Why Even Adults May Soon Face ‘Childhood’ Diseases

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Declining vaccination rates risk resurrecting ‘childhood’ diseases, threatening children and adults worldwide.

Many people tend to think of illnesses like whooping cough, measles, and mumps as old threats that rarely make the headlines, especially in countries with widespread immunization. That perception might change if vaccination rates continue to decline. Back in 2024, whooping cough, or pertussis, surged to more than 32,000 recorded cases across the nation, which happened to be the largest number in a decade. California alone saw about 2,000 people infected from January through October of the prior year, and more than 60 infants under four months old were hospitalized. Tragically, one baby even lost their life. These figures might come as a surprise in an age where many assume that serious childhood diseases have all but disappeared, but these numbers underscore a stark warning: When immunization rates waver, preventable infectious ailments can come roaring back.

It’s not just whooping cough that poses a renewed threat. Medical experts have noted that the recent pandemic years significantly interrupted childhood immunization schedules, and those gaps never fully recovered. As a result, hundreds of thousands of children may be at risk for diseases most of us only read about in history books. Measles, mumps, rubella—these were once regular childhood afflictions that could lead to complications and hospitalizations. But for a while, they seemed controlled, at least in regions where vaccine coverage was high. Now, as vaccine skepticism grows and more individuals question the safety and necessity of immunizations, concerns arise that these diseases may become common once again.

While many people connect whooping cough, measles, and other similar illnesses primarily to children, experts caution that if the downward trend in immunizations isn’t reversed, adults could also become vulnerable. A large share of grown-ups received vaccines when they were children, yet over decades, the immunity conferred by certain shots can wane, leaving them susceptible to diseases they never expected to confront again. It might take a year or two—or even a bit longer—but epidemiologists stress that if national vaccination rates keep dropping, outbreaks across all age groups, including adults, will be inevitable.

Before the first measles vaccine became available in the 1960s, measles was notorious for how easily it spread and how severe it could become, causing massive global mortality, especially among young children. After widespread immunization efforts, it seemed measles was on its way out. But if hesitancy toward vaccines increases, and childhood immunization rates continue to dip, pockets of the virus could spread not only among unvaccinated kids, but also among some adults. The reason? Some adults either never built a robust, long-lasting immunity from the vaccine, or they may have compromised immune systems that do not respond as effectively.

This erosion of herd immunity doesn’t just put individuals at risk; it impacts everyone around them. High vaccination coverage historically created a protective barrier, preventing outbreaks that could infect groups like pregnant women, newborns too young for certain shots, and people whose health conditions keep them from safely receiving specific vaccines. When you reduce that protective wall, these vulnerable populations face a much higher likelihood of exposure. Rubella, for instance—often referred to as German measles—can be particularly dangerous when contracted by a pregnant woman, as it can cause grave complications for the unborn baby. Since pregnant women can’t safely receive a live-virus vaccine, they rely on everyone else being vaccinated to cut down the odds of encountering the virus.

Although rubella cases in the United States are currently very rare, with fewer than a dozen reported annually, that low number could change if more families skip vaccines. In other parts of the world, rubella remains a leading vaccine-preventable cause of birth defects. Those who have lived with congenital rubella syndrome (C.R.S.) can attest to how serious it can be, involving heart problems, vision and hearing impairments, and a range of other lifelong health issues. Imagine the heartbreak of watching preventable illnesses cause permanent disabilities, especially given that preventive measures have existed for decades.

One of the simplest ways to get a glimpse of how fast a virus like measles can spread is to look back at the late 1980s. During that time, budget cuts and lack of adequate access to vaccines led to lower immunization rates among children in lower-income neighborhoods. The consequences were swift and severe: from 1989 to 1991, more than 55,000 Americans came down with measles, and 166 people lost their lives to a disease that was once on track for elimination. While modern medicine has significantly decreased the global mortality rate, measles remains so contagious that the virus can linger in the air for up to two hours after an infected individual has left the space, potentially infecting anyone who comes through.

Nowadays, one of the interesting revelations about measles is that it doesn’t simply make you sick in the moment; it can weaken the immune system for a time afterward, leaving children and adults more prone to other infections. Even though current M.M.R. (measles, mumps, rubella) coverage has been at around 95% in many areas, the pandemic disrupted regular immunizations, and national rates dipped below 93% for the 2023-24 school year. This seemingly minor percentage drop means that roughly 280,000 school-age children are at risk. That number doesn’t include adults who might have lost immunity over the years or never received the vaccine in the first place.

Mumps, while generally less severe than measles, can still trigger major problems if contracted by adults. It can sometimes lead to fertility issues in males or cause complications like meningitis and hearing loss. That potential danger is one reason schools and universities can become hotbeds for mumps outbreaks, considering how frequently students share living and social spaces. A similar phenomenon could occur in workplaces or public venues if adult immunities continue to wane and if vaccination rates plummet.

In the case of whooping cough, public health professionals had once hoped this disease would be almost a relic of the past due to a potent early vaccine that was administered in the mid-to-late 20th century. However, that earlier “whole-cell” vaccine often prompted strong side effects, including high fevers and, in very rare cases, seizures. In the 1990s, scientists developed a newer “acellular” version. This updated shot drastically cut down on side effects, but it proved slightly less effective at preventing infections over the long term. As a result, many children and adolescents vaccinated with the newer formula are well-protected from severe disease but may still acquire or transmit pertussis later on.

In practical terms, that means whooping cough can reappear within a population, especially if a larger chunk of people fall behind on booster shots or skip immunization entirely. Whooping cough earned its name from the characteristic sound that follows a prolonged coughing fit. That sound signals how irritated and inflamed the respiratory passages become. If you contract whooping cough, the first symptoms resemble those of the common cold—maybe a runny nose, low-grade fever, and mild cough. But over the next week or two, it can morph into violent coughing fits so intense that it leads to vomiting, cracked ribs, and serious difficulty catching one’s breath. Infants are particularly vulnerable because their airways are so small, and they’re not yet eligible for the full course of vaccine doses in their earliest months of life.

When immunization rates for whooping cough dip, it puts newborns at the highest risk of complications or death. But older children and adults aren’t necessarily off the hook. While the majority of them survive, the infection can still knock them out for weeks or even months. Some people refer to whooping cough as “the 100-day cough” because of how drawn out the symptoms can be. It’s not something that any parent wants to see their child suffer through, nor do adults want to grapple with it themselves.

Perhaps the most unnerving aspect of dropping vaccination rates is that we might not see its full effect immediately. A decline from 95% coverage to, say, 90% coverage might not prompt large-scale epidemics overnight. Diseases often need a tipping point. But the moment enough susceptible individuals exist in a community, one infected person can trigger a chain reaction. If rates were to plummet to around 75%, the number of available hosts for a disease like whooping cough or measles to spread among would rise substantially. And because schools and workplaces are often bustling environments with people in close contact, those places can become hubs for transmission.

Many vaccine experts are particularly concerned about misinformation and fear surrounding vaccine side effects. Of course, any medical intervention carries some risk, but serious adverse reactions to vaccines are exceedingly rare compared to the complications and death rates historically associated with these diseases. When families hear a story of someone who had a strong reaction or read about inaccuracies online, it can create a powerful emotional response that overshadows decades of science-based evidence. The challenge is that vaccines are a community-minded protective measure. Their aim is not just to shield the individual who gets the shot, but also to safeguard everyone else by reducing the overall opportunities for outbreaks to occur.

In places like Britain, for instance, worrisome upticks in measles and mumps have prompted public health authorities to sound the alarm. The same dynamics apply around the globe; any country that reduces its emphasis on routine childhood vaccinations will likely witness the reemergence of these illnesses. Hospitalizations for measles alone can account for a significant number of complications such as pneumonia or encephalitis (inflammation of the brain). And mumps may be perceived as mild until it causes significant side effects like meningitis, pancreatitis, or hearing loss in those unfortunate enough to develop complications.

People who rely on the community’s immunity include those with weakened immune systems due to cancer treatments or immune disorders. Sometimes, even healthy individuals might not produce enough antibodies in response to a vaccine for various biological reasons—no vaccine offers 100% protection for absolutely everyone. But when nearly all of society gets vaccinated, the virus or bacteria has trouble surviving. Herd immunity, therefore, becomes the shield that keeps vulnerable individuals safe from exposure.

The changing landscape of vaccination means that the older crowd, who may have believed themselves adequately protected, could find themselves reconsidering booster shots or second doses. For example, not everyone knows that for the measles vaccine to be fully effective, two doses are recommended. Some adults only received one, or they aren’t certain if they had both. With potential outbreaks on the horizon, they may become a target group for outreach and education campaigns, if health authorities are proactive in addressing the risk.

While discussions about vaccination sometimes focus narrowly on the safety and side effects of the shots themselves, less attention is paid to the vast number of lives saved thanks to decades of immunization programs. A generation or two ago, parents were more immediately aware of the horrors of diseases like polio, which could cause paralysis, and measles, which could lead to encephalitis or even death. As these diseases faded from public view, the urgency to vaccinate also slipped, replaced by complacency and, in some cases, doubt or outright distrust. Public health professionals note that perceptions about vaccination usually shift only after communities witness outbreaks. Yet by then, the damage can already be significant, with numerous families and individuals affected by preventable illnesses.

The fragile equilibrium that prevents such outbreaks relies heavily on our continued collective participation in routine immunizations. The good news is that in most parts of the country, public school admission requirements mandate vaccinations. But these rules often come with exemptions—religious, medical, or sometimes even personal-belief exemptions. If the number of exemptions grows in parallel with rampant misinformation and skepticism, it can break that delicate balance. Meanwhile, some people who do plan to vaccinate might delay it, not realizing that timely shots are crucial for young children before they are exposed in day care or preschool settings.

Amid this changing backdrop, public health experts are making efforts to communicate the historical context and the lived realities of communities that experienced massive disease outbreaks in the past. Recalling how rubella caused substantial birth defects not so long ago can be an eye-opener, especially for younger adults who have never witnessed such a crisis firsthand. Stories from families whose children were hospitalized with diseases like whooping cough also serve as powerful reminders of why these vaccines exist. Nobody wants to see a child gasping for breath in a hospital setting, hooked to machines, just because prevention through vaccination was overlooked or postponed.

Even with all these cautions, it’s important to emphasize that the vast majority of vaccinations are given safely and effectively to millions of children every year. Side effects, when they occur, are often mild—a sore arm, a slight fever, or general fatigue for a day or two. Serious adverse reactions do happen on extremely rare occasions, but experts underscore that the risk from natural infection is far higher. For example, measles can lead to pneumonia, encephalitis, and even death, while the measles vaccine can prevent those outcomes almost entirely in most children and adults who receive it.

It’s a sobering reality that if ongoing dips in vaccination rates persist, the return of these so-called childhood diseases could affect entire communities. Health care resources might be strained if multiple outbreaks occur simultaneously. Adults who believed they were protected might discover that their immunity has waned just enough to let the infection take hold. And certain groups—infants, pregnant women, those with particular medical conditions—may carry the heaviest burden of all.

We should remain mindful that the current vaccination recommendations exist because they are backed by decades of rigorous research, epidemiological modeling, and real-world observations. If large sections of the population opt out, we may revisit the days when measles infected thousands, when pertussis hospitalized infants, and when mumps led to infertility risks. Even though it might take a few years to fully manifest, public health professionals are sounding the alarm now so we don’t wind up there.

Communication is key. Addressing vaccine hesitancy with empathy, providing credible information, and highlighting the collective benefits can make a difference. Health care providers are often the most trusted source of vaccine information, so fostering strong relationships with doctors and nurses can encourage families to stay up to date with recommended immunizations. While it’s easy to become complacent in a society where these diseases appear rare, it’s only through ongoing vigilance that we keep them that way.

In an era when misinformation spreads quickly, it can be challenging to reach individuals who are on the fence about routine vaccinations. However, the stakes are high, and the cost of inaction grows each time someone remains unprotected or delays essential shots. Experts in disease modeling frequently mention that while the worst-case scenarios might not appear overnight, the gradual drop in community immunity can set the stage for future crises. Vaccination has often been described as a social contract: by choosing to vaccinate, individuals protect not just themselves, but also neighbors, classmates, coworkers, and vulnerable members of their family or community.

If we continue to see falling rates of immunization, diseases like whooping cough may affect older children and teens in large numbers, because their immunity from early childhood shots diminishes over time without boosters. Mumps might appear more frequently in college dormitories, potentially leading to outbreaks that disrupt campus life and threaten the well-being of students. Measles, which can spread so efficiently in environments where many people gather, could become a renewed concern for adults who never had full immunity or have compromised immune defenses. Rubella, though largely forgotten by the average American, could again put expectant mothers at serious risk if they happen to encounter an infected individual.

None of these scenarios are guaranteed to happen, but public health professionals underline they are likely if the steady downward trend in vaccination continues. In many cases, a one- or two-percentage-point drop from year to year doesn’t ring immediate alarm bells. But those small differences can accumulate to create large pools of susceptible individuals. And because the modern world is so interconnected—with travel, workplaces, and educational institutions bringing people together—diseases can move swiftly once they get a foothold.

Science, history, and countless real-life experiences have confirmed that vaccines work remarkably well when enough people commit to them. They’re a piece of the broader puzzle of public health, which also includes sanitation, nutrition, and education. However, vaccines stand out as one of the most effective interventions. Thanks to them, conditions like polio have been nearly eradicated in many parts of the globe, and fatal outcomes from diseases like measles have been dramatically reduced over the last half-century. The main risk now is that we forget those lessons, grow complacent, or get swayed by inaccurate narratives.

Ultimately, the takeaway from rising whooping cough cases and the prospect of measles or mumps outbreaks is that prevention starts with each individual and each family. Society moved away from the days of routine childhood disease fatalities through rigorous, science-based vaccination campaigns. If people choose to step away from that social and medical contract, the door opens for these diseases to reestablish themselves—even in the adult population. Whether due to waning immunity or never having received proper doses, more individuals could discover that these illnesses are not just relics of a bygone era. They remain real threats, ready to return if given the opportunity.

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