There is a generation of American parents who knew exactly what measles meant. They had watched many children disappear, either for short periods of hospitalization or longer periods of more serious illness; too often, they never returned. They lined their children up for the vaccine in 1963 without hesitation. Measles was documented as “eliminated” from the United States in 2000.
We have spent the decades since forgetting what they knew.
On April 27, Gov. Ned Lamont signed Public Act 26-3 into law. Among its provisions, the legislation explicitly bars Connecticut’s Religious Freedom Restoration Act from being used to claim exemptions from school immunization requirements. That decision was the right one, and the contrast with what two other states are doing at this very moment makes clear exactly why.
Measles is not a childhood inconvenience. It is a highly contagious, potentially fatal infection, with children under five at greatest risk. Before the vaccine became available, the United States recorded 3 to 4 million infections every year: tens of thousands of hospitalizations, 1,000 cases of encephalitis, and roughly 500 deaths annually, most of them children.
Measles still kills more than 100,000 people around the world each year, almost exclusively where vaccination rates are low. One infected person can pass the virus to as many as 18 others, and the virus can linger in the air for up to two hours after an infected person has left the room. Reaching the immunity threshold that stops transmission requires at least 95% of a community to be vaccinated – protecting not just those who got the shot, but newborns, immunocompromised individuals, those who might not attain immunity through vaccination, and children too young for the vaccine.
The national picture should alarm anyone paying attention. A Washington Post county-level analysis of 1,616 counties shows that before the pandemic, 48% of U.S. counties met that 95% threshold. After the pandemic, only 27% do. The United States has already recorded 1,893 measles cases this year, more than 80% of last year’s total, despite being well short of halfway through the year. Once a community loses protection, outbreaks are no longer hypothetical. They are inevitable.
For decades, Mississippi and West Virginia demonstrated that this was preventable. Both states maintained medical-exemption-only vaccine policies and consistently posted some of the highest childhood vaccination rates in the nation. Mississippi’s MMR coverage reached 99.1%. West Virginia’s sat at 98.3% as recently as 2023–24, with an exemption rate of just 0.1%.
Both states have changed course. In April 2023, a federal court order required Mississippi to begin allowing religious exemptions; coverage dropped to 97.5% and is trending downward. In January 2025, West Virginia’s governor signed an executive order opening the same door. The question is not whether rates will fall. It is how fast.
Connecticut has moved in the right direction. After the state eliminated religious exemptions from school vaccine requirements in 2021, its non-medical exemption rate collapsed from 4.1% to 0.3% within a single school year. Public Act 26-3 reinforces that achievement by closing the legal door that the ongoing Spillane v. Lamont litigation has kept ajar. The argument for strong immunization policy is not ideological. It is mathematical. Measles requires 95% community vaccination to stay contained. When outbreaks begin, it is too late to vaccinate your way out quickly enough to protect children already exposed.
The urgency is not abstract. This summer, the FIFA World Cup will bring hundreds of thousands of international visitors to venues across the region, including MetLife Stadium in New Jersey and Gillette Stadium in Massachusetts. Travelers from countries with lower vaccination rates will move through our airports, our transit systems, and our communities. In states where vaccination rates are falling, a single infected traveler in an under-vaccinated community is all it takes to start an outbreak. Public Act 26-3 ensures Connecticut will not be among them. Unless the Spillane v. Lamont litigation undoes what the legislature built.
Policymakers in Mississippi and West Virginia still have time to follow Connecticut’s lead. The disease they are risking is not theoretical. The only question is whether legislators will act before the outbreak or explain to parents afterward why they did not.
Frane Marusic is a junior at Yale College and a Global Health Scholar. Howard P. Forman, M.D., M.B.A. is a professor of Radiology and Biomedical Imaging, Economics, Management, and Public Health at Yale University and a practicing physician.
