Amid ongoing chaos and confusion, our teams are already witnessing some of the life-threatening consequences of the administration’s actions to date. Most recently, the US administration cancelled nearly all humanitarian assistance programmes in Yemen and Afghanistan, two countries facing some of the most severe humanitarian needs in the world. After years of conflict and compounding crises, an estimated 19.5 million people in Yemen — over half the population — are dependent on aid. The decision to punish civilians caught in these two conflicts undermines the principles of humanitarian assistance.

Across the world, MSF teams have witnessed US-funded organisations reducing or cancelling other vital activities –including vaccination campaigns, protection and care for people caught in areas of conflict, sexual and reproductive health services, the provision of clean water, and adequate sanitation services.

“It’s shocking to see the US abandon its leadership role in advancing global health and humanitarian efforts,” says Benoît. “US assistance has been a lifeline for millions of people–while yanking this support will lead to more preventable deaths and untold suffering around the world. We can’t accept this dangerous new normal. We urge the administration and Congress to maintain commitments to support critical global health and humanitarian aid.”

Snapshot: How US aid cuts are impacting people worldwide

Malnutrition: US funding cuts are severely impacting people in areas of Somalia affected by chronic drought, food insecurity, and displacement due to conflict. In the Baidoa and Mudug regions, the scaling down of operations by aid organisations — driven by US funding cuts and a broader lack of humanitarian aid — is making a shortage of health services and nutrition programmes even more critical. For example, the closure of maternal and child health clinics and a therapeutic feeding centre in Baidoa cut off monthly care to hundreds of malnourished children. MSF nutrition programmes in Baidoa have reported an increase in severe acute malnutrition admissions since the funding cuts. The MSF-supported Bay Regional hospital has received patients traveling as far as 190 kilometres for care due to facility closures elsewhere.

HIV: Cuts to PEPFAR and USAID have led to suspensions and closures of HIV programmes in countries including South Africa, Uganda, and Zimbabwe — threatening the lives of people receiving antiretroviral (ARV) therapy. South Africa’s pioneering Treatment Action Campaign — which helped transform the country’s response to HIV/AIDS — has had to drastically reduce its community-led monitoring system that helps ensure that people stay on treatment. The monitoring is now only happening at a small scale at clinics. In MSF’s programme in San Pedro Sula, Honduras, there has been a 70% increase in pre-exposure prophylaxis (PrEP) tablet distribution from January to March compared to the previous quarter, as well as an increase of 30% in consultations for health services, including for HIV — highlighting the growing demand as USAID funding cuts reduce access to other HIV prevention services.

Outbreaks: In the border regions across South Sudan and Ethiopia, MSF teams are responding to a rampant cholera outbreak amid escalating violence — while other organisations have scaled down their presence. According to our teams, a number of organisations, including Save the Children, have suspended mobile clinic activities in South Sudan’s Akobo County due to US aid cuts. Save the Children reported earlier this month that at least five children and three adults with cholera died while making the long, hot trek to seek treatment in this part of South Sudan. With the withdrawal of these organisations, local health authorities are now facing significant limitations in their ability to respond effectively to the outbreak. MSF has warned that the disruption of mobile services, combined with the reduced capacity of other actors to support oral vaccination campaigns, increases the risk of preventable deaths and the continued spread of this highly infectious disease.

Sexual and reproductive healthcare: MSF teams in more than 20 countries have reported concerns with disrupted or suspended sexual and reproductive health programmes, which MSF relies on for referrals for medical emergencies, supplies, and technical partnerships. These include contexts with already high levels of maternal and infant mortality. In Cox’s Bazar, Bangladesh — home to one of the world’s largest refugee camps — MSF teams report that other implementers are not able to provide supplies, like emergency birth kits and contraceptives. Referrals for medical emergencies, like post-abortion care, have also been disrupted, increasing urgent needs for sexual and reproductive care in the region.

Migration: Essential protection services — including shelters for women and children, legal aid, and support for survivors of violence — have been shuttered or severely reduced as needs increase due to changes in US immigration policy. For patients and MSF teams along the Central American migration route in areas like Danlí, San Pedro Sula, Tapachula, and Mexico City, referral networks have all but disappeared. This has left many migrants without safe places to sleep, access to food, or legal and psychosocial support.

Access to clean water: In the initial weeks following the aid freeze, our teams saw several organisations stop the distribution of drinking water for displaced people in conflict-affected areas, including in Sudan’s Darfur region, Ethiopia’s Tigray region, and Haiti’s capital, Port-au-Prince. In response to the crisis in Port-au-Prince, in March, MSF stepped in to run a water distribution system via tanker trucks to provide for more than 13,000 people living in four camps for communities displaced by violent clashes between armed groups and police. This was in addition to our regular activities focused on providing medical care for victims of violence. Ensuring access to clean drinking water is essential for health and preventing the spread of waterborne diseases like cholera.

Vaccination: The reported decision by the US to cut funding to Gavi (The Vaccine Alliance) could have disastrous consequences for children across the globe. The organisation estimated that the loss of US support is projected to deny approximately 75 million children routine vaccinations in the next five years, with more than 1.2 million children potentially dying as a result. Worldwide, more than half of the vaccines MSF uses come from local ministries of health and are procured through Gavi. We could see the impacts in places like the Democratic Republic of the Congo (DRC), where MSF vaccinates more children than anywhere else in the world. In 2023 alone, MSF vaccinated more than 2 million people in DRC against diseases like measles and cholera.

Mental health: In Ethiopia’s Kule refugee camp, where MSF teams run a health centre for more than 50,000 South Sudanese refugees, a US-funded organisation abruptly halted mental health and social services for victims and survivors of sexual violence and withdrew their staff. MSF teams provide other medical care but cannot currently cover the mental health and social services these patients need.

Non-communicable diseases: In Zimbabwe, US funding cuts have forced a local provider to stop its community outreach activities to identify women to be screened for cervical cancer. Cervical cancer is the leading cause of cancer-related death in Zimbabwe, even though it is preventable. Many women and girls — especially in rural areas — cannot afford or do not have access to diagnosis and treatment, which makes outreach, screening, and prevention activities vital.

Catalina Friesen, a personal support worker and Low German-speaking liaison, stands in front of a bus outfitted as a mobile walk-in clinic, in St. Thomas, Ont., May 20, 2025. THE CANADIAN PRESS/Hannah Alberga

Catalina Friesen, a personal support worker and Low German-speaking liaison, stands in front of a bus outfitted as a mobile walk-in clinic, in St. Thomas, Ont., May 20, 2025. THE CANADIAN PRESS/Hannah Alberga

Catalina Friesen got a call one night in February from one of her clients, a Low German-speaking mother in Aylmer, Ont. Her daughter had a rash that covered her body. The five-year-old had a fever and was coughing out of control.

“I said, ‘just take her to emerge, especially if she’s not eating or drinking,’” says Friesen, a personal support worker and liaison for a health clinic in St. Thomas, Ont., that caters to the Low German-speaking Mennonite community.

But her client said she already went to the hospital, and that they turned her away.

Friesen called the hospital and found out her client was told to go back to her car — standard practice for a measles patient while they prepare a negative-pressure room.

“But because they couldn’t understand exactly what they were saying, they thought they told them to go home,” says Friesen, of the misunderstanding.

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Friesen helps more than 700 Low German-speaking Mennonites navigate the health-care system in southwestern Ontario. She says she has guided at least 200 people through the current measles outbreak, translating test results and public health measures.

Every Thursday, she drives a bus outfitted as a walk-in-clinic to a church parking lot in Aylmer, Ont., that serves Low German-speaking Mennonites in the surrounding rural areas, where the community has been basedfor approximately 75 years.

Many of these families are from Mexico and have been migrating to the region for seasonal agricultural work since the 1950s, in some cases staying due to better economic opportunities.

Some drive from as far as Leamington, two hours away, for the clinic. Friesen says some don’t have health cards as they apply and wait for permanent resident status, and she estimatesabout half of the people she sees are vaccinated.

Friesen says communication and language barriers paired with a historic distrust in authoritieshas set the stage for a unique set of challenges during the largest measles outbreak the province has seen in almost three decades, infecting more than 2,000 people.

Many of them have been unvaccinated children in southwestern Ontario. On Thursday, Ontario’s Chief Medical Officer of Health Dr. Kieran Moore said an infant in the region who was born prematurely had died after getting measles from their mother.

As the outbreak continues to spread, health providers have had to reckon with why some standard approaches to managing a highly contagious virus do not work for all patient populations, and in doing so, address their own assumptions to better shapecommunication for the community.

Friesen innately knowshow to navigate some of these roadblocks because, she says, “They’re basically my people.”

She was born in a tiny Mexican town called Nuevo Ideal. She was around 10 years old when her family moved to Tillsonburg, southeast of London, Ont.

“When we moved here, it was extremely scary. I didn’t know what anybody was talking about. We got made fun of a lot. Most of my childhood, most of my school life, I got made of as the Mennonite, Low German-speaking, whatever you want to call us,” she says, with a nervous laugh.

At the time she says she only spoke a little English and wore hand-me-down clothes to school. Students said she had an accent, her braids were weird, she smelled bad.

Friesen brings this past with her when she sits across from patients on the mobile clinic bus, or when she accompanies them to appointments, who tell her about similar experiences. She says she has seen doctors and nurses talk down to her patients.

“It’s the stigmatism of – ‘You’re not from here. We don’t like you,'” she says of the way her patients feel when they are treated this way.

Dr. Ninh Tran, the head of the Southwestern Public Health unit, gives regular virtual updates on the region’s measles outbreak, and each week he holds a briefing, he is asked about unvaccinated Mennonites.

Every time, he warns the public of a false sense of safety that can come from blaming a single group for a widespread outbreak.

“Why name any specific groups when it’s not entirely representative of that group anyways?” Tran said in a recent interview on a cold and wet day in late May.

Southwestern Public Health said it does not report on faith-based denomination in its measles immunization data.

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In March, Dr. Moore sent a memo to local medical officers of health linking the rise of measles cases in the province to an exposure at a large Mennonite gathering in New Brunswick last fall, which thenspread to Ontario and Manitoba.

He wrote, “Cases could spread in any unvaccinated community or population but are disproportionately affecting some Mennonite, Amish, and other Anabaptist communities due to a combination of under-immunization and exposure to measles in certain areas.”

In an April interview with The Canadian Press he reasserted that the “vast majority” of Ontario’s cases are among people in those communities.

When asked about Moore’s memo in a subsequent media briefing, Tran again cautioned against singling out a group.

“It’s always nice to finger point at someone, but it’s not necessarily the reality … We’re seeing cases everywhere and in different groups, and really the main thing is vaccination.”

Speaking as a vaccinated Mennonite, Amanda Sawatzky says anyone who believes all Mennonites are unvaccinated is wrong. Just like any other population, some are immunized and some are not.

“To be clear, many, many many, many, Mennonites are vaccinated. Let’s not continue this narrative that this population group as a whole is not vaccinated,” says Sawatzky, who works in the social service sector and consults with health providerson best practices for working with Mennonites and newcomers in southwestern Ontario. She also has a Master of Social Work.

That’s not the only misconception about Mennonites, she says.

“We come from all walks of life and practice in different ways. Some of us dress traditionally and some of us don’t,” she says.

Sawatzky grew up in a Low German Mennonite village in Mexico’s northwestern Chihuahua state where all of the houses were on one side of a dirt road and fields of fava beans and corn were harvested on the other. She didn’t have indoor plumbing or hydrountil she was seven.

But now, she lives in a suburban house on a cul-de-sac in Leamington with a car parked in the driveway and a pool in the backyard. She sports a baby blue blazer and beige heels. She still identifies as a Mennonite.

There are approximately 60,000 Low German-speaking Mennonites living in southwestern Ontario, according to a 2024 guide by the Low German Speaking Mennonite Community of Practice in Elgin, St. Thomas, Oxford, and Norfolk.

Michelle Brenneman, executive director of Mennonite Central Committee Ontario, says that’s likely a low estimate.

She also notes there are more than 30 different groups that identify as Mennonite in Ontario and hold a variety of views on how to practice their faith, dress and live.

Sitting beside her, Linda Ruby, a Low German liaison adds,”There’s this assumption that Mennonites that are being talked about in the media are thesehorse-and-buggy-drivingMennonites. But Low German-speaking Mennonites do not drive a horse and a buggy at all, ever. They drive cars,” says Ruby.

Sawatzky says historical context dating back hundreds of years is relevant to understand the current outbreak. She says governments asked members of the Low German-speaking Mennonite community to work the land in exchange for absolute autonomy to run schools and preserve their faith, language, and culture.

But she says governments went back ontheir word in Europe, and then in Western Canada. Low German-speaking Mennonites left to Mexico and South American countries in the 1920s, but returned to Canada for better economic opportunities in the 1950s.

“Knowing what I’ve explained about the migration and the government taking back what they had promised, there is a lot of mistrust with the government as a whole,” she says, noting that extends to public health.

“So now, when you take any public health crisis – COVID, measles now, I’m not sure what the next thing is going to be, but there will be a next thing – there is mistrust when the government says, thou shall do A-B-C, because of what has happened in the past.”

Sawatzky says she was recently at a community gathering and overheard a parent chatting about how they had pushed back when contact tracers called, refusing to answer their questions. Sawatzky approached the person and explained the purpose of the call was to keep the community safe.

“We were able to have a good conversation, even though they were completely different points of view … And at the end, they were like, ‘Oh, okay, they’re supposed to call me back again. Maybe I’ll give them a little bit more.’”

Not long before that conversation, a local health provider reached out to Sawatzky to try to understand why some Mennonites refused or resisted to provide their whereabouts for infection control.

She asked how they worded their messaging and identified the word “investigation” could be the problem.

“That sounds really punitive when we say that word to individuals who maybe have a very limited understanding of what public health’s role is … because they have tried not to engage with any system that’s government-funded.”

She suggested softening the language to explain that health providers are trying to understand where people have been to determine who is at risk of getting sick.

For Brenneman, executive director of Mennonite Central Committee Ontario, the public is looking at this outbreak as a cause and effect moment – the outbreak started at a Mennonite gathering and it is therefore spreading within that community.

But the longer the outbreak lasts, she says the public narrative will have to expand to hold more nuance and become more accurate.

“It spreads because people are not vaccinated. And if it’s going to spread further … it’s not going to be because of the Mennonites. It is going to be because there are other groups of unvaccinated people in the population and it will spread the way science tells us these things spread.”

This report by The Canadian Press was first published June 5, 2025.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Slashed federal funding cancels vaccine clinics amid measles surge

Credit: Unsplash/CC0 Public Domain

More than a dozen vaccination clinics were canceled in Pima County, Arizona.

So was a media blitz to bring low-income children in Washoe County, Nevada, up to date on their shots.

Planned clinics were also scuttled in Texas, Minnesota and Washington, among other places.

Immunization efforts across the country were upended after the federal Centers for Disease Control and Prevention abruptly canceled $11.4 billion in COVID-related funds for state and local health departments in late March.

A federal judge temporarily blocked the cuts last week, but many of the organizations that receive the funds said they must proceed as though they’re gone, raising concerns amid a resurgence of measles, a rise in vaccine hesitancy, and growing distrust of public health agencies.

“I’m particularly concerned about the accessibility of vaccines for vulnerable populations,” former U.S. surgeon general Jerome Adams told KFF Health News. Adams served in President Donald Trump’s first administration. “Without high vaccination rates, we are setting those populations and communities up for preventable harm.”

The Department of Health and Human Services, which houses the CDC, does not comment on ongoing litigation, spokesperson Vianca Rodriguez Feliciano said. But she sent a statement on the original action, saying that HHS made the cuts because the COVID-19 pandemic is over: “HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago.”

Still, clinics have also used the money to address other preventable diseases such as flu, mpox, and measles. More than 500 cases of measles so far in a Texas outbreak have led to 57 hospitalizations and the deaths of two school-age children.

In Pima County, Arizona, officials learned that one of its vaccination programs would have to end early because the federal government took away its remaining $1 million in grant money. The county had to cancel about 20 vaccine events offering COVID and flu shots that it had already scheduled, said Theresa Cullen, director of the county health department. And it isn’t able to plan any more, she said.

The county is home to Tucson, the second-largest city in Arizona. But it also has sprawling rural areas, including part of the Tohono O’odham Nation, that are far from many health clinics and pharmacies, she said.

The county used the federal grant to offer free vaccines in mostly rural areas, usually on the weekends or after usual work hours on weekdays, Cullen said. The programs are held at community organizations, during fairs and other events, or inside buses turned into mobile health clinics.

Canceling vaccine-related grants has an impact beyond immunization rates, Cullen said. Vaccination events are also a chance to offer health education, connect people with other resources they may need, and build trust between communities and public health systems, she said.

County leaders knew the funding would run out at the end of June, but Cullen said the health department had been in talks with local communities to find a way to continue the events. Now “we’ve said, ‘Sorry, we had a commitment to you and we’re not able to honor it,'” she said.

Cullen said the health department won’t restart the events even though a judge temporarily blocked the funding cuts.

“The vaccine equity grant is a grant that goes from the CDC to the state to us,” she said. “The state is who gave us a stop work order.”

The full effect of the CDC cuts is not yet clear in many places. California Department of Public Health officials estimated that grant terminations would result in at least $840 million in federal funding losses for its state, including $330 million used for virus monitoring, testing, childhood vaccines, and addressing health disparities.

“We are working to evaluate the impact of these actions,” said California Department of Public Health Director Erica Pan.

In Washoe County, Nevada, the surprise cuts in federal funding mean the loss of two contract staffers who set up and advertise vaccination events, including state-mandated back-to-school immunizations for illnesses such as measles.

“Our core team can’t be in two places at once,” said Lisa Lottritz, division director for community and clinical health services at Northern Nevada Public Health.

She expected to retain the contractors through June, when the grants were scheduled to sunset. The health district scrambled to find money to keep the two workers for a few more weeks. They found enough to pay them only through May.

Lottritz immediately canceled a publicity blitz focused on getting children on government insurance up to date on their shots. Vaccine events at the public health clinic will go on, but are “very scaled back” with fewer staff members, she said. Nurses offering shots out and about at churches, senior centers, and food banks will stop in May, when the money to pay the workers runs out.

“The staff have other responsibilities. They do compliance visits, they’re running our clinic, so I won’t have the resources to put on events like that,” Lottritz said.

The effect of the cancelations will reverberate for a long time, said Chad Kingsley, district health officer for Northern Nevada Public Health, and it might take years for the full scope of decreasing vaccinations to be felt.

“Our society doesn’t have a collective knowledge of those diseases and what they did,” he said.

Measles is top of mind in Missouri, where a conference on strengthening immunization efforts statewide was abruptly canceled due to the cuts.

The Missouri Immunization Coalition, which organized the event for April 24–25, also had to lay off half its staff, according to board president Lynelle Phillips. The coalition, which coordinates immunization advocacy and education across the state, must now find alternative funding to stay open.

“It’s just cruel and unthinkably wrong to do this in the midst of a measles resurgence in the country,” Phillips said.

Dana Eby, of the health department in New Madrid County, Missouri, had planned to share tips about building trust for vaccines in rural communities at the conference, including using school nurses and the Vaccines for Children program, funded by the CDC.

New Madrid has one of the highest childhood vaccination rates in the state, despite being part of the largely rural “Bootheel” region that is often noted for its poor health outcomes. Over 98% of kindergartners in the county received the vaccine for measles, mumps, and rubella in 2023-24 compared with the state average of about 91%, and rates in some other counties as low as 61%.

“I will say I think measles will be a problem before I retire,” Eby, 42, said.

Also slated to speak at the Missouri event was former surgeon general Adams, who said he had planned to emphasize the need for community collaboration and the importance of vaccinations in protecting public health and reducing preventable diseases. He said the timing was especially pertinent given the explosion in measles cases in Texas and the rise in whooping cough cases and deaths in Louisiana.

“We can’t make America healthy again by going backwards on our historically high U.S. vaccination rates,” Adams said. “You can’t die from chronic diseases when you’re 50 if you’ve already died from measles or polio or whooping cough when you’re 5.”

A measles outbreak in Texas that resulted in the death of a child has health officials across the nation on high alert as cases of the highly infectious disease grow.

As of Tuesday, Texas health officials reported that 422 cases had been identified across the state since January, including the death of that one unvaccinated school-aged child.

There also have been outbreaks in Minnesota in recent years, and the state Department of Health reported last week that the state’s first case of measles this year was diagnosed in a resident who had traveled to Washington D.C. State health officials and health professionals say they’re ready to respond to this latest outbreak. But much of their work involves prevention, which includes getting children in underserved communities vaccinated, and combating anti-vaccine rhetoric.

What is measles and how does it spread?

Measles is one of the most infectious diseases in human history, which makes it very difficult to contain once the virus starts to spread within a community.

“People who are susceptible to measles can get infected just by being in a room with someone who has measles, or being in that room up to two hours after that person has left,” said Jayne Griffith, a senior epidemiologist at the Minnesota Department of Health (MDH).

Measles has a long incubation period, meaning someone can contract the virus and not show symptoms for three weeks. The virus can be infectious for up to nine days after contracting the virus, from four days before the onset of the rash to four days after.

What are the symptoms?

Someone who contracts measles will start to show flu-like symptoms, like a dry cough, sore throat and a runny nose. What follows is a fever, then the rash for which the disease is known, which starts at the head and goes down the body.

Measles is known for causing complications like dehydration, diarrhea and ear infections that can often lead to hospitalization. More serious complications include pneumonia and encephalitis, or brain swelling.

How is measles treated?

“There’s actually no treatment for measles,” said Sheyanga Beecher, medical director of Hennepin Healthcare’s Pediatric Mobile Health Program. “We know that measles can be prevented quite well, actually, based on the vaccine itself. But when a child gets hospitalized for measles, typically they are treated for secondary infections or complications from measles.”

The measles, mumps and rubella (MMR) vaccine is highly effective. One dose is 93% effective in preventing measles, and the second dose boosts effectiveness to 97%.

The first dose is given to a child around their first birthday, though some children can receive it a few months sooner if traveling. The second dose is administered between 4 and 6 years old, typically before a child starts kindergarten.

Following the development of the MMR vaccine in the 1960s and the ensuing vaccination campaigns, measles cases worldwide began to drop. An aggressive vaccination campaign that began in the 1980s allowed the United States to declare measles eliminated by 2000, which meant the disease was no longer circulating around the nation.

How do outbreaks begin?

The various outbreaks in the U.S. since 2000 have been caused by travelers bringing the disease from elsewhere, which then spread in unvaccinated populations. Griffith said due to the outbreak in Texas, the origin of which is also linked to international travel, there is a concern whether the U.S. will be able to retain its elimination status.

A big outbreak in the New York City area in 2019 went on for almost 11 months, she said.

Minnesota experienced two measles outbreaks in the past decade, one in 2017 and another last year. The 2017 outbreak included 75 reported cases statewide, which mostly affected unvaccinated Somali-American children. Last year’s outbreak lasted from May to November, and included 70 reported cases, 11 of which reported exposure to measles outside of the U.S.

Griffith said the experience gained during those recent outbreaks put Minnesota public health officials and health care providers in the unique position of being ready to quickly take action.

“We’re always on heightened awareness and able to respond really quickly.” she said.

How does Minnesota respond when a case is reported?

When someone seeks treatment for symptoms resembling measles, namely a fever and a rash, health care providers first conduct a blood test. If the test comes back positive for measles, the health care facility immediately notifies MDH through a system developed to enable fast communication during public health emergencies.

The hospital and the state agency then start the contact tracing process, figuring out where the person has been and where they may have been exposed to the virus. Simultaneously, MDH begins to alert local public health agencies where the case was reported, which Griffith said can really help deter any further spread.

“All of that notification can take place within a couple of hours of us finding out about a positive case,” Griffith said. “That will help us if, for example, the new measles case is in a child and maybe that child goes to school or goes to daycare, then right away we can start identifying who might have been exposed at the school or the daycare.”

Why are some children not getting the vaccine?

Hundreds of scientific studies have debunked a potential link between autism and vaccines, but the idea still persists. The claim was first made in a research paper published in 1998, which was later discredited and retracted. It contributed to the 2017 outbreak among unvaccinated children in Minnesota’s Somali community, and has contributed to lower immunization rates.

According to the Centers for Disease Control and Prevention (CDC), about 92.7% of kindergartners nationwide last school year had the two doses. That is lower than the recommended 95% needed to achieve herd immunity.

Beecher said the lower immunization rates can allow the virus to spread more quickly and to more people.

“If you have a community with a low immunization rate, and you’re sitting in a congregated area, whether that’s a church, a mosque, school cafeteria, it’s very easy to spread,” she said. “Within Minnesota, if you break it down by different communities or different races, we find that when there is higher vaccine hesitancy, there may be lower vaccine rates and therefore more susceptibility to measles infection.”

Exacerbating the issue are prominent figures like President Donald Trump and U.S. Health and Human Services Secretary Robert F. Kennedy, Jr., who have both trafficked in anti-vaccine rhetoric. Under their direction, the CDC announced it is researching possible links between autism and vaccines, and hired a known vaccine skeptic who has published papers claiming the link exists to head the study.

“There is no link between autism and the MMR vaccine. We know this unequivocally,” Beecher said. “Spending this money and spending this time to re-evaluate something that we know is inaccurate is actually a disservice to our patients and our families.”

To combat that, Beecher said health care professionals at Hennepin Healthcare meet Minnesotans where they live to address any questions and concerns they may have. Among other locations, that includes a mobile clinic team that goes out into the community to provide care, as well as popup clinics at Head Start programs or school gymnasiums.

Town halls are another method Beecher and her team employ in order to encourage dialogue between communities and their health care providers.

“The point is to have long conversations and discussions between community and health care without judgment, without intimidation, without even any type of vaccine or medical equipment,” she said. “We’re just there to have a conversation, and I’m hopeful that these conversations and this dialogue will start to give people pause when they see a TikTok video that says vaccines cause autism, or that it gives them the confidence to take our information back to their community.”

Measles is so infectious that when under-vaccinated individuals mingle, they’ll always be at risk. That’s why public health officials are stressing the importance of high vaccination rates amid backsliding and growing outbreaks.

The disease is spreading across the country, with hundreds of cases reported this year and the majority in Ontario. The resurgence comes amid falling childhood immunization rates; measles was declared officially eradicated in Canada in 1998, aside from the occasional travel-related case.

The virus spreads easily through airborne droplets and usually causes fever, cough and redness of the eyes to start. What follows includes white spots next to the molars and a distinctive red rash that usually starts around the hairline and moves down the body.

Before effective measles vaccines were developed, most children got the disease and eventually recovered. But physicians stress that it can cause severe complications and can result in hospitalization, including intensive care. In Canada, 12 per cent of cases this year required hospitalization, according to data compiled by the federal government.

“What’s devastating is that this is preventable” with vaccination, said Dr. Caroline Quach, a pediatric infectious diseases specialist and medical microbiologist at Ste-Justine Hospital in Montreal.

Complications can include pneumonia, death

Raising measles vaccination coverage in pockets of communities with low rates really matters now because when the spark of an infection is introduced, it spreads like wildfire among people of all ages who are susceptible.

The measles, mumps and rubella vaccine comes in two doses; one is done before two years of age and the other by seven. Coverage for the first dose decreased from about 90 per cent in 2019 to around 83 per cent in 2023, according to the Public Health Agency of Canada. For the second dose, it fell from about 86 per cent to around 76 per cent over the same time period.

Complications of measles infection include pneumonia, encephalitis — the inflammation of the brain — and even death, Quach said.

It can also lead to lifelong deafness and blindness, and a rare but fatal brain disorder called subacute sclerosing panencephalitis can develop years later.

This illustration provides a 3D graphical representation of a spherical-shaped, measles virus particle. The virus is highly infectious. (Alissa Eckert/CDC)

“People don’t realize that these consequences still happen and that we still don’t have a treatment for measles,” Quach said.

Those born before 1970 and who were raised in Canada are considered protected against measles because it was so rampant. Over time, those individuals represent less of the overall population, Quach said.

“We really have now to rely on very high vaccination coverage if we want to limit the spread of measles.”

A matter of when, not if, measles returns

Those at the highest risk of severe disease from measles include vulnerable populations — like infants who are too young to be vaccinated, pregnant women, and anyone with a weakened immune system, said Dr. Tina Tan, a pediatrics professor at Northwestern University’s Feinberg School of Medicine in Chicago.

In places facing measles outbreaks such as Ontario, Texas and New Mexico, public health officials are offering vaccination to immediately protect infants as young as six months . (These babies will still need two full regular doses for longer-term immunization.)

“When vaccination rates drop in a community, it is not a question of if, it’s a question of when measles is going to come because it is so incredibly contagious,” Dr. David Higgins, a pediatrician at the University of Colorado, told reporters in a virtual briefing.

Higgins said “huge” disruptions in routine childhood vaccination campaigns in places like the U.S. and parts of Europe, Africa and Southeast Asia during the COVID-19 pandemic mean the disease is just a plane flight away.

Ontario’s sharp increase in measles cases is due to transmission among those who are not immunized, Public Heath Ontario says. (Ronaldo Schemidt/AFP/Getty Images)

Outbreaks occur in local communities where people are susceptible to infection because of low immunization rates, Higgins said. National vaccination coverage levels may not reflect the local situation.

Looking at southwestern Ontario

Case in point? Southwestern Ontario’s outbreak.

Many of the cases in Canada were sparked by an international traveller who attended a wedding in New Brunswick in October 2024. In Ontario, as of Thursday, all but seven of the province’s hundreds of cases this year were linked to that outbreak.

More than 30 people in Ontario, largely in the province’s southwest, with measles have needed hospitalization, including two in intensive care. Most of those hospitalized have been unvaccinated children, said Dr. Christine Navarro, a public health physician with Public Health Ontario.

In a report this week, the agency attributed the rise in cases to transmission among unvaccinated people.

In Canada, immunization rates for two doses of the vaccine given before school entry also declined during the pandemic, contributing to backsliding, doctors say.

Repeated surveys suggest the vast majority of parents in Canada want their child to be immunized against preventable infectious diseases including measles, while about three to five per cent are outright against all routine childhood vaccinations, Quach said.

Families as vaccination partners

Provincial catch-up campaigns aim to have 95 per cent of the population vaccinated to prevent person-to-person spread of measles among those who are susceptible.

In Ontario, just 70 per cent of seven-year-olds were considered fully vaccinated against measles during the 2023-24 school year, said Navarro. Reasons include reduced reporting and missed doses, she said.

WATCH | This is the way measles attacks: Measles: Understanding the most contagious preventable disease | About That Duration 10:16 There are early signals that measles — one of the world’s most contagious but preventable diseases — may be spreading in parts of Canada. Andrew Chang breaks down the way the virus attacks the body and what makes it so contagious.

“People who are vaccinated are much less likely to become cases, and if they do happen to become infected, they’re much less likely to continue to transmit that disease,” she said.

Quach, the Montreal pediatrician, said Quebec has a program for every family who gives birth to encounter doctors, nurses or pharmacists who discuss routine vaccinations with them and answer questions, without being judgmental.

One effective method is having both top health officials and trusted community members on the ground to present the facts to questioning or hesitant people, Higgins said.

“We need to approach them as partners,” he said. “We are trying to work together to help their communities, to help their families and their children thrive.”

In southwestern Ontario, the focus remains boosting vaccination coverage.

Grand Erie Public Health’s unit has 112 cases of measles, said Dr. Adelle Chang On, its acting medical officer of health, on Friday. (The unit serves Brantford and surrounding Brant, Haldimand County and Norfolk County.)

It won’t be able to declare the outbreak over until at least two incubation periods, or 42 days, of the last reported case.

Even then, Chang On said, her team will stay vigilant, given potential sparks could reignite chains of transmission as people travel.

“I think we just need to continue … reaching out and being open.”