How is bad public health policy recessionary?
Health-related recessions are precipitated when people who might otherwise work are sick or disabled or dead and therefore not working (or working less). Illness-related absences disrupt business and whittle productivity. Lower earning and higher healthcare expenses translate to less discretionary spending on the part of consumers, affecting sectors such as hospitality. Excess deaths impact demographic economics, longevity, and population.
Human health shapes economies for better or worse. RFK Jr.’s policies and leadership are leading to more sickness and more death while disrupting the national health system. This morning, we offer the first installment in a two-part update.
Specifically, under RFK Jr.’s leadership we are seeing and will see
- Resurgences of infectious diseases once controlled by vaccination
- Rising costs that will run into the billions
- Rising cases, hospitalizations, long-term health impacts, and deaths into the future
- A growing burden on a weakened healthcare system, compromising medical care for all
- Selective suppression of data, particularly data that documents the consequences of policy changes
- A vacuum of expert leadership, pared staffing, pared and redirected research, and public health guidance compromised by misinformation and vaccine skepticism
- The gutting of preparedness for pandemics, whether new pathogens emerge from nature or from labs, ensuring peak national vulnerability to disease-related demographic and economic shocks
Let’s say this on a human level: RFK Jr. and the public health leadership he has assembled are creating a world less safe and less prosperous for our children and for all of us.
Because the entire discussion is long, we are going to split it into Parts 3 and 4 of this series, with Part 4 scheduled for March 22. This week, we will focus mainly on measles.
Weakening Defenses Against Existing Infectious Diseases
RFK Jr.’s change to the childhood vaccination schedule back in September of 2025, along with vaccine skepticism, means that vaccine-preventable infectious diseases are set for a resurgence.
Sen. Bill Cassidy (R-La.), who is a medical doctor, responded to the vaccination schedule change on X:
As a doctor who treated patients for decades, my top priority is protecting children and families. Multiple children have died or were hospitalized from measles, and South Carolina continues to face a growing outbreak. Two children have died in my state from whooping cough. All of this was preventable with safe and effective vaccines.
The vaccine schedule IS NOT A MANDATE. It’s a recommendation giving parents the power. Changing the pediatric vaccine schedule based on no scientific input on safety risks and little transparency will cause unnecessary fear for patients and doctors, and will make America sicker.
(January 5, 2026, https://x.com/SenBillCassidy/status/2008278922350256150?s=20)
Cassidy serves as Chairman of the Health, Education, Labor, & Pensions (HELP) Committee and as a member of the Finance Committee, the Energy and Natural Resources Committee, and the Veterans Affairs Committee.
Measles, among most contagious viruses we know, has of course been first out of the starting gate as vaccination rates have fallen. Through 2025, there were 2283 confirmed cases of measles in the US, a steep increase that continues into 2026. We have to go back 34 years to find another year as bad as 2025 was for measles, and 2026 will be considerably worse. Here is the CDC’s latest update, released on Friday, March 6:
As of March 5, 2026, 1,281 confirmed measles cases were reported in the United States in 2026. Among these, 1,277 measles cases were reported by 31 jurisdictions: Alaska, Arizona, California, Colorado, Florida, Georgia, Idaho, Illinois, Kentucky, Maine, Massachusetts, Minnesota, Missouri, Nebraska, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, and Wisconsin. A total of 4 measles cases were reported among international visitors to the United States.
(“Measles Cases and Outbreaks” | CDC, https://www.cdc.gov/measles/data-research/index.html)
Folks, we’ve seen 1281 US measles cases thus far this year, and it is only early March. In his February 26, 2026, podcast, CIDRAP Director Michael Osterholm pointed out that, of those cases, 29% were adults (age 20+) in 2025. So far this year, the figure is 15%. Measles is going to burn through unvaccinated adults as well as children. Osterholm explained why that figure is significant:
Compared to infants, adults are much more likely to experience measles complications such as pneumonia and encephalitis, and therefore more likely to be hospitalized [than children ages 5–19 are]. And because adults are also generally more mobile than children, they may be more likely to spread the virus to other people.
Osterholm noted that before a vaccine for measles was available, measles infected virtually all children by the time they were 15 years old. Some died. Some suffered lifetime consequences of infection. But survivors had immunity. As long as measles vaccination rates remained at 95% or above, the unvaccinated of any age enjoyed protection because measles couldn’t spread readily. Now that vaccination rates have dropped below that figure in 80% of US states (all but 10), protection conferred by other people’s vaccinations has fallen away. There are no more free passes for the unvaccinated.
As measles burns through the unvaccinated population and even infects some of the vulnerable but vaccinated, we will see more serious health impacts among adults along with those we expect to see in children.
Osterholm’s warning about how mobile adults can spread measles far and wide is already observable: In 2025, an international trip undertaken by one infected and unvaccinated traveler resulted in 17 new measles infections in the US.
Measles Drives Higher Costs
An increase in measles cases is expensive for families and expensive for the healthcare system and expensive for businesses. One recent study added up the projected costs of a gradually eroding MMR vaccination rate:
Researchers modeled the impact of a 1% annual drop in MMR vaccine coverage and found it could lead to about 17,000 cases, 4,000 hospitalizations and 36 preventable deaths each year from 2026–2030. Annual costs would rise to $1.5 billion, which includes $41.1 million in direct medical costs, $947 million in public health outbreak response costs and $510.4 million in productivity and missed work costs, according to the report.
(“Report: Declining measles vaccination could cost $7.8 billion by 2030” | AAP, https://publications.aap.org/aapnews/news/34515/Report-Declining-measles-vaccination-could-cost-7)
Measles Outbreaks Burden the Healthcare System
After interviewing, “more than two dozen doctors, nurses, parents, school officials, pharmacists, pastors, lawmakers and former health officials in South Carolina,” Reuters offered this report from South Carolina’s large outbreak on February 13:
“Doctors bear the burden as ‘medical freedom’ fuels worst US measles outbreak in 30 years” | Reuters, https://www.reuters.com/business/healthcare-pharmaceuticals/doctors-bear-burden-medical-freedom-fuels-worst-us-measles-outbreak-30-years-2026-02-13/
Physicians note the challenges of checking children in vehicles so patients in waiting rooms are not exposed and the likely underreporting of confirmed cases as some parents refuse to allow children with measles symptoms to be tested for the illness. One physician, Justin Moll, who had treated about 50 measles patients as of mid-February, cautioned, “This is not going to be the last vaccine-preventable disease to hit us.”
Sweeping Bad News under the Rug
The official number of confirmed measles cases, no doubt an undercount, is bad news ahead of midterm elections. The US is poised to lose its measles elimination status, earned back in 2000. That’s a headline the administration does not want to see. Delay of the meeting to revisit US measles elimination status until November (after the 2026 midterms) is just one of the ways RFK Jr. and company are trying to forestall negative headlines and quash awareness of the harm that vaccine skepticism is actually doing to Americans and the country as a whole.
In a February 24 Substack post, Dr. Paul Offit explained how other data is being suppressed:
“What RFK Jr.’s CDC Doesn’t Want You to Know” | Beyond the Noise (Paul Offit),
https://pauloffit.substack.com/p/what-rfk-jrs-cdc-doesnt-want-you
Measles Vaccination Rates by County (where data is available)
As we noted in Part 1 of our series, falling vaccination rates are poised to have devastating consequences that take the form of more children and adults sick, more time lost from school and work, higher healthcare costs, and more preventable deaths. The Washington Post on New Year’s Eve published a thoroughgoing picture of changing vaccination rates, tracking every county in every state in the nation, except where states that do not publish data. They focused on the vaccination rate required to prevent measles outbreaks (95%) and observed:
The share of U.S. counties where 95 percent or more of kindergartners were vaccinated against measles — the number doctors say is needed to achieve overall protection for the class, known as “herd immunity” — has dropped from 50 percent before the pandemic to 28 percent, according to The Post’s examination of the public records from 44 states and the District of Columbia.
The same article provides a tool so that readers can view the vaccination rates among kindergartners in US counties, with the exception of counties in Wyoming, Montana, Mississippi, West Virginia, and New Hampshire. Where the data is available, readers can look at the vaccination rates of particular schools. The maps reveal the many places that can expect measles outbreaks in the future. In fact, in more than 70% of US counties, kindergarten classrooms do not enjoy herd immunity and are vulnerable to measles outbreaks. That was as of the first of the year.
“U.S. vaccination rates are plunging. Look up where your school stands.” | Washington Post, https://wapo.st/4qxuWY3
We can expect more measles outbreaks, and we can predict where those outbreaks are more likely to happen and where they are not.
We will continue this discussion in part 4, scheduled for Sunday March 22, picking up with how we might expect infectious disease cases, hospitalizations, and deaths to trend in coming years should vaccination rates continue to fall given leadership prone to vaccine skepticism and disinformation.
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