Health officials are blaming the anti-vaccine movement for almost costing the United States its measles elimination status, a landmark achievement in health that has stood for almost 20 years.

A measles outbreak that threatened New York for a year was finally declared defeated this week, allowing the country to keep its status as having eliminated measles, a goal that was first achieved in 2000.

The New York outbreak started on Oct. 1, 2018. Just over 400 people in the state were infected with measles and recovered before the outbreak officially ended this Thursday, from N.Y. State Health Commissioner Dr. Howard Zucker.

鈥淲e are very pleased that the measles outbreak has ended in New York and that measles is still considered eliminated in the United States,鈥 said secretary Alex Azar from the U.S. Department of Health & Human Services [HHS]. 鈥淏ut this past year鈥檚 outbreak was an alarming reminder about the dangers of vaccine hesitancy and misinformation.鈥

According to the World Health Organization (WHO), measles elimination there is no transmission of the measles virus in a defined geographic area, such as a country or state 鈥渇or at least 12 months in the presence of a surveillance system that has been verified to be performing well.鈥 Small outbreaks of disease occur when travellers bring measles with them into the country, but a country will only lose their measles elimination status if an outbreak continues for more than a year.

The HHS press release says that four countries have lost their measles elimination status in the last year: the U.K., Greece, Venezuela and Brazil. Data from the World Health Organization (WHO) indicates that between January and July of 2019, there were almost 365,000 reported cases of measles worldwide, which is the most since 2006. It鈥檚 part of a trend that health officials find alarming.

In January, WHO listed 鈥渧accine hesitancy鈥 as one of the in 2019.

An advisory group of experts working with WHO that said vaccine hesitancy was 鈥渃omplex and context specific, varying across time, place and vaccines [and] includes factors such as complacency, convenience and confidence.鈥

According to the report, complacency refers to the perception that the risks of vaccine-preventable diseases are low, and that using vaccines is not necessary; convenience refers to the relative availability of vaccines and services that deliver them; while confidence refers to a mistrust of the safety of vaccines and a mistrust of the scientists, policy-makers and media that report on their effectiveness.

These three factors are hard to tackle, particularly in an era where misinformation is only a Google search away.

鈥淚t is a truism that vaccines represent one of the safest and most effective tools available in global efforts to control and prevent infectious diseases,鈥 reads on vaccine hesitancy published in the scientific journal, Vaccine. 鈥淵et, parents searching the Internet about whether or not it is safe to get themselves or their children vaccinated will find this consensus recast as a controversy, or even a conspiracy.鈥

Canada officially eliminated measles . According to the Public Health Agency of Canada, somewhere between 300,000 and 400,000 Canadians used to contract measles before vaccinations. Although measles cases in Canada are far below those in the U.S., there was an increase observed between 2018 and 2019. According to , there have been 111 cases of measles reported in Canada so far this year, compared to only 29 cases in 2018.

WHO says that vaccinations prevents 2-3 million deaths a year, but that up to 1.5 million more deaths could be prevented globally if vaccinations were more widely understood and distributed.

This past June, New York took steps to tackle their outbreak by revoking a religious exemption for mandatory school vaccinations, making them the fourth state to revoke religious and personal-belief exemptions after California, Mississippi and West Virginia. Around 26,000 children in New York had gone unvaccinated due to religious reasons, according to the state鈥檚 health department.

The statement from N.Y. State Health Commissioner Dr. Howard Zucker said that the state had gone more than 42 days, which is 鈥渢he equivalent of two incubation periods,鈥 without any new outbreaks of measles, meaning that they could officially say the outbreak was over. Over the course of the outbreak, the statement said that nearly 85,000 vaccinations had been given out in the affected counties.

This is a 75 per cent increase in the amount of vaccines administered when compared to the previous year, the statement said.

鈥淥ur Nation鈥檚 successful public health response to this recent measles outbreak is a testament to the commitment and effectiveness of state and local health departments, and engaged communities across the country,鈥 said Centers for Disease Control and Prevention Director Dr. Robert R. Redfield in the HHS press release. He added that the CDC wants 鈥渢o emphasize that vaccines are safe.

鈥淭hey remain the most powerful tool to preserve health and to save lives. The prevalence of measles is a global challenge, and the best way to stop this and other vaccine preventable diseases from gaining a foothold in the U.S. is to accept vaccines.鈥

Had the U.S. lost their measles elimination status, it wouldn鈥檛 have meant that any funds to immunization or public health would鈥檝e been taken away, but the CDC emphasized on their website that attaining elimination status in the first place was a historic achievement.

Before the measles vaccine, almost all children in the U.S. contracted measles before they were 15 years old, according to the HHS press release. Out of 500,000 measles cases that were reported every year before the vaccine became widespread, 48,000 would be hospitalized, and around 500 people would die.