Unmasking Vaccine Myths: Dr Marschall Runge on Measles, Misinformation, and Public Health Solutions

Measles

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Despite decades of scientific data proving vaccine safety, measles cases are on the rise, fueled by lingering myths and mounting mistrust. In this exclusive interview, Marschall Runge, PhD, author of The Great Healthcare Disruption and a top leader at Michigan Medicine, discusses with Infection Control Today^® (ICT^®) the roots of misinformation, the limits of vitamin A, and how clinicians can engage communities with empathy and science to restore confidence in immunization.

ICT: What are the most persistent myths about the measles vaccine, and why do you think they continue to circulate despite decades of scientific evidence?

Marschall Runge, PhD: One of the most persistent myths is the belief that the measles vaccine, particularly the MMR vaccine, causes autism. This falsehood originated with a now-debunked 1998 study by Andrew Wakefield, which was later retracted due to ethical violations and fraudulent data. Despite overwhelming scientific consensus disproving any link, the myth endures. Another dangerous myth is that natural infection is safer or more effective than vaccination. Unfortunately, that myth has also been shown to be untrue. In fact, natural infection can render the immune system less effective in protecting children or adults from other types of infections. In other words, a natural measles infection can worsen natural immune defenses. While measles is not the only type of infection with this effect, given its worldwide prevalence, this is a significant concern.

These myths persist for several reasons. Much of this is due to the influence of social media, as well as the presence of seemingly authoritative voices on social media and elsewhere, and highly emotional and sometimes politically driven biases.

ICT: The claim that the measles vaccine causes autism has been widely debunked. Why does this particular myth remain so powerful in public discourse?

MR: This myth persists because it plays on deep emotional fears that parents have about their children’s well-being. The temporal proximity of early childhood vaccinations to the onset of autism symptoms creates a false impression of causation. In addition, Wakefield's original claim received significant media attention, which unfortunately gave it credibility in the public eye. Even though the study was retracted and he lost his medical license, the initial damage had already been done. Once a fear is seeded, especially when tied to a vulnerable population like children, it becomes tough to uproot—even with mountains of evidence.

ICT: Can you explain why vitamin A, while necessary for overall health, is not a substitute for the measles vaccine?

MR: Vitamin A is essential for immune function and can reduce the severity of measles in malnourished children, particularly in developing countries, as well as in immunocompromised children. The World Health Organization (WHO) recommends high-dose vitamin A supplementation for all children diagnosed with measles. Doses up to 200,000 IU (international units) are recommended for children over 12 months. Younger children get lower doses. There is evidence that Vitamin A reduces mortality and serious complications, such as pneumonia, encephalitis, and ocular complications (including blindness), by up to 50%. [However,] it doesn’t prevent infection in any population. Relying on it in place of vaccination leaves populations vulnerable to infection and outbreaks.

ICT: How have systemic issues in health care, such as lack of access or health literacy, fueled confusion around vaccine alternatives like vitamin A?

MR: Lack of access (because of shortages or self-imposed lack of access) to consistent, culturally competent health care providers contributes to communities seeking alternative or "natural" remedies. For example, when people don’t understand how vaccines work, they're more susceptible to misinformation that positions supplements like vitamin A as equivalent or superior. There is also growing mistrust of the medical establishment for these same reasons.

ICT: In your view, what does the resurgence of measles say about public trust in health institutions and the spread of misinformation?

MR: The resurgence of measles is a stark indicator of declining public trust in health institutions and the success of misinformation campaigns. This is likely also impacted by delayed public health responses to vaccine hesitancy, particularly during the COVID-19 pandemic, and the ability of social media to disseminate falsehoods far more quickly than institutions can correct them. Trust is built slowly but eroded quickly. Part of the problem relates to the need for more primary care in the US. When you compare us to peer countries, the number of primary care providers [to the] population is at the lowest in the group.

ICT: What strategies can health care leaders use to communicate science-backed vaccine information to diverse communities better?

MR: Health care leaders should prioritize cultural humility, multilingual resources, and partnerships with trusted community voices. There are community-focused NIH grants, known as Clinical and Translational Science Awards, that have done an excellent job of connecting with trusted community voices, and this approach is needed much more broadly. Community health workers, faith-based leaders, and local influencers can enhance the credibility [of the initiative]. And anecdotes, especially from within the community, can be much more powerful than statistics.

ICT: How can clinicians reframe vaccine conversations to focus on empathy and lived patient experience rather than data alone?

MR: Reframing begins with listening. Clinicians should approach vaccine discussions not as debates, but as opportunities to understand a patient’s fears and beliefs. Instead of leading with statistics, they can start by asking, “What are your concerns?” or “Can you tell me what you’ve heard about vaccines. Using storytelling, such as sharing experiences from their own families or other patients, can be far more powerful than charts or graphs. For instance, one relative of mine rejected childhood vaccines due to concern about autism in her husband’s family. Another is a pediatrician who works diligently to connect with the community about the importance of childhood vaccinations.

ICT: What roles do formal and informal education play in correcting vaccine misinformation, and where are the most significant gaps?

MR: K-12 schools can be extremely effective in communicating health issues. This used to be done much more broadly, but school boards are now often under significant pressure regarding their curriculum. But the principle of education in a school setting has been proven for multiple health-related issues like hypertension control, reduction of risk of sexually transmitted disease, and healthy food choices. I don’t want to pretend that these problems could be “fixed” with more K-12 education, but it’s a start. If for no other reason, related to vaccination, kids can learn how vaccinations work. Of course, we have homeschooling, which increased dramatically during the COVID-19 pandemic, and the trend continues. Unfortunately, informal advice on social media is often curated by the person providing their version of information. Although this might not be realistic, I think that more accessible and trusted social media sites might have an impact.

ICT: How should public health systems adapt their messaging when facing surges of preventable diseases like measles?

MR: Public health messaging must be rapid, transparent, and responsive to the evolving concerns of the community. When surges occur, messages should clearly outline the current risk, steps individuals can take, and the rationale behind those steps. Messaging must be multilingual, accessible, and inclusive. Visual media—short videos, infographics, social posts—are especially effective during crises. Public health authorities should also pre-identify and train community liaisons who can help amplify and contextualize messages quickly. Once again, we need to consider using the communication channels that people prefer, particularly social media.

ICT: Looking ahead, what steps can institutions like Michigan Medicine take to restore public confidence in immunization programs and public health guidance overall?

MR: Institutions like Michigan Medicine can lead by example through transparency, accountability, and community partnership. We have several programs that provide outreach to area schools. One, called “Healthy Schools,” is supported by Michigan Medicine and has been especially effective. We need to use our brand, and other health care providers use theirs to rebuild trust. But there is probably no better way to increase awareness of all health problems than to amplify the voices of trusted messengers within communities, all communities.