Reader response
Myron Yaster MD
From Myron: In a recent PAAD Howard Zucker MD reviewed Measles. Because by design PAADs are 5-6 minute reads I wasnt able to post his review and summary in full. Here is a final thought from Howard.
The measles situation in the United States is deeply concerning. Growing vaccine skepticism has created challenges for pediatricians and public-health officials nationwide. To date in 2026, 416 measles cases have been reported in the United States, with 413 occurring across 14 states. Notably, 94% of confirmed cases are outbreak-associated that originated with the 2025 cases. Among cases reported in 2026, 25% have occurred in children under five years of age, and 61% in those aged 5–19 years. An important fact is that 94% of infected individuals were either unvaccinated or had unknown vaccination status. The last major measles outbreak in the United States prior to the current crisis occurred in 2018– 2019 in New York, during my tenure as state health commissioner. We contained that outbreak successfully through close collaboration with a tight-knit religious community, grounded in trust, sustained engagement, and communication about the safety and benefits of vaccination. As a result, the outbreak abated and the United States retained its measles elimination status. More recently, CDC’s Advisory Committee on Immunization Practices (ACIP), with its newly appointed members, has questioned established childhood vaccination schedules. This has generated public uncertainty about vaccinations at precisely the moment when clarity and consistency are most needed. Inaccurate statements about the links between vaccines and autism, stemming from leadership at HHS, have fueled the flames of theories lacking scientific evidence. For a deeper discussion of the clinical, epidemiologic, and policy dimensions of measles, see my Docology podcast conversation with Adam Ratner, MD (author of Booster Shots: The Urgent Lessons of Measles and the Uncertain Future of Children’s Health) at
From Richard Berkowitz MD community based anesthesiologist
The following is ludicrous
Rejecting Decades of Science, Vaccine Panel Chair Says Polio and Other Shots Should Be Optional
Dr. Kirk Milhoan, a pediatric cardiologist who leads the Advisory Committee on Immunization Practices, said a person’s right to refuse a vaccine outweighed concerns about illness or death from infectious diseases.
https://www.nytimes.com/2026/01/23/health/milhoan-vaccines-optional-polio.html?smid=nytcore-ios-share
Although I am only working a few days per month, I work on pediatric surgical days... and still review charts for the department. I have found that many children are showing up or are being scheduled for surgery without having received immunizations at a much greater frequency (Indiana, just outside Chicago)...than in the past. Have you found the same issue? If so, have you been more reluctant to proceed with these children for totally elective surgery even if URI symptoms are minor...putting immunocompromised staff and patients at risk...why did we do pediatric residencies? Oy!
From David Mandelbaum MD pediatric neurologist Brown University
Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis. here
This is an issue of great relevance to us child neurologists. I am particularly sympathetic to point number 6:
6. What are additional predisposing factors? For example, what role is played by comorbidities that require the child to require surgical intervention in the first place?
There is a large body of literature indicating an increased incidence of Neurodevelopmental issues in children with even minor congenital anomalies, e.g. cleft lip and palate, dysmorphisms, etc. Why the child needed surgery is a serious uncontrolled variable that is going to be very hard to sort out.
But something else occurred to me from your introduction in which you wrote: “It is simply impossible for practicing physician anesthesiologists to keep up with the tidal wave of medical literature.” In the study cited, the authors state: “After evaluating over 5,000 potential studies, the authors settled on 3 that met the inclusion criteria and used similar outcome scores.” Did the other 4,997 studies warrant being published if they didn’t meet criteria for inclusion in the meta analysis? Is one of the reasons for the “tidal wave of medical literature” a failure to be selective enough about what is being published?