Measles Outbreaks Are Forcing Parents of Immunocompromised Kids to Make Hard Choices
Measles Outbreaks Are Forcing Parents of Immunocompromised Kids to Make Hard Choices
麻疹疫情迫使免疫功能低下儿童的家长做出艰难抉择
As students head back to school, parents have all the usual worries about their kids, like remembering to pack lunch and making it to the bus stop on time. But parents of immunocompromised kids have a new one: How to deal with the resurgence of measles. 随着学生们重返校园，家长们都有着各种常见的担忧，比如记得准备午餐、准时赶到校车站等。但免疫功能低下儿童的家长们却面临着一个新的难题：如何应对麻疹的卷土重来。
Cases of the highly transmissible disease have reached a 35-year high in the US, with nearly 3,000 confirmed infections in 2026 so far. The first two measles-related deaths of the year were recorded in Pennsylvania, right as the school year is getting going. With vaccination rates dropping across the country, parents of kids who aren’t able to get vaccinated or don’t mount a strong enough immune response due to weakened immune systems are weighing whether it’s safe enough to go to school. 这种高传染性疾病在美国的病例数已达到 35 年来的最高点，2026 年迄今已确诊近 3,000 例感染。就在新学年开始之际，宾夕法尼亚州记录了今年首两例与麻疹相关的死亡病例。随着全国疫苗接种率的下降，那些因免疫系统减弱而无法接种疫苗或无法产生足够强免疫反应的儿童，其家长们正在权衡去学校上学是否足够安全。
Victoria Schiano, national community engagement coordinator for Little Lobbyists, a nonprofit that advocates for children with complex medical needs and disabilities, says the return of measles is “absolutely terrifying.” “Little Lobbyists”是一家倡导为患有复杂医疗需求和残疾儿童提供支持的非营利组织，其全国社区参与协调员维多利亚·斯基亚诺（Victoria Schiano）表示，麻疹的回归“绝对令人恐惧”。
While it’s not known exactly how many US children have compromised immune systems, a study by the Centers for Disease Control and Prevention estimated that 2.6 percent of children are immunocompromised. Immune deficiencies can have genetic causes or secondary reasons, such as chemotherapy for cancer treatment. 虽然目前尚不清楚美国有多少儿童免疫系统受损，但美国疾病控制与预防中心（CDC）的一项研究估计，有 2.6% 的儿童属于免疫功能低下。免疫缺陷可能由遗传因素引起，也可能由继发原因导致，例如癌症治疗中的化疗。
Schiano’s kid is among them. Her 10-year-old has mitochondrial disease. The family lives in Chester County, Pennsylvania, which has the second-highest number of measles cases in the state right now. Schiano has been closely monitoring the vaccination rates in her son’s school district, which have dipped below the 95 percent threshold needed for community protection against measles. Measles is breaking through in places where vaccination has dropped below that threshold. In neighboring Lancaster County, for example, just 87.6 percent of kindergartners are fully vaccinated against measles and 83.3 percent of seventh graders are. 斯基亚诺的孩子就是其中之一。她 10 岁的孩子患有线粒体疾病。他们一家住在宾夕法尼亚州的切斯特县，该县目前的麻疹病例数位居全州第二。斯基亚诺一直在密切关注她儿子所在学区的疫苗接种率，该接种率已跌破了实现麻疹群体免疫所需的 95% 门槛。在疫苗接种率低于该门槛的地方，麻疹正在爆发。例如，在邻近的兰开斯特县，只有 87.6% 的幼儿园儿童和 83.3% 的七年级学生完全接种了麻疹疫苗。
Her son can’t be vaccinated, and he receives weekly infusions of immunoglobulin—concentrated antibodies from donated human blood plasma—to help his body fight infections. “Measles is dangerous for anyone, but for him, this absolutely could be life or death,” she says. 她的儿子无法接种疫苗，他每周都需要输注免疫球蛋白（从捐献的人类血浆中提取的浓缩抗体），以帮助他的身体对抗感染。“麻疹对任何人来说都是危险的，但对他而言，这绝对关乎生死，”她说。
The virus can cause severe, life-threatening complications such as pneumonia and brain swelling. Measles can also wipe out the body’s memory of past infections—a phenomenon known as immune amnesia—leaving people susceptible to other diseases. 这种病毒会导致严重的、危及生命的并发症，如肺炎和脑肿胀。麻疹还会抹去人体对既往感染的记忆（这一现象被称为“免疫失忆症”），使人更容易受到其他疾病的侵袭。
Her son already wears a mask and uses a plexiglass screen at school, and the family is diligent about handwashing. Now, Schiano says they’ve had to make the difficult decision to limit her son’s time with friends and after-school activities like karate. She says it’s hard as a parent to balance his quality of life with his safety. “He just wants to play and to do all the things that he sees other kids doing,” she says. 她的儿子在学校已经佩戴口罩并使用有机玻璃隔板，全家人也坚持勤洗手。现在，斯基亚诺说他们不得不做出一个艰难的决定：限制儿子与朋友相处的时间以及空手道等课外活动。她说，作为家长，要在孩子的生活质量和安全之间取得平衡非常困难。“他只是想玩耍，想做他看到其他孩子在做的所有事情，”她说。
Her son did online school for a time during Covid-19, and she says she’s prepared to take him out of school if there’s even one confirmed measles case. That comes with a different set of risks, though. During the pandemic, remote learning was associated with an increase in social isolation and behavioral and mental health issues among students. 在新冠疫情期间，她的儿子曾有一段时间进行在线学习。她说，如果出现哪怕一例确诊的麻疹病例，她也准备让儿子退学。但这会带来另一系列风险。在疫情期间，远程学习与学生中社交孤立、行为和心理健康问题的增加有关。
Amalia, a parent in South Carolina who asked to go by a pseudonym for privacy reasons, has already chosen to keep her 16-year-old son home this year and do online schooling due to concerns about measles. Her son has immunoglobulin A deficiency, in which the body doesn’t produce enough of an antibody found in mucous membranes, body fluids, and digestive tracts that help fend off germs. 南卡罗来纳州的一位家长阿玛利亚（Amalia，出于隐私考虑使用化名）因担心麻疹，已经选择让 16 岁的儿子今年留在家中进行在线学习。她的儿子患有免疫球蛋白 A 缺乏症，这种疾病会导致身体无法产生足够的抗体，而这种抗体存在于粘膜、体液和消化道中，有助于抵御病菌。
“Even if there’s just a flu going around, he gets sicker than the average kid will,” she says. Her son was able to get the measles vaccine, but doctors monitor his antibody levels regularly to check for waning immunity. “即使只是流感流行，他也会比普通孩子病得更重，”她说。她的儿子能够接种麻疹疫苗，但医生会定期监测他的抗体水平，以检查免疫力是否减弱。
She lives in Spartanburg County, where measles broke out earlier this year and caused nearly 1,000 cases and 21 hospitalizations. About 91 percent of those cases were among children and teens, and most were among those who were not fully vaccinated or had an unknown vaccination status. Even though there was a 94 percent increase in the number of vaccines administered during the outbreak in Spartanburg County compared to the year before, she still wasn’t comfortable sending her son back to school. 她住在斯帕坦堡县，今年早些时候那里爆发了麻疹，导致近 1,000 例病例和 21 例住院治疗。其中约 91% 的病例发生在儿童和青少年中，且大多数是未完全接种疫苗或疫苗接种状况不明的人群。尽管斯帕坦堡县在疫情期间的疫苗接种数量比前一年增加了 94%，但她仍然不放心让儿子回学校。
“Covid happened, and then measles happened, and we just feel like it’s not going to be the last time,” she says. “If it’s not measles, it’s going to be something else because rates for other vaccines have fallen, too.” “新冠疫情发生了，接着麻疹又来了，我们觉得这不会是最后一次，”她说。“如果不是麻疹，也会是其他疾病，因为其他疫苗的接种率也下降了。”
Before this year, her son shared a classroom with other students who have special accommodations. But outside of that setting, Amalia says it has been difficult for him to make friends because of his medical condition. She says it’s hard to talk to other parents about vaccination status because it can be such a hot-button issue. The family is thinking about moving because of what she views as an anti-vaccination sentiment in the community as well as “hostility” toward masking that she’s encountered. 在今年之前，她的儿子与有特殊照顾需求的学生在同一个教室上课。但阿玛利亚说，在那种环境之外，由于他的医疗状况，他很难交到朋友。她说，与其他家长谈论疫苗接种状况很困难，因为这可能是一个非常敏感的话题。这家人正在考虑搬家，因为她认为社区里存在反疫苗情绪，而且她还遭遇了对佩戴口罩的“敌意”。
“Some people don’t want to take ownership of the responsibility of public health,” she says. “I think it’s something we’re supposed to share across humanity. It’s not supposed to be carried by one person.” “有些人不想承担公共卫生的责任，”她说。“我认为这是我们全人类应该共同分担的事情。它不应该由某一个人来独自承担。”
Cortney, another South Carolina parent of an immunocompromised kid, says the state’s measles outbreak was highly concerning because the family needed to travel near the epicenter for medical appointments. Whereas before they might stop in town to eat lunch or do some shopping, they ended any unnecessary stops. “We planned to drive directly into that county, we go only to the doctor, and we leave,” Cortney says. 南卡罗来纳州另一位免疫功能低下儿童的家长科特尼（Cortney）表示，该州的麻疹疫情非常令人担忧，因为他们一家需要前往疫情中心附近进行医疗预约。以前他们可能会在城里停下来吃午饭或购物，但现在他们取消了所有不必要的停留。“我们计划直接开车进入该县，只去看医生，然后就离开，”科特尼说。
Her 17-year-old daughter Grace’s condition means that rhinovirus—the cause of the common cold—led to her getting hospitalized. During Covid, Grace and her brother were homeschooled, and that is something mother and daughter considered again for Grace’s senior year. “At the end of the semester, we’re going to reevaluate and see where things stand.” 她 17 岁的女儿格蕾丝（Grace）的病情意味着鼻病毒（普通感冒的病因）曾导致她住院。在新冠疫情期间，格蕾丝和她的兄弟在家接受教育，这是母女俩为格蕾丝高三学年再次考虑的选择。“学期末，我们将重新评估并观察情况如何。”