In December 2019, when I was serving as lieutenant governor of Hawaii, I led an emergency medical mission from Hawaii to Samoa, which was overwhelmed by a deadly measles epidemic. Our team of doctors and nurses helped vaccinate 37,000 people in less than 48 hours, but the virus had already infected thousands and ultimately killed over 80 people, most of them children.
For months before the measles outbreak in Samoa, misinformation and conspiracy theories questioning the safety of vaccines had spread throughout the Pacific island nation, leading to a dangerous drop in vaccination rates and making that country vulnerable to disaster.
As an emergency room doctor and family physician in Hawaii for over 20 years, I knew what vaccine misinformation and conspiracy theories can do to patients’ trust in science-based medicine, especially when it comes from public health officials who should know better. It can undermine their confidence in evidence-based care and prevent them from getting their children vaccinated, and the consequences can be deadly.
In Samoa, I saw firsthand the damage that vaccine policy failure can do to a country. Falling vaccination rates, inadequate health policy, and a lack of preparedness can trigger a crisis that brings an entire nation to its knees.
Safe and effective vaccines have saved more than 150 million lives worldwide over the last 50 years, cutting infant mortality by 40%. International vaccination programs have eradicated smallpox and reduced polio cases by more than 99% globally, with the measles vaccine alone saving an estimated 94 million lives.
Measles is an extremely contagious virus, but it is almost completely preventable through effective vaccination, with two doses of the current vaccine about 97% effective at preventing the disease, and a single dose about 93% effective. When vaccination rates fall below 95%, measles can rip through an unprotected population.
Since 2000, measles has been virtually eliminated in the United States—until early last year. Now we are seeing the same deadly process unfold in America for the first time in a generation, with outbreaks of measles spreading from state to state, moving from one unprotected population to another in a dangerous patchwork of infections across our entire country.
National rates of kindergarten vaccination with the measles-mumps-rubella (MMR) vaccine have dropped from 95.2% in 2019-2020 to 92.5% in 2024-2025 and vaccination exemptions have climbed to a record 3.6%, leaving an estimated 286,000 kindergartners at risk of infection.
In 2025, the U.S. Centers for Disease Control and Prevention reported 2,284 confirmed measles cases and 50 outbreaks in the United States. This year alone the CDC has confirmed 1,362 measles cases, with 89% linked to outbreaks. This out-of-control spread of measles has been allowed to happen through a failure of vaccine policy at the highest level of our national healthcare leadership.
From the very first outbreaks in Texas last year, the U.S. Department of Health and Human Services (HHS) should have launched an emergency campaign to raise vaccination rates above 95% in every area where they had fallen too low. The message should have been loud and clear from every public health official from the HHS Secretary on down: get your children vaccinated now.
Instead, HHS leaders failed to mount an effective response, allowing measles to spread across the country. While measles cases were rising last year, HHS Secretary Robert F. Kennedy Jr. failed to forcefully and unequivocally call for the one measure that can stop measles outbreaks: rapid MMR vaccination of vulnerable populations. Kennedy instead irresponsibly diverted public attention from vaccination to unproven and ineffective treatments such as vitamin A supplements and inhaled steroids.
As HHS has failed to stop the measles outbreaks spreading across our country, we have pulled back from investment in crucial new vaccine development. In August 2025, HHS announced it would wind down mRNA vaccine development under the Biomedical Advanced Research and Development Authority (BARDA), terminating 22 projects totaling nearly $500 million, including the late-stage development of a bird flu vaccine for humans.
This withdrawal from new mRNA vaccine development is putting our country at risk. The 2022 National Biodefense Strategy calls managing biological risk a vital interest of the United States. The Government Accountability Office has warned that infectious diseases with pandemic potential, including bird flu, threaten American lives, our national security, and our entire economy.
As lieutenant governor and COVID liaison in Hawaii during the pandemic, I saw firsthand the crucial importance of these investments. Rapid vaccine development through mRNA technology allowed us to slow the spread of the virus, achieving the lowest infection and mortality rates in the country and saving thousands of lives. A major modeling study in The Lancet Infectious Diseases estimated that the COVID vaccine prevented about 14.4 million deaths globally in the first year of rollout.
We must be able to rapidly develop vaccines against newly emergent pathogens. The World Health Organization has said that mRNA technology allows vaccines to be developed and manufactured quickly, which will be essential in slowing or preventing the next global pandemic.
Experts fear that the next global pandemic could come from bird flu. The H5N1 virus is already circulating widely in wild birds and has spread through poultry and dairy herds, creating repeated opportunities for the virus to adapt. If a mutation enables it to spread easily from person to person, there will be clusters of severe pneumonia, and a wave of infected farmworkers, sick healthcare staff, and overwhelmed hospitals.
If bird flu spreads, poultry and dairy production would be disrupted, food prices would rise, and schools and workplaces would close. Rural communities would be hit especially hard because too often they have the least hospital capacity. In a matter of weeks, a public health emergency could become a supply-chain shock, a labor shortage, and a crisis of public confidence in government competence.
That is why abandoning mRNA research is such a dangerous mistake. Speed matters in a pandemic, and mRNA technology allows scientists to design, test, and update vaccines far faster than older platforms. If we weaken that capability now, we will lose time we cannot recover later. In a fast-moving outbreak, months of delay would cause countless deaths, deeper economic disruption, and a much longer and more difficult road to recovery.
We know what must be done to protect our country from extremely contagious diseases like measles, COVID, and potentially, bird flu. We must restore urgent national leadership on vaccination, rebuild BARDA’s investments in rapid-response mRNA vaccine technology, and treat public health preparedness as a matter of national security, not partisan ideology.
If we fail to take these actions, the current measles outbreak will only be the beginning. It will be a warning we ignored before bird flu or another deadly virus puts America through an even more devastating pandemic.