Mark Herz: This is GBH’s Morning Edition.

We’re talking public health issues in Massachusetts again this morning. Among Trump Administration changes in this realm have been the U.S. leaving the World Health Organization and cuts to federal agencies like the CDC. These things are happening as we watch a measles outbreak and bird flu continues to cause concerns. With us once again, is the state’s top official in this area, Commissioner Robbie Goldstein from the Department of Public Health. Commissioner, good morning.

Robbie Goldstein: Good morning. Great to be here.

Herz: Always great to have you. Let’s start with measles. What is the state’s vaccination rate?

Goldstein: So it’s hard to give you one specific number for our state vaccination rate. We look as folks enter kindergarten, as kids go into the seventh grade, as folks come for college, I would say overall, our vaccination rates are incredibly high. Specifically, if we look at that kindergarten group, which is where we really want to get the highest number, we’re around 96% of children in the Commonwealth who are entering kindergarten are vaccinated for measles, mumps, and rubella. I think we should put this into context. We know that you need around 95% of the population vaccinated to have good herd immunity levels. We’re there, here in Massachusetts. So I feel pretty comfortable that we’ve built the wall that we need, but we also need to look towards the future. We have to continue to have these high levels of vaccination so that we can protect children, teachers, communities, parents, everyone from measles, which we know is now spreading around the country.

Herz: Do you feel the messaging coming out of Health and Human Services with the new secretary, Robert F Kennedy Jr, is where it needs to be?

Goldstein: Vaccines prevent disease and that is the message that we need to get out there. I would hope that the Secretary of Health and Human Services at the federal level would say that loudly, clearly, and as often as possible. We’re not seeing that happen, and I really am hopeful that there will be a shift. But I am encouraged by the fact that CDC is sending vaccines to West Texas and to New Mexico, that HHS at the federal level is investing in this response and that they are at least talking about the importance of vaccines.

Herz: Okay. And there’s a cohort of older people, I think I’m among them, who got a childhood measles shot a long time ago but are now being recommended to get a booster. Who should be doing this and why?

Goldstein: Yeah. So there’s a group of people who got a vaccine before 1966 that may not provide the long lasting protection that we would want for measles. So if you’re in that group, if you were born before 1966, really after 1954, then we would recommend that you go out and get a vaccine for measles, mumps and rubella.

Herz: And is this a “well, maybe I’ll wait to see if it gets here from West Texas and New Mexico?” Or is this a “no, go get this”?

Goldstein: I would recommend that folks who are in that cohort in that window go out and get the vaccine.

Herz: Now let’s talk bird flu or avian flu again. Last time we talked, you were emphasizing surveillance of our dairy cows in the state because the virus has managed to jump from birds to cows. And now I noted that there’s concerns about people’s pets, right?

Goldstein: We here in Massachusetts have H5n1 avian influenza in wild birds that are flying around the state in and out of the state, and also in the domesticated bird. So those backyard flocks that folks have and because the virus is here, it does pose a risk to household pets that go outside. In particular, nationally, we’ve seen a lot of cats that are getting the infection. So we’re recommending that folks keep their cats inside, that they don’t allow their cats to get near dead or sick animals who might be infected with the virus and then could bring it into the household.

Herz: And are you concerned at all about the virus’s ability to infect people? I mean, it’s been rare, but I mean, we did have a death in Louisiana.

Goldstein: We did. You know, we’re up to 70 human cases here in the United States since 2022, which is a really small number. If you think about the millions of birds that are infected and the hundreds of dairy cows that have been infected during this outbreak, I have a healthy skepticism right now of this virus. I think it’s important for us to remain vigilant, but it is important to remember the risk to humans is low. Those that have been infected have either been dairy cattle workers or poultry workers, not folks who are living their normal life, kind of going out to work every day in an office building or kids who are going to school. It’s really a particular subset of people that are at risk.

Herz: Okay. Well, let’s turn to DC because we just had yet another Trump potential appointment withdrawn. This was Florida congressman and physician David Weldon, who is going to be put up to lead the CDC. And of course, you were once a CDC official yourself. So I’m hoping you can give us your perspective on this.

Goldstein: I think we’re we have to remember we’re living through a little bit of history right now. This is the first time that a CDC director has required Senate confirmation. And there were many who said that the act of putting a CDC director up for confirmation politicized the agency, politicized his public health, and that might make it really challenging to get someone in the role of leading CDC that can do the work of public health, absent all of the political interference. You know, I think we should remember there are acting leaders at the CDC right now. There are career civil servants at the CDC who are doing the work of public health every day. We engage with them here in Massachusetts to make sure that we have the resources we need and the support we need. But time will tell. It will tell us who President Trump may nominate next to be CDC director, what position that person holds, and whether that person can also make it through a Senate confirmation.

Herz Well, staying with D.C. lastly, there have been cuts at CDC. There have been cuts to disease programs run by USAID overseas. We’re at the five year mark of Covid right now – this week, Covid came from overseas. So how concerned are you about our ability to track and surveil a pathogen coming from overseas now?

Goldstein: Public health has always recognized that diseases don’t know borders. They don’t understand international waters or end the way that humans travel, right, that creates these disease pathways. Folks can come from China and go to Africa and then come to the United States, and with them comes the disease. And so when we see things like cuts to USAID or cuts to the State Department or cuts to CDC and its global work, I do worry that we are less prepared for what might be overseas and may be coming to us here in the United States. That said, I think we have a really collaborative group in public health. The states have come together to make sure we’re sharing information. We’re engaged with our international colleagues, and we’re providing whatever support we can in the surveillance part of this work. Through what we do in public health, what’s happening in academia with all of our collaborations so that we’re prepared for whatever might come.

Herz: Massachusetts Department of Public Health Commissioner Robbie Goldstein, thanks for your expertise, as always.

Goldstein: Thanks for having me on.

Herz: And a small correction from the Commissioner – he says that window of birth years for people who need a repeat dose of the measles, mumps and rubella shot are those born from 1958 to 1967.

Herz: This is GBH.

U.S. public health officials are currently monitoring a measles outbreak, along with cases of avian influenza. Those concerns come after the country withdrew from the World Health Organization, and the Trump administration has made cuts to federal agencies like the Centers for Disease Control.

When it comes to measles in Massachusetts, at least, Commissioner of the Department of Public Health Dr. Robbie Goldstein said the state is in pretty good shape because of high vaccine rates.

“We look as folks enter kindergarten, as kids go into the seventh grade, as folks come for college, I would say overall, our vaccination rates are incredibly high,” he said. “Specifically, if we look at that kindergarten group, which is where we really want to get the highest number, we’re around 96% of children in the commonwealth who are entering kindergarten are vaccinated for measles, mumps, and rubella.”

Goldstein added that a 95% vaccination rate is needed to have “good herd immunity levels.”

“So I feel pretty comfortable that we’ve built the wall that we need, but we also need to look towards the future,” he said. “We have to continue to have these high levels of vaccination so that we can protect children, teachers, communities, parents — everyone from measles, which we know is now spreading around the country.”

NPR reported that Health and Human Services Secretary Robert F. Kennedy Jr. has addressed the ongoing measles outbreak by emphasizing treatments for the disease, including vitamin A and steroids.

Goldstein said he is “hopeful there will be a shift” in that messaging.

“Vaccines prevent disease and that is the message that we need to get out there ... but I am encouraged by the fact that CDC is sending vaccines to West Texas and to New Mexico,” he said. “That [the Department of Health and Human Services] at the federal level is investing in this response and that they are at least talking about the importance of vaccines.”

The state’s Department of Public Health is also recommending that people born from 1958 to 1967 get a booster for measles, mumps and rubella.
 
As for the rates for bird flu, Goldstein said the state is seeing cases in wild birds that are flying in and out of the state, along with domesticated birds.

“So those backyard flocks that folks have — and because the virus is here, it does pose a risk to household pets that go outside,” he said. “In particular, nationally, we’ve seen a lot of cats that are getting the infection.”

He recommends keeping cats inside, and keeping them away from dead or sick animals who might be infected with the virus.

Human cases, however, remain fairly low, according to Goldstein.

“We’re up to 70 human cases here in the United States since 2022, which is a really small number,” he said. “If you think about the millions of birds that are infected and the hundreds of dairy cows that have been infected during this outbreak, I have a healthy skepticism right now of this virus. I think it’s important for us to remain vigilant, but it is important to remember the risk to humans is low.”

He added that those that have been infected have been in a “particular subset of people,” including dairy cattle workers or poultry workers.

In public health changes at the federal level, the White House recently withdrew the nomination of former Florida congressman Dr. David Weldon to lead the Centers for Disease Control and Prevention. This year marks the first time a CDC director nominee is being required to go through Senate confirmation, due to a provision in a law passed during the Biden administration.

“I think we’re we have to remember we’re living through a little bit of history right now ...” Goldstein said. “We should remember there are acting leaders at the CDC right now. There are career civil servants at the CDC who are doing the work of public health every day. We engage with them here in Massachusetts to make sure that we have the resources we need and the support we need. But time will tell.”

Goldstein added that with funding cuts to agencies like USAID and the CDC’s global work, he worries that the U.S. is “less prepared” to deal with pathogens overseas that may come into the states.
 
“That said, I think we have a really collaborative group in public health. The states have come together to make sure we’re sharing information,” he said. “We’re engaged with our international colleagues, and we’re providing whatever support we can in the surveillance part of this work — through what we do in public health, what’s happening in academia, with all of our collaborations — so that we’re prepared for whatever might come.”