1,748 Measles Cases

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

From CDC:

As of April 16, 2026, 1,748 confirmed* measles cases were reported in the United States in 2026. Among these, 1,738 measles cases were reported by 33 jurisdictions: Alaska, Arizona, California, Colorado, Florida, Georgia, Idaho, Illinois, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, and Wisconsin. A total of 10 measles cases were reported among international visitors to the United States.

There have been 19 new outbreaks** reported in 2026, and 94% of confirmed cases (1,637 of 1,748) are outbreak-associated (388 from outbreaks starting in 2026 and 1,249 from outbreaks that started in 2025).

  Sheryl Gay Stolberg and Dani Blum at NYT report on RFK Jr's appearances at hearings yesterday.

:When asked during his confirmation hearings if he could “assure mothers, unequivocally, that the measles and hepatitis B vaccines do not cause autism?” he said he would do so only “if the data showed” that the assertion was true. The scientific consensus is that there is no link between the measles vaccine and autism. Appearing on Capitol Hill Thursday for the first of seven hearings on Mr. Trump’s budget, Mr. Kennedy sparred with members of two House committees on vaccines and Mr. Trump’s granting of clemency to a nursing home entrepreneur.

....

A recent poll by the nonpartisan Annenberg Public Policy Center found that fewer than 40 percent of Americans were very confident or somewhat confident that Mr. Kennedy is providing the public with “trustworthy” information. More than half of Americans felt that way about Dr. Anthony S. Fauci, the former director of the National Institute of Allergy and Infectious Diseases, whom Mr. Kennedy has criticized.

Mr. Kennedy’s stance on vaccines, and his effort to roll back longstanding vaccine policy, has become a sore point with the White House, which has made clear that it wants him to pivot away from talking about vaccines and stress more bipartisan issues, like healthy eating, ahead of November’s midterm elections.

...

Republicans mostly threw Mr. Kennedy softball questions about topics like ultraprocessed foods and other of the health secretary’s priorities.

But one Republican, Representative Blake Moore of Utah, who said he was the father of a 10-year-old neurodivergent son, told Robert F. Kennedy Jr. that he was “underwhelmed” with the Trump administration’s efforts on autism. He cited in particular Mr. Trump’s announcement in September — without any new evidence — that Tylenol might cause the disorder.

“My wife was hurt, and she felt for a split-second until we came to our senses and we talked about this, that there was any way she was responsible,” Mr. Moore said. “We don’t even know if she took Tylenol during her pregnancy, but that was a hurtful moment for her.” He urged the administration to do more to search for potential causes.

1,487 Measles Cases

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

In March, the US has already had more measles cases than in all of 2024.

From CDC:

As of March 19, 2026, 1,487 confirmed* measles cases were reported in the United States in 2026. Among these, 1,478 measles cases were reported by 32 jurisdictions: Alaska, Arizona, California, Colorado, Florida, Georgia, Idaho, Illinois, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, and Wisconsin. A total of 9 measles cases were reported among international visitors to the United States.

There have been 14 new outbreaks** reported in 2026, and 94% of confirmed cases (1,398 of 1,487) are outbreak-associated (323 from outbreaks starting in 2026 and 1,075 from outbreaks that started in 2025).

IEP Settlements and Inequality

In The Politics of Autism, I write about social services, special education and the Individuals with Disabilities Education Act.  Inequality is a big part of the story. 

Maddie Hanna at The Philadelphia Inquirer reports that Pennsylvania schools districts have spent millions to settle special education disputes.

To get a settlement with a school district over special education, first a child has to be identified by the district as requiring services — with an individualized education plan spelling out how the school will meet the student’s needs.

If parents disagree with what a district offers, they can take legal action by filing a due process complaint.

That can trigger formal hearings, which result in public decisions issued by hearing officers. But the vast majority of complaints are resolved through privately negotiated settlements.

As a result, most disputes around special education are happening out of the public eye, with little known about parents’ allegations or what districts are paying out.

“It’s something almost no one knows anything systematic, objective, and complete about,” said Perry Zirkel, a professor emeritus of education and law at Lehigh University.

In the Philadelphia collar counties, where special education-focused law firms have proliferated, lawyers say affluent parents, who know their rights and have the means to hire attorneys, are more likely to sue than poor ones.

The Individuals with Disabilities Education Act — the 1975 federal law entitling students to special education services — has never been fully funded by Congress, leaving schools vulnerable to litigation when they’re strapped to deliver the “free appropriate public education” the law requires, [Attorney Andrew] Faust said.

The IDEA is a “very much a rich-get-richer, poor-get-poorer statute,” Faust said, because unlike other civil rights laws, it relies on parents, not the government, to enforce it. [As my book notes, IDEA is not a civil rights law at all, but a "conditions of aid"law.]

Project 2025

 In The Politics of Autism, I write about social services, special education and the Individuals with Disabilities Education Act. 

Project 2025 of the Heritage Foundation has a long volume titled Mandate for Leadership: The Conservative Promise.  Page 326:

 The Office of Special Education and Rehabilitative Services (OSERS) houses nearly two dozen programs, ranging from funding for the Individuals with Disabilities Education Act (IDEA) and the National Technical Institute for the Deaf to Special Olympics Funding and the American Printing House for the Blind. Most IDEA funding should be converted into a no-strings formula block grant targeted at students with disabilities and distributed directly to local education agencies by Health and Human Service’s Administration for Community Living.

IDEA is not a civil rights statute.   Its requirements are conditions of federal aid -- also known as "strings."  "No strings" means "no requirements

Autistic College Students, Social Connections, Depression, and Anxiety

 In The Politics of Autism, I discuss the growing number of college students on the autism spectrum. 

 McKenney, E. E., Richards, J. K., Day, T. C., Brunwasser, S. M., Cucchiara, C. L., Kofner, B., McDonald, R. G., Gillespie-Lynch, K., Lamm, J., Kang, E., Lerner, M. D., & Gotham, K. O. (2024). Satisfaction with social connectedness is associated with depression and anxiety symptoms in neurodiverse first-semester college students. Autism, 0(0). 

https://doi.org/10.1177/13623613231216879

Lay abstract:

How satisfied people feel with their social connections and support is related to mental health outcomes for many different types of people. People may feel less socially connected at some times in their life—like when they start college. Feeling disconnected from others could lead to depression or anxiety. The transition to college may be especially difficult for autistic students as they are more likely to have difficulties adjusting socially. In our study, we asked 263 college students to answer questions about their emotions and social satisfaction twice per week during their first semester of college. We found that students who reported being less satisfied with their social connectedness (either at the beginning or throughout the semester) tended to express more symptoms of depression and anxiety. This relationship between social satisfaction and anxiety was even stronger for people who had a strong desire for social interaction (i.e. were more socially motivated). Students with more autistic traits tended to report more mood concerns, and they also reported being less satisfied with friendships at the beginning of the semester. This information may help to support ongoing efforts to better address mental health in autistic college students by encouraging efforts to improve social satisfaction.

Diabetes and Autism

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. Health problems are prominent among them.

Daniel Gilmore and colleagues have an article at Autism titled "Diabetes mellitus in privately insured autistic adults in the United States"

Lay abstract:

Diabetes is a chronic health condition that is challenging to manage. Estimates of how common diabetes is among non-autistic adults are available, but improved estimates for autistic adults are needed. The purpose of this study was to obtain improved diabetes estimates for autistic adults. We analyzed a large private health insurance claims database to estimate how common diabetes was among autistic adults, and how likely autistic adults were to have diabetes compared to non-autistic adults at 5-year age intervals throughout adulthood (e.g. 18–22, 23–27). We found that diabetes was more common among autistic adults than non-autistic adults and that autistic adults were significantly more likely than non-autistic adults to have diabetes throughout most of adulthood. Our findings suggest that autistic adults may be more likely than non-autistic adults to experience diabetes in adulthood. The development of diabetes support services and programs that accommodate autistic adults’ individual needs are important for future study to promote positive diabetes outcomes for autistic adults.

Employment Services

In The Politics of Autism, I discuss the employment of adults with autism and other developmental disabilities.   I presented a paper titled "Autism and Accountability" at the 2020 Annual Meeting of the American Political Science Association. The abstract:

We expect policymakers to be accountable to the public for their handling of public issues. The case of autism presents fundamental difficulties. First, the boundaries of autism have shifted over the years, and they remain contested. Second, there are multiple publics with radically different views about the character of the issue. Third, there is no single “autism policy.” Instead, the issue spans multiple issue areas where responsibility is diffused and the connections between policy outputs and outcomes are difficult to establish. The paper ends with modest recommendations for improving our knowledge base.

Anne M. Roux and colleagues have an article at Milbank Quarterly titled "Unrealized Cross-System Opportunities to Improve Employment and Employment-Related Services Among Autistic Individuals."  Policy Points:

• Employment is a key social determinant of health and well-being for the estimated 5.4 million autistic adults in the United States—just as it is for citizens without disabilities. Evaluation and monitoring of publicly funded employment services is paramount given the dramatic increases in adults with autism who need job supports.
• Vocational Rehabilitation agencies appeared to be absorbing short-term employment needs of autistic people, but Medicaid was severely lacking—and losing ground—in serving those who need longer-term employment services.
• Across both Vocational Rehabilitation and Medicaid, we estimated that only 1.1% of working-age autistic adults who potentially need employment services are actually receiving them—leaving an estimated 1.98 million autistic individuals without the employment services that are associated with achievement of well-being.

From the article:

In general, state VR [vocational rehab] agencies administer short-term vocational services using a ratio of 79% federal funding granted by the RSA to 21% state matching funds.29 VR services do not have income eligibility thresholds but do require evidence of functional limitations that restrict ability to work. In contrast, Medicaid HCBS 1915(c) waivers fund long-term supported employment services and related supports using proportions of state dollars and federal matching funds,30 which generally vary between 50% and 75%.31 Eligibility for HCBS waivers is based on both disability and income criteria set by states, which range from 83% to 300% of the federal poverty level.32 Both VR and Medicaid guidance prioritize employment in community-based settings integrated with workers without disabilities.33,34 Legal and administrative infrastructure that support these priorities include a revision to Medicaid HCBS federal regulations known as the “HCBS Settings Rule,” the Workforce Innovation and Opportunity Act (WIOA) of 2014 (formerly the Rehabilitation Opportunities to Improve Employment Autism 5 Services Act) governing VR, Department of Justice actions to enforce integration in least restrictive settings, and state definitions of integrated employment.

However, a complicated relationship exists between VR- and Medicaid-funded employment services. Federal policies, including the WIOA, require that Medicaid and VR avoid duplication of services while simultaneously facilitating coordination across these service systems.33 For example, Medicaid HCBS policy requires that individuals exhaust VR employment supports before Medicaid waiver funds can be utilized.30 Meanwhile, the WIOA emphasizes that state VR agencies formally collaborate with the state Medicaid agency and state I/DD agencies in delivery of vocational services.34 Publicly available information illuminating how collaboration is executed in terms of service delivery and payment across systems, however, is limited.35

The degree of complexity within and between VR- and Medicaid-funded employment services is reflected in the administrative burden that autistic people and their families encounter when attempting to access and navigate services through these programs. Administrative burden includes effort required to understand the services these programs fund, psychological costs of being found ineligible for services and having to reapply, and compliance costs in dealing with requirements such as documentation.36 Service seekers weigh these costs against the assumed benefits of accessing services, and this self-assessment is influenced by other stressors in the person’s life and perceptions of how respectfully they are treated within administrative processes.37 Perhaps as a result of administrative burden, in addition to a scarcity of needed employment services, parents of autistic youth and those with other developmental disabilities describe encountering a “services cliff” as youth exit the special education services they were entitled to during high school and enter the fragmented world of adult disability-related services, each with its own administrative burden.8,38 

8. Roux AM, Shattuck PT, Rast JE, Rava JA, Anderson KA. National Autism Indicators Report: Transition into Young Adulthood. A.J. Drexel Autism Institute; 2015. Accessed March 27, 2023. https://policyimpactproject.org/transitioninto-young-adulthood-full-re

 29. Rehabilitation Act: Vocational Rehabilitation State Grants. Congressional Research Service; 2014. Accessed March 23, 2023. https://www.everycrsreport.com/files/20141230_R43855_d5a0c2acc49edfe1fa726907c4d8cad01b94de2d.pdf 

30. Butterworth J, Winsor J, Smith FA, et al. StateData: The National Report on Employment Services and Outcomes. Institute for Community Inclusion; 2015. Accessed March 27, 2023. https://scholarworks.umb.edu/ici_pubs/74/

31. Federal medical assistance percentage (FMAP) for Medicaid and multiplier.Kaiser Family Foundation. Accessed August 9, 2021. https://www.kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/

32. State financial eligibility criteria for Medicaid HCBS waivers by target population. Kaiser Family Foundation. Accessed March 23, 2023.https://www.kff.org/other/state-indicator/state-financial-eligibility-criteriafor-medicaid-hcbs-waivers-by-target-population

33. Updates to the Section 1915(c) Waiver Instructions and Technical Guide regarding employment and employment related services. Centers for Medicare & Medicaid Services. September 16, 2011. Accessed June 22, 2022.https://www.hhs.gov/guidance/document/updates-1915c-waiver-instructionsand-technical-guide-regarding-employment-and-employment

34. The State Vocational Rehabilitation Services Program Before and After Enactment ofthe Workforce Innovation and Opportunity Act in 2014. Rehabilitation Services Administration; 2020. Accessed March 17, 2023. https://rsa.ed.gov/sites/default/files/publications/state-of-vr-program-after-wioa.pdf

35. Boeltzig H, Winsor J, Haines K. Research to Practice: Collaboration betweenState Intellectual and Developmental Disabilities Agencies and State Vocational Rehabilitation Agencies: Results of a National Survey. Institute for Community Inclusion; 2011. Accessed March 23, 2023. http://scholarworks.umb.edu/ici_researchtopractice/3

36. Moynihan D, Herd P, Harvey H. Administrative burden: learning, psychological, and compliance costs in citizen-state interactions. J Public Adm Res Theory.2015;25(1):43-69. https://doi.org/10.1093/jopart/muu009

37. Herd P, Moynihan D. Administrative burdens in health policy. J Health HumServ Adm. 2020;43(1):3-16. doi:10.37808/jhhsa.43.1.2

38. Bagenstos SR. The disability cliff. Democracy. 2015;(35):55-67.

RFK and Wakefield

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.

Derek Beres, Matthew Remski, and Julian Walker at Time:

By 2019, Kennedy was the leading buyer of antivax ads on Facebook, and was implicated in a measles outbreak in Samoa that infected 5,700 and killed 83. The outbreak followed the tragic deaths of two children who had received contaminated vaccines. Kennedy traveled to Samoa, and was pictured with a local antivax advocate. This was followed by Children’s Health Defense sending a letter to the Prime Minister of Samoa, urging him to question the general safety of the Measles, Mumps, & Rubella (MMR) vaccine. This tragedy echoed the measles outbreaks in Somali immigrant communities in Minnesota in 2011 and 2017.

The Somalis had been specifically targeted by the antivax propagandist Andrew Wakefield, whose falsified 1998 study started the still-lingering conspiracy theory that the MMR vaccine causes autism. More than a year before Kennedy lost his Instagram account for spreading medical misinformation, he used it to sing Wakefield’s praises, dubbing him “among the most unjustly vilified figures of modern history.” In 2021, the Center for Countering Digital Hate linked Kennedy on their list of the 12 influencers responsible for up to 73% of all antivax content on Facebook, and 65% of all digital antivax content overall. (Kennedy was reinstated to Instagram on June 4, 2023, on the grounds that he’s running for president.)

Discrimination in Kidney Transplants

In The Politics of Autism, I discuss the civil rights of people with autism and other disabilities.   A number of posts have provided details on discrimination in organ transplantation.

Brittany N. Hand and colleagues have an article at JAMA Surgery titled "Comparing Kidney Transplant Rates and Outcomes Among Adults With and Without Intellectual and Developmental Disabilities."

Key Points

Question How do rates of kidney transplant and transplant outcomes differ for adults with vs adults without intellectual and developmental disabilities (IDD)? [see 2/16/23 post]

Findings In this cohort study, adults with IDD were 54% less likely to be evaluated for and 62% less likely to receive a kidney transplant than adults without IDD. However, among those who received a kidney transplant, postoperative outcomes were similar for adults with and without IDD.

Meaning These data suggest the IDD should not categorically disqualify adults from transplant and underscore the urgent need for antidiscrimination initiatives to promote the receipt of equitable care for this population.
Abstract

Importance Improving equity in organ transplant access for people with intellectual and developmental disabilities (IDD) is a topic of social discourse in mainstream media, state legislation, and national legislation. However, few studies have compared evaluation rates, transplant rates, and outcomes among adults with and without IDD.

Objective To compare rates of kidney transplant and transplant-specific outcomes between propensity–score matched groups of adults with end-stage kidney disease (ESKD [also referred to as end-stage renal disease (ESRD)]) with and without co-occurring IDD.

Design, Setting, and Participants This retrospective cohort study included all Medicare inpatient and outpatient standard analytical files from 2013 through 2020. A total of 1 413 655 adult Medicare beneficiaries with ESKD were identified. Propensity–score matching was used to balance cohorts based on age, sex, race, follow-up duration, and Charlson Comorbidity Index. The matched cohorts consisted of 21 384 adults with ESKD (10 692 of whom had IDD) and 1258 kidney transplant recipients (629 of whom had IDD). Data were analyzed between June 1, 2022, and August 1, 2022.

Exposure IDD.

Main Outcomes and Measures Evaluation for kidney transplant, receipt of kidney transplant, perioperative complications, readmission, mortality, graft rejection, and graft failure.

Results Of the 21 384 propensity–score matched adults with ESKD, the median (IQR) age was 55 (43-65) years, 39.2% were male, 27.4% were Black, 64.1% were White, and 8.5% identified as another race or ethnicity. After propensity score matching within the ESKD cohort, 633 patients with IDD (5.9%) received a kidney transplant compared with 1367 of adults without IDD (12.8%). Adults with IDD were 54% less likely than matched peers without IDD to be evaluated for transplant (odds ratio, 0.46; 95% CI, 0.43-0.50) and 62% less likely to receive a kidney transplant (odds ratio, 0.38; 95% CI, 0.34-0.42). Among matched cohorts of kidney transplant recipients, rates of perioperative complications, readmission, and graft failure were similar for adults with and without IDD.

Conclusions and Relevance Using the largest cohort of adult kidney transplant recipients with IDD to date, the study team found that rates of evaluation and transplant were lower despite yielding equivalent outcomes. These data support consideration of adults with IDD for kidney transplant and underscore the urgent need for antidiscrimination initiatives to promote the receipt of equitable care for this population.

RFK Jr is Still Pushing the Autism Myth

 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.

Isabelle Han at The Dartmouth:

On April 26, the Concerned Alumni of Dartmouth College hosted a sold-out roundtable discussion titled “Important Conversations Never Had — College COVID-19 Vaccine Mandates: Scientific, Legal and Ethical Considerations” at the Hanover Inn, followed by a speech from lawyer and presidential candidate Robert F. Kennedy Jr. A Q&A session had originally been scheduled to take place after the panel, but the segment was canceled after Kennedy announced his last-minute appearance at the event, according to Michael Koss, a member of Concerned Alumni of Dartmouth College.

...

Kennedy’s speech, which replaced the advertised Q&A, lasted for approximately 30 minutes and focused on the claim that vaccines cause autism in children.

“We have solid proof that they are causing more harm than [good]… that they are killing our children,” Kennedy said. “And yet a thousand colleges in this country still have these [COVID-19 vaccine] mandates.”

Kennedy added that he has met multiple women with children who have intellectual disabilities, which they believe “were caused by vaccines.” He pointed to the statistic that the rate of autism in children has increased as vaccination numbers have also increased.

“In my generation, [the rate of autism] is still one in 10,000,” Kennedy said. “In my kids’ generation, one in 34 kids have the diagnosis.”

According to the National Institutes of Health, while the rate of autism among children has risen since initial estimates in the 1960s, the diagnostic criteria used to classify the disorder has also expanded. The claim that vaccines cause autism has also been disproven, according to the CDC.

Kennedy added that he is not “anti-vaccine” but skeptical because there is no “placebo-controlled” study that proves that vaccines are safe. However, all vaccines approved for use in the United States are subject to placebo testing, according to the Food and Drug Administration.