The Milbank Quarterly   |  June 9, 2019

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Measles was officially eliminated from the United States in 2000, yet it and other childhood diseases (chickenpox, mumps, pertussis) have surged. This year is on track to have the most measles cases since 2000. The reason is dangerously low vaccination rates, often clustered in insular communities. “Herd immunity” or “community protection” requires 95% vaccine coverage. For “vaccine deniers,” no evidence will change their view. But most “vaccine hesitant” parents are unsure whom to trust, want to do what’s best for their children, and are reachable through honest education. Here, I offer a national action plan to achieve full community protection. However, first I need to explain why well-intentioned, often punitive, policies will only backfire.

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