A sharp decline in childhood vaccination rates could open the door to a resurgence of measles and other long-eliminated diseases in the United States, according to new research published Thursday in JAMA.
The study warns that even at current immunization levels, the country may no longer be shielded from the return of measles as a regularly circulating virus.
Using simulation models covering all 50 states and Washington, DC, researchers from Stanford University and the University of California, San Francisco projected the impact of various vaccine coverage scenarios over the next 25 years. They found that with existing vaccination rates, measles has an 83% chance of becoming endemic again, resulting in more than 850,000 cases.
A 10% drop in measles-mumps-rubella (MMR) vaccination could push that figure to 11.1 million cases over the same period, the report noted.
A more severe 50% drop in childhood vaccination could bring 51 million measles cases, along with 10 million rubella cases, over 4 million polio infections, and hundreds of diphtheria cases. That scenario would result in an estimated 159,000 deaths and more than 10 million hospitalizations, the study found.
While the focus of public health efforts has long centered on immunization, at least one biotech company is now pursuing a pharmaceutical approach to measles treatment. Connecticut-based NanoViricides (NYSE-A:NNVC) has begun preclinical work to assess its antiviral NV-387 against the measles virus.
“A drug for measles is at present a completely missing link in the response to measles virus outbreak,” said Anil Diwan, executive chairman of NanoViricides. “Viral spread cannot be contained without an effective drug to minimize illness and stop the virus transmission from the patients.”
The company plans to test NV-387 in laboratory settings using cell cultures and animal models. Diwan argued that a therapeutic is essential in complementing vaccination campaigns, particularly in outbreak scenarios.
“Without a drug, there is no help for the patients, and the virus continues to expand its reach, in spite of increased vaccination campaigns,” he said. “The leading scientists should support our efforts at developing NV-387 and enabling a true victory over the measles virus, rather than merely clamoring about the vaccine.”
NanoViricides said NV-387’s mechanism of action is designed to remain effective even as viruses mutate—a factor that could be advantageous in future outbreaks.
The JAMA study, authored by a team that includes vaccine expert Dr. Peter Hotez and UCSF physician-scientist Dr. Nathan Lo, emphasizes that preventing resurgence through routine immunization remains the most effective public health strategy. Measles transmission could return to endemic levels within five years under the most severe decline scenario, while rubella and polio could follow in roughly two decades.
The findings offer a stark warning: vaccine-preventable diseases that had all but vanished from the US could return in force if immunization rates continue to slide.