, Anuj Chopra and Marisha Goldhamer at AFP:

An anti-vaccine group founded by US presidential contender Robert F. Kennedy Jr raised millions of dollars during the coronavirus pandemic, tax records show, boosting its coffers as it ramped up what experts call dangerous health misinformation.

Children's Health Defense (CHD), repeatedly called out for promoting vaccine falsehoods, collected about $46 million between 2020 and 2022, roughly 10 times its revenue in the three years preceding the pandemic.

CHD and four other non-profit organizations collectively raked in more than $100 million during that period, public tax records compiled by investigative news site ProPublica show.

...

CHD, which raked in $23.5 million in 2022 alone, has risen to become one of the world's top "alternative and natural medicine" websites, according to digital intelligence company Similarweb.

...

Kennedy, a longtime vaccine skeptic, received about $510,000 in compensation for serving as CHD's chairman in 2022 -- more than double his pre-pandemic salary, records show.

The 70-year-old Kennedy is on leave from that role as he pursues his third-party presidential bid.

...

 Other well-funded anti-vaccine groups include Informed Consent Action Network (ICAN), which pulled in $13.4 million in 2022, compared to just $1.4 million in 2017, public records show.

The group's founder Del Bigtree, who was hired by Kennedy to be his presidential campaign's communications director, was a vocal critic of masking during the pandemic and touted unproven Covid-19 treatments on his podcast.

Black Families and Autism Diagnosis

In The Politics of Autism, I write about the experiences of different economic, ethnic and racial groups.   Inequality is a big part of the story. 

 Wendy Chung at STAT:

In two separate studies of Black families with autism, partially funded by SPARK, investigators from Vanderbilt University and the University of Arkansas found that cultural barriers, stigma, and a basic lack of understanding of autism often led to delays in seeking an initial diagnosis. What’s more, when Black families did seek an evaluation or tried to access services, many experienced cultural bias and overt racism. Both studies underscore the role of misinformation, misperception, and misunderstanding in perpetuating false narratives about autism and increasing the amount of anxiety parents felt about receiving a diagnosis.

The Vanderbilt study documents the lived experience of 400 Black or multiracial families seeking care. In it, one in 10 parents said they delayed seeking an evaluation for their child because they simply did not know enough about autism and its signs. When Black parents did seek help, they often encountered a system misaligned with their needs. Parents noted evaluations that relied on toys and activities their children weren’t familiar with, clinicians who didn’t understand their culture, and a scarcity of available, affordable resources within their communities.

Autism Society Observes Autism Acceptance Month

 In The Politics of Autism, I write:

The most basic questions trigger angry arguments. For instance, into what category do we put autism in the first place? In 2013, President Obama said that “we’re still unable to cure diseases like Alzheimer's or autism or fully reverse the effects of a stroke.” The language of “disease” and “cure” offends some in the autism community. “We don’t view autism as a disease to be cured and we don’t think we need fixing,” says Ari Ne’eman of the Autistic Self-Advocacy Network. “We do feel comfortable with the word disability because we understand what it means.” From this perspective, autism is difference that requires accommodation, not an illness that requires eradication. Adherents of this position liken autism to homosexuality, which psychiatrists once deemed to be a  disorder. Conversely, some parents take offense at opposition to a cure. “Anyone with the mental and verbal ability to challenge autism research is not autistic on a scale that I care to recognize,” writes autism parent James Terminello. “Opposition to finding a cure is particularly hurtful to parents who still mourn the loss of the child that could have been. A line has been crossed.”

The Autism Society now observes Autism Acceptance Month, though not everyone agrees. 

 

Measles 2024

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.

In Iowa, Nevada, Virginia, and Georgia, Trump has said:  "I will not give one penny to any school that has a vaccine mandate or a mask mandate."

Washington Post editorial:

This year is not yet one-third over, yet measles cases in the United States are on track to be the worst since a massive outbreak in 2019. At the same time, anti-vaccine activists are recklessly sowing doubts and encouraging vaccine hesitancy. Parents who leave their children unvaccinated are risking not only their health but also the well-being of those around them.
...
Vaccine hesitancy is being encouraged by activists who warn of government coercion, using social media to amplify irresponsible claims. An article published March 20 on the website of Robert F. Kennedy Jr.’s Children’s Health Defense organization is headlined, “Be Very Afraid? CDC, Big Media Drum Up Fear of ‘Deadly’ Measles Outbreaks.” The author, Alan Cassels, claims that the news media is advancing a “a fear-mongering narrative,” and adds, “Those of us born before 1970 with personal experience pretty much all agree that measles is a big ‘meh.’ We all had it ourselves and so did our brothers, sisters and school friends. We also had chicken pox and mumps and typically got a few days off school. The only side effect of those diseases was that my mom sighed heavily and called work to say she had to stay home to look after a kid with spots.”

Today, he adds, “Big media and government overhyping the nature of an illness, which history has shown us can be a precursor to some very bad public health policies such as mandatory vaccination programs and other coercive measures.”

This is just wrong. The CDC reports that, in the decade before the measles vaccine became available in 1963, the disease killed 400 to 500 people, hospitalized 48,000 and gave 1,000 people encephalitis in the United States every year — and that was just among reported cases. The elimination of measles in the United States in 2000, driven by a safe and effective vaccine, was a major public health success. Although the elimination status still holds, the U.S. situation has deteriorated. The nation has been below 95 percent two-dose coverage for three consecutive years, and 12 states and the District below 90 percent. At the same time, the rest of the world must also strive to boost childhood vaccination rates, which slid backward during the covid-19 pandemic. According to the WHO, low-income countries — with the highest risk of death from measles — continue to have the lowest vaccination rates, only 66 percent.

The battle against measles requires a big — not a meh — effort.