Vaccines work. For decades, the measles vaccine has been so effective that developing a treatment felt like a waste of time and money. If you didn’t get sick, why build the fire extinguisher?
But the fire is growing.
Measles cases are hitting a 35-year high in the US. Vaccination rates are dipping. And now, a handful of biotech firms and academic researchers are finally working on treatments for the infected or vulnerable individuals needing short-term protection.
It will likely be years before these countermeasures are on pharmacy shelves. Even then, it’s highly uncertain if those refusing vaccines would actually take them.
The Resurgence Is Real
Fueled by large outbreaks in states like South Carolina and Utah, the US has already surpassed last year’s total of 2,289 cases. It is only July. Compare that to just 285 cases across the entire year of 2024.
The virus is incredibly contagious. Public health guidelines state that at least 95 percent of a community must be fully vaccinated to protect immunocompromised people and infants under 12 months who are too young for shots. In many areas, coverage is well below that threshold.
Young children bear the brunt. Complications can include pneumonia from direct respiratory damage or suppressed immunity. The virus can also cause deafness and fatal brain damage.
Without specific treatments, doctors rely on supportive care: preventing dehydration, managing breathing, and giving steroids for inflammation. Vitamin A helps replenish depleted levels, but it doesn’t touch the virus itself.
“We’re seeing a horrible lack of options,” says Michael Mina, epidemiologist and chief medical officer at Invivyd.
Monoclonal Antibodies: A Short-Term Shield
Invivyd is developing a monoclonal antibody therapy. These mimic natural antibodies the immune system produces to fight disease. Administered via IV or injection, they offer protection for a few months. They proved vital during the pandemic, especially for immunocompromised patients.
Healthcare providers are already asking Mina when a measles version will be available. In an outbreak, these antibodies could provide short-term protection for high-risk groups.
Invivyd hasn’t tested its measles antibody in humans yet. But Mina says the company is gathering data for the Food and Drug Administration (FDA) to approve clinical trials.
At the La Jolla Institute for Immunology president and CEO Erica Ollmann Saph is studying the human antibody response. Her team published findings in May describing antibodies that bind to key sites on the virus, blocking infection. Infusions reduced viral loads in rodents by 500-fold.
The Manufacturing Hurdle
Getting these treatments into humans won’t be easy. Manufacturing monoclonal antibodies at scale is costly and complex. Clinical trials run into the millions. Pharma companies usually hold the purse strings, and infectious disease drugs are often hard sells due to sporadic outbreaks and short treatment courses.
“I think this is a real opportunity,” Saphire says. Preventing disease is cheaper than managing fatal encephalitis in a child.
Some models predict measles could become endemic in the US over the next 25 years if current vaccination trends hold.
Monoclonal antibodies could be expensive for patients and insurers too. The US government spent $855 million on Evusheld for the pandemic. Patients sometimes faced hundreds in out-of-pocket administration costs despite the drug being free.
Vanderbilt University scientists created the Evusheld combination in just 25 days. They have also discovered potent measles antibodies. The university partnered with small biotech firm Saraviv Biopharma to continue development.
James Crowe, director of Vanderbilt’s Center for Antibody Therapeutics, leads that effort. He uses a combination of two antibodies to prevent viral mutation from evading treatment. His team has been targeting potential pandemic viruses and happened to be deep in measles work when US cases intensified last year.
“The antibodies are so potent, they could be formulated as a single long-acting shot,” Crowe says.
Testing Dilemmas
Once ready for human testing, regulators face a tricky evaluation process. New drugs typically start in adults to ensure child safety. But measles complications are more likely to hospitalize kids, particularly those unvaccinated. Who do you test on when the most vulnerable are children?
Antivirals are another path, but they are often short-lived. They must be administered shortly after infection or symptom onset. Researchers at Georgia State University tested an oral antiviral in rats, ferrets, and dogs using related viruses. The drug lowered viral loads, and all treated animals survived. Human trials haven’t happened yet.
A major challenge with antivirals is toxicity. Drugs strong enough to kill viruses often cause unpleasant side effects in people.
Will People Take It?
The biggest question remains usage. Will parents allow their children to receive treatments developed through science?
Anti-vaccine sentiment is driving current outbreaks. Mina hopes that people who rejected vaccines will accept monoclonal antibodies because “this is a molecule our bodies create naturally.”
Skepticism is entrenched. During the Utah measles outbreak some parents refused immune globulin, a mixture of antibodies from donated plasma. Anti-science sentiment is mainstream. Robert F. Kennedy Jr., now leading the Department of Health and Human Service, has cast doubt on vaccines and other established treatments.
That doesn’t make the research pointless. Crowe emphasizes that funding measles treatment development is urgent as vaccination rates decline.
“There’s going to be hundreds of thousands of people affected,” Crowe says. “People are going die. There’s urgency to finishing this work.”
The tools might come. Whether society will use them before more lives are lost remains an open wound in public health.
