随着资金被投入州和地方卫生部门，以帮助应对全国范围内日益增长的麻疹爆发，专家表示，来自顶级卫生领导人的清晰沟通似乎缺失，而公开表态的内容可能弊大于利。该国麻疹病例已超过4000例，且似乎已经达到去年麻疹相关死亡人数的两倍。根据全美县市卫生官员协会（NACCHO）政府与公共事务主管阿德里安·卡萨洛蒂的说法，地方卫生部门仅因麻疹病例规模之大而不堪重负。
While money is pumped into state and local health departments to help counter the growing measles outbreaks across the country, experts say clear communication from top health leaders seems lacking and what has been said publicly may have hurt more than helped. The country has surpassed 4,000 measles cases and appears to have already doubled the number of measles-related deaths from last year. Local health departments are simply overwhelmed by the sheer scope of measles cases, according to Adriane Casalotti, chief of Government and Public Affairs for the National Association of County and City Health Officials (NACCHO).
她说：“到处都是麻疹，因此它在不同社区爆发的可能性非常高。因此，地方层面的关注度确实非常高。”为应对疫情，美国疾病控制与预防中心（CDC）已向州、地方和部落卫生部门拨付约1亿美元的额外资金，用于疫苗接种、预防和疾病检测工作。本周，CDC表示将向宾夕法尼亚州部署额外支援，该州报告的病例数最多，且是目前唯一一个出现确诊麻疹相关死亡的州。
"There's so much measles out there that the chances of it popping up in different communities is really high. And so, the attention certainly at the local level is very much there," she said. In response to the outbreaks, the Centers for Disease Control and Prevention (CDC) has issued roughly $100 million in additional funds to state, local and tribal health departments, going toward vaccinations, prevention and disease detection efforts. This week, the CDC said it would be deploying additional support to Pennsylvania, the state reporting the highest number of cases and the only one with confirmed measles-related deaths.
尽管物资和财政支持已到达各州，但来自联邦当局的指导或对麻疹疫苗接种及缓解措施的公开支持却未能顺畅传达。CDC主任埃里卡·施瓦茨如今已就职两个月，此前该职位长期悬空，她对麻疹持续传播鲜有表态。她在九月接受亚特兰大新闻第一台（ANF）采访时提及了此次爆发，称麻疹为“最具传染性的疾病”，并重申MMR疫苗是“安全有效的”。
Despite material and financial support reaching states, what hasn't flowed as readily from federal authorities is guidance or vocal endorsements of measles vaccinations and mitigation efforts. CDC Director Erica Schwartz, now two months into the job after the position had long gone unfilled, has had little to say about the ongoing spread of measles. She touched on the outbreak in September during an interview with Atlanta News First (ANF), calling measles "the most contagious disease" and reiterating the MMR vaccine is "safe and effective.
虽然官员在被问及麻疹疫情时会发表评论，机构也在继续发布支持，但传染病专家表示，联邦层面的强有力信息传播活动将在提升麻疹应对方面发挥重要作用。美国传染病学会首席执行官兼国家过敏和传染病研究所（NIAID）所长珍妮·马拉佐表示，一项阐述麻疹、腮腺炎和风疹（MMR）疫苗作用的全面信息将是一个良好的开端，尤其是考虑到今年已经发生了如此多的疫情——截至目前最新统计为42起。
While officials are commenting on measles outbreaks when asked about them and agencies are continuing to issue support, infectious disease specialists say a strong messaging campaign at the federal level would go a long way toward boosting the measles response. Jeanne Marrazzo, CEO of the Infectious Diseases Society of America and National Institute of Allergy and Infectious Diseases (NIAID), opined that an overarching informational message explaining what the measles, mumps and rubella (MMR) vaccine does would be a good start, especially given how many outbreaks there have been this year — 42 at the most recent count.
“我不认为联邦政府的声明一定能填补那个更为复杂的空间，因为决策往往受到我们常常不理解或未能明确表达的诸多因素影响，”马拉佐说。“但我认为可以制定一条国家层面的信息，以涵盖人们对疫苗犹豫更广泛的接受度，”她补充道。“我们只是还没有真正看到这一点，因为，再说一次，我认为我们还没有看到对目前为何疫苗如此关键的全力支持或解释。”
"I don't think that pronouncements from the federal government are necessarily going to fill that much more complex space where decision-making is impacted by a lot of things we often don't understand or aren't articulated," said Marrazzo. "I do think that a national message can be crafted to encompass a more broad kind of acceptance of people's vaccine hesitancy," she added. "We just haven't really seen that because, again, I don't think we've seen a full-throated endorsement or explanation of why the vaccine right now is so critical."
而与此同时，该领域的专家们正期待来自上层的更强有力的信息传播，但也有人认为，目前公开表态的内容可能在对抗麻疹传播方面起到了适得其反的作用。“随着病例持续增加，标准应对措施是向司法管辖区提供支持，包括疫苗、财政资源和人员。这些措施目前仍在进行中，”前美国疾病控制与预防中心（CDC）国家免疫和呼吸道疾病中心主任、Callen-Lorde首席医疗官德梅特雷·达斯卡拉克伊斯表示。
And while experts in the field hold out for stronger messaging from the top, some argue that what has been said publicly may have done more harm to countering the measles spread. "With an ongoing increase in cases, the standard response is to provide support to jurisdictions, including vaccine, financial resources, and offer staff. These things are currently still happening," said Demetre Daskalakis, former director of CDC's National Center for Immunization and Respiratory Diseases and chief medical officer at Callen-Lorde.
“不寻常的是，CDC对宾夕法尼亚州在归因或与麻疹相关的死亡案件的裁决进行质疑所引发的摩擦，”他补充道。
"What is atypical is the friction created by CDC second-guessing Pennsylvania on their adjudication of deaths attributed or related to measles," he added.
拥有一名散布虚假信息、歪曲数据以支持个人议程的秘书，这本身也是不寻常的。达斯卡拉基斯去年因抗议他所称的机构工作受到公开政治干涉而辞去疾控中心职务，他指的是联邦卫生领导人，包括卫生及公众服务部（HHS）部长罗伯特·F·肯尼迪 Jr. 和医疗保险及医疗补助服务中心（CMS）行政管理员梅赫梅特·奥兹，他们迅速质疑宾夕法尼亚州的麻疹死亡病例是否真的发生。
"It is also atypical to have a secretary that is a disinformation agent that distorts data to support his personal agenda." Daskalakis, who resigned from the CDC last year in protest of what he claimed was overt political interference in the agency's work, was referring to when federal health leaders, including Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and Mehmet Oz, administrator of the Centers for Medicare and Medicaid Service, were quick to question whether the measles deaths in Pennsylvania had really occurred.
疾控中心目前的麻疹死亡总数并未反映宾夕法尼亚州的六起死亡病例，这是因为疾控中心转用了另一个数据库来核实麻疹死亡病例，不再使用允许地方司法管辖区提供实时病例信息的那个数据库。当被ANF询问为何疾控中心未记录这些死亡病例时，施瓦茨回溯到COVID-19疫情时期，当时病毒与可能并非直接由其导致的死亡被关联，因为个体在当时检测呈阳性。
The CDC's total tally of measles deaths does not currently reflect Pennsylvania's total of six deaths, owing to the CDC switching to a different database for verifying measles deaths and no longer using one in which local jurisdictions can provide real-time case information. When asked by ANF why CDC isn't recording these deaths, Schwartz harkened back to the COVID-19 pandemic, when the virus was linked to deaths that may not have been directly caused by it because the individual had tested positive at the time.
施瓦茨说：“很多美国人觉得，你知道，人们只是在增加死亡人数，让这件事看起来比实际更糟。那是我们不得不经历的一件可怕、可怕的事情。但定义很重要。” 全国城市及县卫生官员协会（NACCHO）的卡萨洛蒂呼应了达斯卡拉基斯的担忧，认为联邦层面目前的情况在某种程度上阻碍了抗麻疹工作。卡萨洛蒂说：“当政府公共卫生各级层面传出混杂信息时，这会让地方卫生部门开展工作变得更加困难。”
"A lot of Americans thought, you know, people are just adding deaths to make this thing look worse than it is. It was a terrible, terrible thing that we had to go through. But definitions matter," said Schwartz. Casalotti of NACCHO echoed Daskalakis's concerns that what has come from the federal level so far hindered anti-measles efforts in some ways. "When there are mixed messages coming at any of the levels of governmental public health, it makes it a lot harder for the local health departments to do their job," said Casalotti.
“但这也让人们更难弄清楚‘我应该做什么？’，因为你在听到不同的说法。” 肯尼迪以质疑麻疹、腮腺炎和风疹（MMR）疫苗的安全性和有效性而闻名，他曾著名地拒绝排除该疫苗可能与自闭症相关联的可能性，尽管目前没有证据建立这种联系。
"But it also makes it harder for people to figure out 'What should I be doing?' when you're hearing different things." Kennedy has a well-known history of questioning the safety and efficacy of the MMR vaccine, famously refusing to discount the possibility it could be linked to autism despite no evidence establishing a connection.
去年，他称MMR疫苗是阻止麻疹传播的“最有效”方式，并在8月表示，父母应为孩子接种针对该病毒的疫苗。但与此同时，他一直在对疫苗安全性提出质疑。“在我们国家，我们关注罕见疾病和死亡。我们关注每一个死于麻疹的孩子。他们会登上头条，”他在9月由儿童健康防御组织（他曾担任主席的反疫苗组织）主办的会议上说。
Last year, he called the MMR vaccine the "most effective" way of stopping measles spread and in August said parents should get their children vaccinated against the virus. But at the same time, he has continued to cast doubt on vaccine safety. “In our country we care about rare illnesses and deaths. We care about every child who dies from measles. They get headlines,” he said at a September conference hosted by Children’s Health Defense, the anti-vaccine group he previously chaired.
“我希望你们关注那些因疫苗损伤而死亡、受苦或受伤的孩子。”他声称，“疫苗损伤的儿童”因哮喘和自闭症等状况而“受损”，并表示婴儿猝死综合征和厌食症是常见副作用。“疾控中心也在直接与州和地方卫生部门合作，提供流行病学、实验室和技术支持。德克萨斯州、南卡罗来纳州、弗吉尼亚州、堪萨斯州、新墨西哥州和威斯康星州已请求疾控中心Epi-Aid援助，并与联邦团队协作，帮助其疫情迅速且成功地得到控制，”美国卫生与公众服务部高级新闻秘书埃米莉·希利尔德在一份声明中表示。
“I’d ask you to care about children who are dying or suffering or being injured by vaccine injuries." He claimed " vaccine-injured children" were "damaged" by conditions like asthma and autism and said sudden infant death syndrome and anorexia were common side effects. "CDC is also working directly with state and local health departments to provide epidemiological, laboratory, and technical support. Texas, South Carolina, Virginia, Kansas, New Mexico, and Wisconsin have requested CDC Epi-Aid assistance and worked alongside federal teams to help bring their outbreaks rapidly and successfully under control," HHS senior press secretary Emily Hilliard said in a statement.
“疾控中心继续向应对疫情的社区提供指导和资源，肯尼迪部长和疾控中心主任埃里卡·施瓦茨博士继续明确表示，MMR疫苗是预防麻疹的最有效方式，”希利尔德补充道。
"CDC continues to provide guidance and resources to communities responding to outbreaks, and Secretary Kennedy and CDC Director Dr. Erica Schwartz continue to make clear that the MMR vaccine is the most effective way to prevent measles," Hilliard added.