As measles outbreaks rage in a number of states across the country, President Trump urged families to vaccinate their children on Friday.

“They have to get the shots. The vaccinations are so important,” Trump told reporters as he left the White House. “This is really going around now. They have to get their shots.”

The endorsement of vaccination from a previously vaccine-questioning president comes as a bit of a surprise. Before winning the presidency, Trump several times alleged there was a link between the number of vaccines children get in early infancy and the development of autism.

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But since his inauguration, Trump has made no public comment about vaccines at all.

With the measles count in the United States hitting its highest point since 1994 this week, public health observers have questioned why this president, unlike predecessors going back to Franklin Delano Roosevelt, hasn’t been urging parents to vaccinate their children.

Some raised concerns that Trump’s track record on vaccination would undercut the credibility of any pro-vaccination message he delivered. But others noted that his base voters might be swayed if he endorsed vaccines.

“To me, this is one of the best things President Trump has done,” said Jonathan Zimmerman, a professor of the history of education at the University of Pennsylvania, who called out Trump publicly on his silence in a recent op-ed published in the Philadelphia Inquirer.

Zimmerman called the move “politically brave,” noting there is an anti-vaccine faction within his base.

“I hope my fellow liberals will take a break from lambasting the President and congratulate him. Whatever his other wrongs, he was dead right about this,” Zimmerman said.

On Wednesday, the Centers for Disease Control and Prevention said that reported measles cases in the country had hit 695, the highest number since before measles was declared in eliminated in the U.S. in 2000. Cases have been reported from 22 states.

The president’s comments were welcomed by Dr. Matt Zahn, the chair of the Infectious Diseases Society of America’s public health committee, who suggested they could be helpful in winning over parents who worry about the safety of vaccines.

“It’s just so important that there’s clarity here,” said Zahn, who is medical director for the communicable diseases program for Orange County Public Health in California. “You are safer and the public will be healthier when our kids are getting immunized and when our community immunization rates go up.”

Orange County is home to Disneyland, the epicenter of a big measles outbreak in 2015. Working to contain it was an enormous amount of work, Zahn said.

He said there is a fear among public health officials that the ground is now shifting. Where in recent years U.S. measles numbers have been driven by one or two large outbreaks — among Amish communities in Ohio in 2014, Disneyland in 2015 — this year there are multiple large outbreaks around the country.

“It feels different,” Zahn said, noting that even counties like his that aren’t currently battling a measles outbreak are finding themselves having to chase down contacts who were exposed elsewhere. “There is an awful lot of spillover to other communities and to other counties.”

“I think for all of public health, we’re all a little apprehensive that we’re reaching a new normal wherein every community deals with these events or cases or outbreaks on a semi-regular basis,” he said.

And with a growing number of pockets across the country where vaccination rates are low, the U.S. is likely to find itself having to fight ever larger outbreaks when unvaccinated Americans get infected abroad and return home sick, or when infected tourists bring the virus to the country.

“We certainly have … communities of significant size in this country where immunization rates are quite low,” Zahn said. “So the ground in the United States is more fertile for these outbreaks than it has been in decades past.”



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