The Compliance Divas Podcast
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The Compliance Divas Podcast
#240 When Immunity Fades: Inside the 2026 Measles Surge
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A deep‑dive conversation on the 2026 U.S. measles outbreak—now one of the most significant resurgences in decades. The episode explores why cases are rising, how past outbreaks set the stage for today’s vulnerabilities, and why immune amnesia is a growing concern for clinicians, parents, and public health leaders.
Resources:
- CDC Measles Cases and Outbreaks https://www.cdc.gov/measles/data-research/index.html
- American Society for Microbiology - Measles and Immune Amnesia https://asm.org/articles/2019/may/measles-and-immune-amnesia
- National Institute of Health - National Library of Medicine - Measles Wipes out Immune System's Memory, Study Finds https://www.ncbi.nlm.nih.gov/search/research-news/7353/
- Schulich School of Medicine & Dentistry - What is "immune amnesia"? This long -term side effect of measles is newly relevant. https://bit.ly/4rAfydx
A measles outbreak once felt like history, but 2026 has made it a headline again. When a virus this contagious collides with falling immunity and the threat of immune amnesia, the ripple effects reach far beyond the initial infection. Welcome to the Compliance Evans podcast. This is Linda Harvey. I'll be your moderator today. And we'll be discussing when immunity fades inside the 2026 metal surge. Let's get right to the heart of the topic, Mary. Would you please start the conversation off for us and let's set the stage and why this why our conversation today is different than other conversations on measles?
SPEAKER_01Well, as you said, Linda, this concept of immune amnesia is a game changer. Many people still think of measles as a minor childhood disease, that the kids get over it and they sometimes are hospitalized, but they don't think about the consequences to adults. And what we're seeing is kind of the perfect storm. We thought that because of measles vaccine and the effectiveness of the vaccine, that measles was essentially eliminated as a public health threat in the US in the year 2000. And we remained that way until the late 1900s, early 2000s, when we started hearing information about the relationship, which has been disproven, by the way, between the MMR vaccine and autism. And so that created a lot of vaccine hesitancy and resulting in the resurgence of measles through the past 20 years or so. And it's really peaked in the last few years, 2025, 2026. We've seen a whole lot of cases. As of March of this year, right now there are 1,362 confirmed cases of measles. Contrast that with all of 2025 having 2,284 cases. So we're over halfway ahead of 2025, and we're only in the first quarter of the year. So we've seen some very, very serious numbers. And these cases of measles, 94% of them are linked to outbreaks. And an outbreak is defined as three connected cases or more. The problem with measles is it's one of the most infectious diseases, if not the most contagious. And it is so easy to spread from person to person or from aerosols that remain in the air for up to two hours after a person has left an area, left a room, left a dental office, that we have the continued potential for exposure. So you combine that infectivity and less people who are immunized, meaning from childhood, and we have adults now whose immunity in many cases has declined and they may need boosters and don't think about it or don't realize that. So now what we're seeing is the result of that. The other complication is global travel. Global travel has increased so much over the last 20 years or so, and measles is prevalent in other countries as well, maybe even more so in some countries than it has been in the US. So now you have people traveling from the US to these countries. They get infected, can come back and expose people maybe when they're on the plane or when they come home. Or you have unvaccinated or infectious people coming from those countries where measles are prevalent into the US and infecting people. So that alone, just the cases spreading, now combined with this research on immune amnesia, is really scary. And we're going to talk about immune amnesia a little bit later in the podcast.
SPEAKER_00Mary, that information almost makes me want to go back and wear a mask again. And I'm not an alarmist by any stretch of the imagination. I just want to be safe and protected. So I'll be speaking to my physician again about boosters and so forth, what needs to be happening, you know, checking my immunity levels of different with different diseases. So it's something that we really be have to be aware of in our practice because as you mentioned, the first quarter is not even over. And we're already half half as many cases as we had of all of 2025. So it's just good that we keep our finger in the pulse. So thank you, Mary, for that wonderful information. Leslie, if you could help us out, let's take a walk back through history for just a minute and talk about some of the previous outbreaks so we can bring that forward and really keep it tied in because I think that's an important component for our listeners to understand a little bit of the history. So it's not that we're just uh sounding an alarm here, but we just want everybody to stay connected and understand how this is all rolling out.
SPEAKER_02Well, you know, Linda, it's so interesting to look back over time. Really, in most pediatric practices, they've never seen a case of the measles in the last 26 years or so. And uh an interesting outbreak that brought this back front and center to focus of attention was the Disneyland outbreak in 2014. And because measles is such a highly contagious respiratory infection and it had been essentially eradicated from our country, we see cases occasionally come in from other countries, as Mary mentioned. And so the measles case in Disneyland was really something interesting because it was not a strain found here in the United States. It was something that they were found circulating in another part of the world. There were 125 people from six states who were part of that Disney outbreak. And the majority of those who got the measles were unvaccinated. So again, measles is common in many parts of the world, Europe, Asia, the Pacific, Africa, and people who travel with measles, of course, they can bring it to the United States. And I just want to, you know, interject my own personal um opinion here is that you know, if I was invited to go to Disneyland and I came from another country to go to Disneyland, you would find me hard-pressed to stay in my hotel room in bed because I didn't feel well, because I was coughing or sniffling. I would still be out enjoying Disney. And so I can see how visitors to our country would have gone to the park. And you know, Disneyland, if you everyone remembers, you walk in lines where you're uh shoulder to shoulder with other people, and you you pass sometimes those same people and the lines back and forth as they zigzag through. So I can see how easily measles would spread. And as Mary mentioned, it's something that can remain for two hours or so in the air. And it many of the rides are indoors in Disneyland, passing through the same air that other people have been breathing, coughing, maybe someone that's sick might be spreading more easily. So, with that Disney case, it was actually the largest outbreak that we had seen since we had thought our measles had been eradicated. There was another outbreak in 2019 where we had 1,274 cases, and that was in New York. It is just kind of mind-blowing how quickly we're seeing this spread for a disease for which we had thought we had completely eliminated in the United States. So, reflecting on the lessons learned, the individuals who are not vaccinated have a very high chance of catching the measles, and those who are vaccinated have a very high chance, I mean high 90s percentile of not getting the measles if they're exposed to that virus.
SPEAKER_00Thank you, Leslie. That's some valuable information to really put a full perspective to what's happening with the measles outbreak across the different years. And I appreciate you sharing that detailed information. And that brings us back to the question then why is 2026 different? You know, as Mary mentioned, we've got half the number of cases that we had last year already, and this is not even the end of March of 2026. And so far the geographic spread has been across more than 30 jurisdictions, showing how widespread the vulnerabilities to measles has become. And so thinking about, oh, I had it when I was a child, or I'm not going to catch it. We still need to be mindful of what's happening in our own communities. You both have mentioned, Mary Ann Leslie, the global factor and the post-pandemic immunization disruptions. We didn't talk about that yet. People that didn't get vaccinated, they weren't seeing their physicians, things were focusing on COVID and COVID vaccinations for that period of time. And coupled with international travel and all the global surges is coming into our country on a regular basis. So, Mary, could you bring us back then to something you mentioned earlier? And that was the immune amnesia. What kind of public health implications does that have?
SPEAKER_01That has huge public health implications, Linda. The whole concept of immune amnesia is one that we've really not heard much about until just recently. And what can happen to anyone, but particularly an adult, if they have measles, the virus can destroy immune cells in the body and literally erase the body's memory of previously encountered infections. And we've talked about this idea of immune memory in the past related to the hepatitis B vaccine, that some people are non-responders to the vaccine, meaning they don't keep the antibody markers circulating at high enough levels to detect in the bloodstream all the time. But the belief has been that your immunologic memory could kick in if you were exposed to hepatitis B and then produce antibodies on demand. That happens with pneumonia, it happens with influenza, it happens with lots of different types of infectious diseases, vaccine-preventable diseases in particular. And so the long-term impact could be that not only are you not immune to measles, that you could lose your immunity to all other diseases for up to five years. They're saying perhaps two to five year time span. So then you may need to be revaccinated for many of those diseases. And we know that we have so many newer vaccines out now, like the RSV vaccine. There's a new bacterial pneumonia vaccine that's out for older adults. So this is, as I said before, I think this is a huge issue that an infectious virus could literally wipe out our immune system and cause us to be more susceptible to other diseases. And again, you mix that in with fewer people being vaccinated to begin with, so they can spread measles or other infectious diseases more easily, and international travel coming and going from our country, and it just has disaster written all over it. We could have epidemics or pandemics of other infectious diseases because of this immune amnesia.
SPEAKER_00Okay, Mary. I think you have our listeners' attention with all of that because the fear of losing your immunity to other illnesses for a period of up till five years is a pretty serious situation if it occurs. So thank you for sharing that. So, Demas, let's take a moment now and just reflect on the information that we've shared and pull it into some succinct points and reflections for our listeners to take back today. Leslie, what thoughts do you have?
SPEAKER_02Linda, one of the most interesting things lately is after having information about having immunity for measles, if you've vaccinated, nowadays we're hearing that older adults, mostly adults that were either born during or after 1957, need at least one dose of the measles, mumps, rubella vaccination. While high-risk adults, people who are travelers or healthcare workers, college students, require two doses. And a booster is generally not needed if you have documentation of two doses or were born before 1957. However, today the conversation has switched to check with your physician and see if your physician recommends a measles booster for you. That seems to be what I'm hearing. And, you know, one of the things that we also want to keep in mind is that there are communities of individuals who don't vaccinate, which are also some of the ways we're finding this transmission occurring. And so there's a lot of reasons for non-vaccination. And of course, you know, we want to be respectful of all, but there's religious beliefs and distrust and misinformation, access barriers, of course, uh, perception of risk or benefit, what you know, balancing those out. So just bear in mind again, each person on their own individual basis should be checking with their physician to see what is recommended for them in their community and with the spread that we're seeing today.
SPEAKER_00Perfect. Thank you so much, Leslie. Mary, could you please take us back then as our reflection and talk about how long have we known about immune amnesia and what's the urgency of restoring vaccination confidence? Because you mentioned that earlier too.
SPEAKER_01Vaccine confidence is just such a scary sort of topic right now because we're getting lots of mixed messages from health officials throughout the country. The concept of immune amnesia isn't new, but it was linked to measles around 2015. And it's not really been discussed a lot, especially not in dental circles, because we haven't had this big resurgence of measles until now. So now we do need to be concerned about this because it's not just the effect, and we didn't really mention that, but there's serious complications to measles if you even if you set that whole issue of immune amnesia aside, encephalitis, pneumonia, you can die from measles. And last year we had three pediatric deaths from measles, but now that the measles are more prevalent, now this whole issue of this immune amnesia raises its ugly head. So now you can, you know, have secondary infections based on uh a measles infection if it wipes out your immune system and they're saying somewhere around 73% of an immune system can be wiped out. That's a that's a scary, scary number. So again, not new, but very important, so much so that the CDC has issued some alerts and some warnings about this because we know that as measles cases increase, then the potential for immune amnesia increases along with it.
SPEAKER_00Beautiful recap, Davis. Thank you so much. And I will just add to that that this really emphasizes the need for coordinated public health communication. Well, this is outside the purview of a of the average dental practice, but we still need to be, you know, as I keep saying, we still need to be, it sounds like uh preaching to the choir here, but it's important to stay abreast of what those communications are by checking your state and county public health department websites and helping to share that information as needed with your patients and family members. Today we really looked at measles a little differently than we have in the past. We talked about the severity and the growing numbers of this outbreak and only in the first quarter of 2026. So it really reinforces the fact that measles is not a benign childhood illness. Its complications, including immune amnesia, have long-term consequences. So as we wrap up our podcast today, I'd like to leave you with a thoughts about the importance of vaccination. Okay, staying vigilant about what's going on in your communities and the community level prevention. As at Compliance Divas, we bring clarity and simplicity to compliance to navigate your world to keep you on course. We invite you to subscribe by joining at our website at compliancedevas.com or your favorite podcast channel. We always welcome your questions to support at the compliancedevas.com. And please scroll down to the bottom of this podcast to see the resource citations that we have for you, and as well, invite you to leave us a review or a comment. We'll see you next time.