As measles cases surge, the Trump administration is loosening vaccine rules and downplaying a fatal complication that’s far more common than anyone knew.
Trump signs executive order reducing recommended childhood vaccines
President Trump signed an order reducing recommended childhood vaccines.
Does liberty mean a right to kill other people’s children, slowly and painfully? It would, if the Trump administration had its way. It’s pressing states to allow broad vaccine exemptions as part of its larger campaign against settled medical practice.
The danger is clearest with measles. Children usually recover from it, albeit often with some permanent damage. But a 2016 California study found that when infants under a year old are infected, subacute sclerosing panencephalitis (SSPE) – in which the virus lingers in the brain and slowly destroys it – develops in about 1 in 600 cases, far higher than the 1-in-100,000 figure doctors had long cited.
Long after the initial infection, the child becomes clumsy and forgetful, then experiences headaches, fevers and seizures, loses motor control and finally becomes bedridden and dies.
There is no cure.
Babies can’t be vaccinated on the standard schedule until 12 to 15 months old – earlier doses, at six months, are given only for travel to outbreak areas and don’t count toward full protection. (Under the schedule revisions the Department of Health and Human Services just proposed, some of that timeline would push even later.)
Until children are protected, the only way to guard against SSPE is to keep them away from unvaccinated people.
In Germany in 1999, an unvaccinated 11-year-old boy was taken to the pediatrician with a fever. He infected six children in the waiting room, including three babies. Two of them developed SSPE. Natalie died in 2011 and Micha in 2013.
Measles cases are climbing – and most of the infected are children
Measles is astoundingly contagious. You can catch it by entering a room two hours after an infected person left.
The country has recorded more cases since early 2025 than in the previous 25 years combined, according to Centers for Disease Control and Prevention data. More than 70% of confirmed cases are children.
The administration’s anti-vaccine rhetoric is a principal driver, and if it gets its way, the unvaccinated share of the population will keep rising. Scale up that 1-in-600 figure, and that’s a lot of dead children.
Robert F. Kennedy Jr., head of the Department of Health and Human Services, claims that immunity from having the disease is better than immunity from the vaccine. That is dangerous quackery. Beyond SSPE, measles causes lasting damage to the immune system, leaving children vulnerable to other infections for years afterward.
About 1 in 1,000 children who get measles will develop encephalitis, brain swelling that can cause convulsions, deafness or intellectual disability. Between 1 and 3 of every 1,000 infected children will die of respiratory or neurologic complications. (Trump has also endorsed the debunked claim, which Kennedy pushed for decades before joining the administration, that vaccination causes autism.)
Vaccination should be required for everyone, with exemptions only for medical necessity. Vaccine resisters should be thought of like drunken drivers: people who recklessly endanger innocent strangers.
Kennedy’s vaccine recommendations misunderstand freedom
The Trump administration relies on a strange conception of liberty. Kennedy has said that people should be free to refuse vaccination for any reason at all. During a 2025 Texas measles outbreak that had already killed one unvaccinated child, he wrote: “The decision to vaccinate is a personal one.”
Kennedy went further: “I’m a freedom-of-choice person. … We should have informed choice, and if people don’t want it, the government shouldn’t force them to do it.”
In January, CDC Principal Deputy Director Ralph Abraham said that it would “not really” be a significant loss if the United States lost its measles-free status.
“It’s just the cost of doing business, with our borders being somewhat porous (and) global and international travel,” Abraham explained. “We have these communities that choose to be unvaccinated. That’s their personal freedom. … You know, the president, the (health) secretary, we talk all the time about religious freedom, health freedom, personal freedom, and I think we have to respect those communities that choose to go somewhat of a different route.”
Florida’s attorney general has an even weirder idea of freedom: He is seeking to force Catholic schools in his state to permit exemptions from immunizations, turning classrooms into vectors for a disease that kills.
Defense Secretary Pete Hegseth recently said, “If you kill Americans, if you threaten Americans anywhere on earth, we will hunt you down without apology and without hesitation and we will kill you.”
Cabinet meetings would not go smoothly if he meant it.
Right now, somewhere in America, some toddler is becoming a bit clumsy. The mother is thinking, “The baby must be tired.” She does not know that Trump and Kennedy – and Republicans in Congress who have gone along with them – have already doomed her child.
In a better world, it would be a political liability for politicians to kill American kids.
Andrew Koppelman, the John Paul Stevens Professor of Law at Northwestern University, is the author of “Burning Down the House: How Libertarian Philosophy Was Corrupted by Delusion and Greed.” Follow him on Bluesky: @andrewkoppelman.bsky.social