Bulwark Takes - Measles Is Back and the Government Doesn’t Care

Episode Date: February 2, 2026

Sam Stein and Jonathan Cohn give their takes on the alarming return of measles in the United States. The disease is spreading again, with major outbreaks in South Carolina and hundreds of cases appearing nationwide. They break down why falling vaccination rates are driving this preventable crisis, how government leaders are downplaying the threat, and why vaccine skepticism has become a badge of honor on the right, from RFK Jr.’s influence at HHS to Florida Surgeon General Joseph Ladapo’s push to end vaccine mandates altogether.Get 30% off your entire order with Soul at https://GetSoul.com, promo code BULWARKTAKES.

Hey, everyone, it's me, Sam Stein, managing editor at the Bullwork. I'm here with Jonathan Cohn, author of The Breakdown. If you want to be depressed about the state of health in this country, that's the newsletter for you, folks. Subscribe. Never an uplifting version. Always a disaster. It's just what you want. John, thanks for doing this. Appreciate it. You wrote about the measles epidemic, which, you know, it's kind of been at this, like, slow burn a little bit in the backdrop of our politics. But it's become a real issue. issue, obviously, in South Carolina predominantly, but not just South Carolina. We had this new story over the weekend about an ice facility that has its own measles outbreak. I want to put up a graph that shows just how bad 2026 is shaping up to be. You can see it there as we talk compared to 2025, which was already bad. And then I'm just going to ask you, like, exactly how

bad is it? It's pretty bad. I know, I know we're not bringing the sunshine here, but I mean, the measles is back. I mean, that's really bad. I mean, it's bad and it's stupid. I mean, we have a vaccine. You know, we used it. Measles was a part of life once upon a time. It circulated. You know, a lot of people think, oh, measles, you know, not so big a deal. You get some rash. You know, you may remember the Brady Bunch episode if you're old enough from the, you know, in 1969 where the whole family got it. And, you know, most people who get it will be. be okay after a week or damn. It's not, it's not like an easy one. You get the high fever and everything, but, you know, most people get over, but some people don't. You know, I mean, you get blindness.

You can get pneumonia, swine the brain. You know, hundreds of people used to die every year from the measles. And then we got a vaccine. Woo, you know, we got the vaccine. Pretty much wiped it out. And you would have cases in this country, but they were always, you know, from someone would go abroad and bring it back because, you know, random, you know, somebody who wasn't vaccinated. And since Most people were vaccinated. We had herd immunity and it didn't spread. Well, now it's spreading. And, you know, we got last year we had the Texas outbreak, which was big.

And three people died, including two children. That hadn't happened in 10 years. And, you know, children dying from a preventable, when they didn't have to, is really awful. I mean, that should not happen. And of course, many more got hospitalized. And now we got this outbreak in South Carolina. It's getting bigger. I mean, they're logging 100 cases.

a week. Now they're seeing it over the border in North Carolina. There's cases, other parts of the country, and we don't know which are connected to which yet, but this shouldn't be happening. From your reporting, do you get a sense of how the government is monitoring and trying to contain this? So it's weird. You know, first of all, the front line is always the states, right? I mean, state public health authorities are honest. And they're doing, you know, they're on top of this. People who run state public health departments mostly. We may talk about this in a second, but, you know, most of the people run state health departments, they're sort of, you know, they're not political people, they're doctors, their scientists,

or epidemiologists, and they want to get this under control. They rely heavily on technical assistance and support from CDC, which my understanding is so far, they've been getting, it's hard to know for sure. I mean, you know, we saw in the Texas outbreak last year. Later, it turned out that they were real slow to get some of the, the support they needed. But in general, you know, there's still, there's a kind of, even now, even after Doge, after Trump, even with Robert F. County in charge, there is still, you know, the career people at CDC who are still there are really good. They're really dedicated. And they are

sort of the technical support does seem to be getting there so far. At least that's what I'm hearing. I would not be shocked if we learn something else later. But at the top level, I mean, there's no, the messaging. You know, you would want the measles are back. You know, we should be on top of this. We should be pushing back saying, everyone, get vaccinated. But instead, we... No, it's the opposite. It's totally the opposite. Yeah, so I want to get to that because there's like a nonchalance about it from the top level.

We're about to lose our elimination status this year. And there's a quote in your piece that like just floored me. It's from a mid-January press briefing. Reporter asks the CDC deputy director Ralph Abraham if he is concerned about losing the elimination status. And his response is this. Not really. He said it was the cost of doing business, quote unquote, in a world of global travel. I'm just a simple dude.

I don't really know things. But I'm pretty sure we've had global travel prior to 2025, 2026. I mean, well, we're not 2026 yet. We are in 2016. It feels it's hard to keep track. It feels like we haven't left 2035. I do believe we've had global travel prior to the past year and a half. So this seems insane to me that the person who's chiefly responsible for helping with

containment efforts, it's just like, yeah, it happens. So let's say, he's wrong, right? I mean, it is not the cost of doing business. That is false. Five years ago, we were, you know, we weren't about to lose elimination status. You know, we had enough protection 10 years ago. There's no reason. I mean, I quoted a couple of people, other people in the article, Jennifer Nuzzo, Nuzzo, actually, you know, one of those you, I always forget how she pronounces her last name, but she's at Brown, very well-respected epidemiologist. And, you know, what she said was there is no reason why a country like the United States should be having measles, you know, constant measles outbreaks anymore. That just should not be. So it is not the cost of doing business. It is the cost of falling vaccination rates

and an administration that at best is happy to let that happen. And you listen to people like Abraham, who was against, you know, was sort of undermined, you know, when he was in Louisiana. pulled back on vaccine promotion by the state, even like just doing clinics and things. And obviously you have RFK Jr. with his long history of suggesting vaccines are unsafe. And again, it falls, you know, just picking up on constantly misrepresenting and lying about the evidence. And, you know, I think that is the attitude right now at the top, which is that, let the measles, you know, it's not the end of the world. You know, he made some comment not too long ago that, you know, we used to.

have measles all the time and people didn't write about it in the news. Well, yeah, because we didn't have a vaccine and there was nothing you could do about it. But I think that is the attitude. The attitude is, you know, they don't like vaccines. They're at best skeptical. They keep insisting there's dangers. And, you know, what's the latest data we have on vaccine uptick? I mean, how bad has it gotten in terms of administering the measles vaccine? Do we have actual hard numbers on it? So we do. I mean, measles vaccination rates have been falling. I don't have the numbers on my head. The two things I know is that, you know, the threshold for herd immunity is generally considered

to be 95%. And what we are seeing is we're seeing that level fall. And it's not an even falling. So what you see is that in some communities and in some schools, it's falling far below that. And that's where the problem becomes because that's when you get these pockets of where it's going to spread. Because, you know, you get one case. I mean, this is literally one of the most contagious diseases on the planet.

So, you know, one person gets measles in a community where people aren't protected, it's going to spread quickly. And again, in a world where that was not a very common, because we've had this for a while, we've had communities that don't vaccinate for one reason or another. Sure. But as long as they're like isolated, they're not going to spread. But now you've got a lot of these communities, well, it's going to jump, right? People travel, go to a hotel, they go to, you know, they go to amusement parks, right? Theaters, you name it, indoor, any kind of indoor, you know, shopping malls. that things are going to spread.

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is that back in the day, there were communities, like you said, that resist. vaccinated vaccination. They were oftentimes lefty communities that didn't want to, you know, they were like real maha ancestors. They didn't want to put anything foreign or different in their bodies. They felt like natural immunity was the way to go. What you didn't have back then, which is a new phenomenon, is political leadership and top health officials saying, actually, this is the proper practice. And I remember back 10 years ago, I think it was Governor Stitt in Oklahoma, was kind of VAC skeptical openly. And it was a big scandal. People were like, Like, what is he doing?

Like, he's a governor of state? Like, why is he talking like this? This is deeply irresponsible. And now it's like become a point of pride for some state officials to act this way. And never is that more true than down in Florida, where you have the state surgeon general openly insisting that it is a matter of personal choice and freedom and that to push vaccine mandates is to, I don't know, violate someone's sacred right to their own body. So let's play the clip of this. This is an old clip.

And what I want people to look out to listen for is not just what he says. Listen to the applause. The applause is what really surprised me. So let's play the clip. What I'm most excited about is an announcement that we're going to make, that we're making now, which is that the Florida Department of Health, in partnership with the governor, is going to be working to end all vaccine, mandates in Florida law.

All of them. All of them. All of them. Every last one of them. Every last one of them. All of them. Every last one of them. Every last one of them is wrong and drips with disdain and slavery.

So that's Joseph Lapo. He's the Surgeon General of Florida. And ironically, he does have the responsibility to tell people what they should put in their body. He's the chief medical professional for the state of Florida. His job is to advise people on how to best protect themselves, what best practices are. And if you take his logic to the nth degree, I mean, does he think that people should just be able to take whatever drugs they want? Does he think that that's like a smart thing to do? Would he advise people that can drink themselves, you know, to death? I mean, it makes no sense to me. Of course his responsibility is to protect people

and to provide sound medical advice. But that's where we are. And the standing ovation, you could see the shadows of the people on the flags behind him because they were standing and applauding him goes to show you that there's a real constituency here for this stuff. Now, more recently, you can see some of the lawmakers in the state of Florida have some ambivalence about this. And maybe you could talk to that because you do have roots in the state. And the state did have an effect on you, Jonathan. So what the hell is going on here?

Yeah, my home state. So I mean, this is the position. I mean, this is basically the position Kennedy has at HHS, too, or at least the public position. This is the way it is being presented as we, you know, when they, you know, when they recently pulled back on the vaccine guidelines and pulled all these shots off the list of recommended shots for children. They're like, you know, this should be up to, you know, shared, you know, decision making. You and your doctor can decide. It's not our job to be telling you what to do. And, you know, it's what they, they were like, we're telling you too much.

We should pull back. Well, no, I mean, the reason we have public officials to protect health is that these are really complicated questions and we need a reliable set of authorities to guide us, to interpret this evidence and say, this is what the United States government recommends, is what your state government recommends. And, you know, until very recently, it was just sort of assumed, you know, that would be a sort of mainstream scientific view, which, you know, for all these vaccines have been, you know, tested. they understand that they're effective against these diseases that are really harmful, and that's why we recommend you get them. And just to his point, just to remind people, you know, these are, you know, when he talks about vaccine mandates, what kind of mandates are we talking about? Well, typically we're talking about mandates to go to send your kid to public school, right?

I mean, those are the mandates that people think about or to be a health care worker. Well, that's because you're in settings, you know, you are sending your child or you are working in a setting where there are going to be people who are vulnerable to this. Remember, there are people who cannot get vaccines because they're immunocompromised, right? I mean, you know, there are babies who are born or very young in that period before they get the vaccines and they've lost whatever immunity they've gotten from their mothers. They are vulnerable. And there are breakthrough cases sometimes.

Some of these vaccines, you know, most vaccines are not perfect. You can get cases now and then. So you're making, I mean, and this idea that this is all about you and you don't affect anybody else, well, no, what, you know, the premise of this, and this goes back, you know, there's a famous Supreme court case from Massachusetts about this and it's been upheld constantly, even, you know, liberal courts, conservative courts, is that, you know, you do have some obligation when you go to school, when you're in your kid to school or you're part of the, you know, you are exposing other people. This is public health. That's what you do when you protect public health. So, you know, but this is,

this is different now. I mean, you know, putting somebody like this in charge, Surgeon General of Florida, large estates, it's wild. But you pulled up an article that said the lawmakers in the state are not necessarily going to follow through on this. Right. So the legislature is back now and they're debating and the committee, I'm not the world's leading expert on state politics in Florida anymore, but I think it was the health committee and the state senator of the state house. I can't remember which chamber voted to advance a bill that they called a medical freedom bill. It sounded like, but it didn't actually remove any mandates. What it did was it made it easier to apply for exemptions. So on, you know, two things about which is exemptions are already a bit of, you know, if you care about public health or

bit where and then they're giving them out like candy, you know, in a lot of places and they become a kind of catch-all. You know, you don't have to actually show that your religion, you know, it's a religious exemption. You don't have to show that you know, you could go to some, you know, online church basically or whatever and get a recommendation. At the same, you know, I do think it, but this demonstrates the fact that I think these legislators, lawmakers in Florida, are torn because I think a lot of them understand that these vaccines are important and useful and generally popular. Most people still want their kids vaccinated. Most people support vaccination. But this has become such a political badge of honor on the right. And that's what's new

here, you know, that this feedback loop where not only, you know, used to, you were talking about before there were people on the left who were anti-vaccination. There was a lot of people on the left who are anti-vaccination. And now you're seeing that pop up on the right. What I think is different on the right. And we really didn't see this on the left before is that at this point, there are people who are turning against vaccines because that's what my political tribe believes. That's what Donald Trump is saying. That's what Robert F. Kennedy Jr. is saying, therefore, I believe that. You know, the sort of the political identity is driving the feelings about vaccines, which I think is quite dangerous because historically, vaccines were not a partisan issue. The only thing I would say,

it's not pushback, but it is sort of a useful note here, which is so much of this is, obviously a response to what happened during COVID, right? and under Biden particularly. But some of this did predate Biden, right? Like Trump did operation warp speed, but even early on when vaccines hit the market for COVID, there was already a partisan breakdown about who was taking. Republicans were much more likely to resist taking those vaccinations. So some of it was signaling for sure.

And some of it might have just been, you know, recoiling the Biden administration for pushing the vaccine so hard. but it does seem like we're in a place where it's now become kind of internalized among conservatives that any government mandate, regardless of whether it's for buying insurance or getting a vaccine or anything that's mandating you to do something, cannot be trusted because it's coming from the government. And so we're in a bad place. I guess the only question is this cyclical, right?

Like, are we going to get to a place where the politics shift? And you would say maybe, but COVID would have been the point, right? It would have been like, oh, my God, we have this, you know, wild epidemic that's killing tens of thousands. Like, we should be supportive of vaccines. But it did the opposite. You know, we ended up in place where we are now. And it's hard to see, like, a measles outbreak in South Carolina sparking a reconsideration. But maybe.

Yeah. I mean, I feel like if I were going to channel my JVL here, I would say we ran the experiment and it failed. I mean, you know, lots of AP. And I say this all the time. I'm sort of a million. Americans died from COVID. And it's very clear that if you got vaccinated, you were much less likely to die from COVID. There's no ambiguity there. And it is just written off, which is very disturbing. But, you know, I guess if I was going to be hopeful, because I always like to be hopeful in these

conversations, as you know. Yes, of course. Despite what your newsletter content is, you're a hopeful person. Maybe we'll do some soon, right? I don't know if there's much to work with, buddy. You know, COVID was such a, there was so much going on with COVID in so many different ways. And it was such a weird experience. And it came at a time when I think we have seen this sort of, you know, predating that even, right? Now, number one, you know, we have this predating this loss of faith in institutions that's been going on for a while, right, for reasons that have nothing.

And then the public health establishment did make some mistakes in COVID. I think, you know, there were some overpromises, so all of that built in. I do think as we, you know, you see sort of things like the measles come back. I wonder if we won't see some backlash. I mean, one thing, I don't want to steal a future newsletter, but there are these pockets all over the country of the sort of grassroots movements to push vaccines. I mean, there are people making that case right now and who are sort of making the argument. You see, you can see bits and pieces of it on Instagram.

There are, you know, and there are politicians. also running. I mean, we'll see. I mean, my story this week, right? I talk about Annie Andrews, who's a Senate candidate down in South Carolina, who's a pediatrician and is really been hammering away at this, you know, tough as a Democrat to win in South Carolina, obviously, but, you know, we'll see. We'll see. Maybe it's cyclical. So, I mean, I, you know, people, this is pretty bad, and so are some of these other diseases. It's pretty bad. Yeah, maybe I'll get people's attention. I mean, that chart is just mind-blowing. It's a mind-blowing chart. It's really frightening. I know people think it's not a big deal. Well, some people think

it's not a big deal. But as you write in the piece, I mean, there are real consequences. Loss of life for sure, but real, even if you do survive it, real long-term medical consequences for people get measles. And it's painful to watch because it's all self-inflicted. Jonathan, thank you so much, man. I do appreciate this. Everyone in all seriousness, should be subscribing to the newsletter. It's instrumental. It's essential. There's some good topics coming up, too, on it. So we'll be following it. You should subscribe to it. Cohn, I'll talk to you later about it.