The Cost of Forgetting: Vaccines, Measles, and My First-Hand Experience
By Dr Sara Watkin, Optimal Healthcare Ltd, Cayman Islands
I trained and practised paediatrics through a period of immense change in child health. When I began medical training in the early 1980s, the UK had introduced a single measles vaccine in 1968, but uptake was still patchy. Rubella immunisation for schoolgirls followed in 1970, and the combined measles, mumps and rubella (MMR) vaccine only arrived in 1988, after I qualified in 1987. A catch-up campaign in 1994 and a routine second dose in 1996 were the key steps to reaching herd immunity.
This timeline mattered. During my student and early years, I saw significant numbers of measles cases in outbreak years. Children lay frightened, febrile, often coughing, with the characteristic rash spreading. Some developed pneumonia or encephalitis. A few died. Parents sat exhausted at bedsides, siblings were sent to relatives, and families endured weeks of disruption. For a child, the fear of needles, masks, isolation, and prolonged stays was often as traumatic as the illness itself.
After MMR became routine and coverage climbed, the change was dramatic. Cases fell sharply. Hib meningitis and epiglottitis disappeared within a few years of the Hib vaccine in 1992. Pertussis admissions, still common during the 1980s after the earlier vaccine scare, also dropped once uptake recovered. As more vaccines joined the schedule, such as MenC in 1999 and pneumococcal conjugate vaccine in 2006, the pattern of children’s admissions shifted profoundly. I witnessed, first hand, the before, the during and the after.
What the Data Confirmed
- Before vaccination in 1968, the UK saw over 400,000 measles cases a year and close to 100 deaths annually.
- Through the 1970s and 1980s, with coverage incomplete, tens of thousands of cases still occurred every year, although deaths dropped over this time to an average of 13 deaths annually.
- With the MMR rollout in 1988, followed by the 1994 catch-up and the 1996 second dose, measles hospitalisations and deaths plummeted.
- By the early 2000s, measles was declared eliminated in the UK.
This was public health success at its best, with clear policy, high uptake and herd immunity.
Why This Matters Again
Measles requires 95 percent two-dose coverage for herd immunity. When rates dip, outbreaks return, as seen after the false MMR-autism scare in the late 1990s, and again in recent years. In 2024, England confirmed nearly 3,000 measles cases, the highest in a decade, overwhelmingly in unvaccinated children.
Yet in the public arena, figures such as Donald Trump and Robert F. Kennedy Jr have revived claims that sow doubt about vaccines. Trump has recently echoed discredited autism links, while RFK Jr has implied that vaccine schedules are unsafe. Such claims have been rejected by every major health authority, but they carry influence. They risk eroding the trust and uptake that underpin herd immunity.
I’d go further. Everything I do is held to a standard of evidence-based medicine. Where the evidence exists, I must follow that evidence or place my licence and my livelihood at risk. Where the evidence is still emerging, it is incumbent on all professionals to work together to build the evidence, through both clinical observations and rigorous research. What I say is held to the same standards as what I do. And yet individuals such as Donald Trump and RFK Jr, with media access to millions of people, are seemingly able to make unsubstantiated and even disproven statements without any standards, let alone the same standards.
Responding to Recent Claims
It is healthy in medicine to keep testing assumptions. Vaccine safety is continuously studied in clinical trials, surveillance programmes, and real-world monitoring. But there is a difference between legitimate scrutiny and repeating claims long disproven.
- MMR and autism. Multiple large studies across several countries show no causal link.
- Safety monitoring. Adverse events are reported and investigated. Risks are rare and far outweighed by the benefits.
- Schedules. Vaccination schedules are designed to protect children at the most vulnerable ages. Spacing them out delays protection when it is most needed.
The most damaging example of misinformation came from Andrew Wakefield’s 1998 paper in The Lancet, which suggested a link between the MMR vaccine and autism. The study involved only 12 children, lacked proper controls, and was later shown to contain falsified data and undisclosed conflicts of interest. The paper was fully retracted in 2010, and Wakefield was struck off the UK medical register. Since then, multiple large-scale studies, involving hundreds of thousands of children in different countries, have confirmed that there is no link between MMR and autism. Despite this overwhelming evidence, the myth persists, and it continues to cause real harm by lowering vaccine uptake and fuelling preventable outbreaks.
The comments by Donald Trump and RFK Jr reopen what was debunked through rigorous clinical trials involving hundreds of thousands of children, and surveillance programmes involving millions. When public figures amplify doubt without evidence, the consequences are not abstract. They are sick children.
Cayman Islands Perspective
Since moving to Cayman in 2016, I have seen the benefits of a structured national schedule delivered through Public Health and primary care clinics. Our population is small, but travel links to the US, UK, and Latin America mean imported measles is a real risk. Cayman’s Public Health Department has recently warned residents about rising global cases and emphasised the importance of MMR.
Here in Cayman, maintaining high uptake is not just individual. It is community protection. It shields infants too young for their first dose, children with compromised immunity, and older adults at risk of severe complications. With global measles surges, Cayman cannot afford complacency.
The importance of that community or herd protection couldn’t be reinforced more profoundly than through the heart-breaking story of Renae, a Liverpool youngster aged 10 who died from a rare condition that can develop after catching measles. Pleading to all parents to vaccinate their children, Renae’s mother was clear “If there wasn’t an outbreak and more kids had their vaccinations, then she wouldn’t have got the measles in the first place. And it wouldn’t have ultimately ended her life.”
What I Ask of Parents and Community Leaders
- Check records. Make sure your child has received both doses of MMR, along with other vaccines. If unsure, ask your GP or Public Health.
- Protect infants. Vaccination in pregnancy against pertussis is vital to protect newborns before they can be immunised.
- Travel wisely. With measles circulating overseas, confirm protection before travel, and seek advice if symptoms develop after returning.
- Use trusted sources. WHO, CDC, UKHSA, and Cayman HSA publish clear, current guidance. Avoid relying on claims made in political debates or on social media without scientific backing.
What Needs to Be Done Professionally
From my clinical and child health experience, I recommend:
- Strong, clear communication from trusted health authorities. Messages must emphasise what we know well, such as vaccine safety, lives saved, and also honestly discuss what we are still studying.
- Education of healthcare professionals so that they can respond confidently to vaccine hesitancy, answer questions, dispel myths.
- Robust surveillance and transparency: adverse events need open reporting; vaccine schedules and safety must be based on evidence; independent review where conflict of interest may exist.
- Community outreach and tailoring, particularly in smaller or remote settings such as the Cayman Islands, where trust, culture and personal relationships matter. Health education must be culturally aware.
- Rapid response to misinformation. When claims by public figures are misleading, authorities must correct them, with data, without shaming, but with clarity.
Final Thoughts
I have seen what measles and other vaccine-preventable diseases can do. I have also seen how dramatically that burden lifts when vaccines are widely used. Those memories stay with me, the sick children, the frightened faces, the grieving families. And I have seen the alternative, where hospital beds remain empty of these cases because children are protected.
Vaccines are not abstract. They are why countless children in the UK, Cayman, and worldwide are alive, healthy, and free from preventable suffering. We must protect that achievement, not allow doubt and misinformation to erode it. And we should hold all individuals with reach and influence, not just clinical professionals, to rigorous standards and probity.
References & Sources
Vaccine Knowledge Project, University of Oxford: Measles history and vaccine introduction
https://vaccineknowledge.ox.ac.uk/measles
UK Health Security Agency (Green Book: Measles) – Epidemiology, mortality, vaccination timeline
https://assets.publishing.service.gov.uk/media/5e021b9140f0b6665e80187b/Greenbook_chapter_21_Measles_December_2019.pdf
UKHSA blog: “What is measles and why is it so important we’re all up to date with our MMR vaccine?” (May 2025)
https://ukhsa.blog.gov.uk/2025/05/23/what-is-measles-and-why-is-it-so-important-were-all-up-to-date-with-our-mmr-vaccine
BBC News: “Trump vaccine claims spark debate” (Sept 2025)
https://www.bbc.com/news/articles/cdx2rk10ep0o
AP News: “RFK Jr, Trump revive vaccine debate with discredited claims” (Sept 2025)
https://apnews.com/article/0847ee76eedecbd5e9baa6888b567d66
How the case against the MMR vaccine was fixed by Brian Deer, published in The British Medical Journal (BMJ) 2011. This investigation exposed how Wakefield manipulated evidence, had undeclared conflicts of interest and breached ethical codes.
https://www.bmj.com/content/342/bmj.c5347
Lancet retracts 12-year-old article linking autism to MMR vaccine by Laura Eggertson, Canadian Medical Association Journal (CMAJ), 2010. This article reports the full retraction of Wakefield’s original 1998 paper after findings that several elements of the paper were incorrect and that the conclusions were not supported.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2831678/
My daughter died of measles complications and I have a message to every parent. Liverpool Echo. July 2025.
https://www.liverpoolecho.co.uk/news/liverpool-news/daughter-died-measles-complications-message-32062113
Cayman Islands Health Services Authority – Vaccination schedules and measles updates
https://www.hsa.ky/public-health/vaccinations
