Growing up, I always thought of my dad as one of six siblings. But he was actually one of seven.
In my fourth year of medical school, I was driving my grandmother home for Thanksgiving, and she started talking to me about her third child, a baby girl. There was a new combined vaccine available, but my grandparents were worried about it, so the baby did not get it. Their baby died of pertussis when she was a month old. My grandmother told me she thought about her daughter every day.
My grandparents were not bad parents — they were good parents who were scared. Eventually, I graduated medical school and went on to do a combined residency in internal medicine and pediatrics and a fellowship in pediatric critical care medicine. Over the span of 20 years and multiple institutions, I have taken care of countless infants and children who did not get the recommended vaccinations, including a small subset of those who died from vaccine-preventable diseases.
Vaccine-preventable diseases include measles, pertussis, some forms of pneumonia and meningitis, tetanus, mumps, rubella, polio, rotavirus, human papillomavirus (which can lead to cervical cancer), respiratory syncytial virus and influenza, among many others. Vaccinations have accounted for over 40% of the decline in infant mortality over the last 50 years and prevent four million childhood deaths per year. Despite this, we have seen vaccine rates decline in kindergarten aged children over the last several years.
News broke that a school-aged child died of measles in February. Tragically, a second child passed away from measles earlier this month. There have been over 600 confirmed cases in 22 jurisdictions in 2025 alone, and most of those are concentrated in regions associated with outbreaks (three or more infections noted). Because few people have a living memory of measles, many people associate it with a benign infection. About one in five unvaccinated children who contract the illness are hospitalized, and measles can lead to pneumonia, deafness, intellectual disability or even death.
Measles is extremely contagious. Ninety percent of those who are exposed will contract it if they are not immunized or otherwise protected. Symptoms include cough, runny nose, fever and red and watery eyes. It is spread in the air when an infected person coughs or sneezes, and since those droplets can linger on surfaces, it can last in a room for up to two hours. That means you can be exposed to measles without ever physically encountering a person who is infected. Measles is especially dangerous for infants and young children, pregnant people and immunocompromised people.
Luckily, we have an extremely effective and safe vaccine for measles, and despite the decline in vaccination rates, most parents choose to immunize their children. If the vaccination rate remains over 95% in the community, vulnerable people are protected. When this rate falls, there is a risk for an outbreak, which is what we are seeing now.
There is a lot of misinformation and disinformation on the internet and in the news, and it is easy to be wary in the face of such an onslaught. People do not know who or what to trust, and so it might seem safer to not vaccinate, especially if the true dangers of a particular pathogen are minimized. By having ongoing, open, evidence-based discussions, I hope that pediatricians can decrease the hesitations felt by many. The medical community also needs to work to make sure that immunizations are easily available and affordable to anyone who is eligible for one.
I hope that my grandparents were treated with compassion by their child’s doctors. I have never forgotten the pain in my grandma’s voice. I told her it was not her fault, and I believe that. I do not blame parents of children who get ill, but do work to educate other parents so that other children do not share the same fate. I have dedicated my professional life to taking care of the sickest and most vulnerable patients, but I also work to keep children out of my intensive care unit in the first place. Pediatricians and organizations like the American Academy of Pediatrics can help. If a child is behind on their vaccinations, we can help catch them up. I urge parents to work with trusted doctors, call their doctors if they or their children are exhibiting signs of infectious illnesses and provide their children with all of the recommended immunizations.
Dr. Deanna Behrens is a fellow of the American Academy of Pediatrics and a member of the Illinois Chapter of the American Academy of Pediatrics.
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