Urgent Plea: Safeguarding Public Health in North Dakota Through Enhanced Vaccination Efforts

To the editor,

Public health in North Dakota is facing a serious setback. We’re experiencing the worst measles outbreak since 1978, with 34 reported cases as of June 3. This decline starkly contrasts with 1990, when we were celebrated as the healthiest state in the U.S.

Let’s look at some recent issues:

• In 2020, North Dakota had the highest COVID death rate in the U.S. for nearly two months.
• In 2024-25, whooping cough affected over 200 people statewide.
• In 2025, we reported the highest measles outbreak in the nation, based on cases per capita.

So, why is this happening, and what can we do?

One major factor is the falling immunization rates among school-aged children. North Dakota has the eighth-highest rate of vaccine refusal in the country. Many state leaders hesitate to address this, fearing backlash from extreme groups that oppose vaccinations.

Vaccines are crucial. They are among the safest and most effective health tools we have. However, the situation worsened when Health and Human Services Secretary Kennedy, known for his anti-vaccine stance, cut more than 40 grants aimed at improving vaccine acceptance.

The previous administration didn’t prioritize public health, but now Governor Kelly Armstrong has a chance to make a difference. An upcoming Dakota Conference on Rural and Public Health in Bismarck could be pivotal. Here are some ideas to consider:

• Set a target of 95% childhood measles immunization to effectively control the outbreak.
• Urge Senators Hoeven, Cramer, and Fedorchak to demand that Secretary Kennedy restore funding for immunization programs.

For years, public health in North Dakota has been neglected, and our children are suffering the consequences. Now is the time for action. How will you tackle this alarming measles outbreak, Governor Armstrong?

Stephen McDonough
Bismarck, North Dakota

McDonough has been a pediatrician in North Dakota since 1980.

Recent studies highlight the importance of vaccination for community health. According to the CDC, when vaccination rates drop below 95%, herd immunity is compromised, allowing diseases like measles to spread. Public health strategies must emphasize education and accessibility to vaccines. A concerted effort from state leaders can bring our vaccination rates back up and protect our children.

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