A public health officer serving Michigan's Upper Peninsula for nearly 50 years, Dr. James Terrian graduated from medical school in 1966. Throughout those years, most recently with Luce Mackinac Alger Schoolcraft Health Department, he has seen firsthand how immunizations have decreased infectious disease and saved lives throughout Michigan. And he remembers getting the injectable Salk polio vaccine in the ‘50s.

“We've gone full cycle on the polio vaccine from the injectable to the oral now, back to the injection because there were a few cases of preventable polio from the oral vaccine,” he says.

He also recalls the year when the CDC declared that smallpox had been eradicated thanks to the vaccine — and no longer having to immunize patients against it.

“It is a good thing to increase our number of vaccine preventable diseases,” Terrian says. “We can reduce the amount of miseries that people have, reduce the number of hospitalizations, and the number of deaths. From my public health perspective, that's a good thing.”

Terrian shares that the CDC declared that measles had been eradicated in the U.S. in 2000. No cases were seen in the preceding 12 months. However, because the disease remained prevalent in other parts of the world, global travel reintroduced it to the U.S. The CDC has reported 13 measles outbreaks so far in 2024. As of August 16, Michigan has had nine cases.

“You are 3,000 times more likely to get measles if you're not immunized and exposed than if you are immunized,” Terrian says.

Michigan experienced its first confirmed case of measles since 2019 in March 2024. By April 10, five unrelated cases had been reported throughout the state. Because sixteen other states were also reporting Measles cases, public health officials across Michigan acted quickly to send out messaging and education to their communities in order to mitigate the spread of disease. 

Using new knowledge and methods developed during the peak of the COVID-19 pandemic, health departments had reevaluated the ways in which they disseminate information to their communities, as well as how they promote vaccination.

Jimena Loveluck

Two of the confirmed cases in Michigan were in Washtenaw County, according to the Washtenaw County Health Department (WCHD). An immediate press release warned any individuals who may have been exposed to the virus, as well as detailed what potential measles symptoms could look like. WCHD health officer Jimena Loveluck says that actions like this make the difference between stopping the spread of the disease and a potential outbreak in the county.

“When we do have a measles case like we did in March, time is of the essence in terms of responding and identifying others who may have been exposed,” says Loveluck. “It's not just us as a health department responding, it’s a whole host of health care providers. We work to make sure we protect those who may have been exposed, which requires good partnerships and good communication.”

While Washtenaw County has fairly high vaccination rates, Loveluck mentions how the quick development of COVID-19 vaccinations led to some concern from community members about vaccine effectiveness. Two press releases from the health department alleviated those concerns by highlighting the effectiveness of the measles vaccine and letting those who have not yet received the vaccine know they can get it from their health care provider or directly from the health department.

“Even though we have a great amount of information and evidence about COVID vaccines, they were developed very quickly, which contributed to some concern from the general public,” says Loveluck. “With the measles vaccine, we have over 50 years of evidence and data around the effectiveness and safety.”

In addition to early reporting, Loveluck cites strong partnerships with local organizations throughout the county as a way to spread information to as many residents as possible. Through working with local health providers, businesses, schools, and local media outlets, the WCHD has successfully acted as a safety-net for those who may not be aware of or have access to the most up-to-date vaccine information.Updates on measles information and prevention are provided on the WCHD website.

“We had a ‘catch up on your vaccines’ campaign, we developed materials schools could share with their families, and we’re working with a variety of partners to get the information across,” says Loveluck. “It’s through trusting relationships we’ve developed that we’re able to make sure people know how important it is to get vaccinated, where to get vaccines, and make sure lack of insurance isn’t a barrier to access.”

Matthew BuddAfter seeing WCHD’s quick response to its measles cases, Jackson County Health Department (JCHD) health officials also felt it necessary to ensure the health and safety of its own residents. Deputy health officer Matthew Budd stated that although the county hadn’t seen any measles cases, public health officials still wanted to make sure that county residents had up-to-date information on where possible exposures could have occurred, while sharing information in a straightforward and unbiased way.

“I think we have learned a lot since 2020,” says Budd. “I think there is a wider acceptance that we, as a health department, need to be more concise and thoughtful with our community members regarding disease spread, prevention, mitigation, and surveillance.”

Like many health departments, Budd feels that JCHD is “a victim of its own success.” Like in Washtenaw County, most of Jackson County’s residents are vaccinated, but Budd feels that the increased feelings of safety may cause some residents to feel like measures taken by the health department are overly cautious or unnecessary.

“We’ve done a great job at mitigating the spread of disease, which puts us in a position where people in our community feel very safe,” says Budd. “We want that, but it also makes it seem like some things we do are for nothing, when really we want to maintain those levels of safety.”

Budd says that while COVID did change the pace that the health department releases up to date information, the language used in press releases and health department materials and resources didn’t change too much. However, they have focused on being more mindful of all situations a resident could be in that could expose them to a disease like measles and providing up-to-date information from a variety of national and local sources. 

MMR vaccine

Budd hopes that JCHD’s approach to disseminating health information can also lead to county residents taking agency over not only their own health but also the health of their families, neighbors, and co-workers while still being aware the health department is an accessible resource. Updates and health news from JCHD can be found on its website.

“It’s really important that when we provide information to our community, we also provide information as to what community members can do, such as how to recognize signs and symptoms and steps to take if you see them,” says Budd. “We always want to give our community members something to do instead of just providing information.”

Both Loveluck and Budd emphasize the necessity of community involvement and awareness to ensure resident health and safety. Ongoing efforts by health departments to promote the efficacy of the measles and other vaccines and break through barriers such as a lack of insurance or transportation ensure that health departments across the state continue to protect the communities that they serve. 

“We need to be cognizant of how we say our words, ensure we are nonjudgmental but also remain resolute in our belief and recommendations to the community,” says Budd. “What we’re doing here really matters. We have passionate people here who come to work every day wanting to make a difference in their community, and I'm very proud of the work that we do.”

“We vaccinate to protect not just ourselves, but others in our community,” explains Loveluck, mentioning vulnerable populations such as infants under twelve months and those who are immunocompromised. “We emphasized that during COVID, and it’s true of other vaccine preventable illnesses as well.”

Measles isn’t the only preventable disease worrying Dr. Terrian either. He cites concerns about chicken pox, tetanus, Hepatitis A and B, whooping cough, influenza, HPV, pneumonia, mumps, rubella, rotovirus, and whooping cough.

“Infants get whooping cough from adults who don't get as sick from whooping cough as children do, because the airways are much larger for adults,” he says. “That vaccine was developed by a couple of people at the state health department in Michigan back in the teens. For a long time, the state had manufacturing capacity for vaccines, and so there was no cost for whooping cough vaccine. Michigan also had a rabies vaccine that was available and an anthrax vaccine, the only one in the world during the during the Engler administration that that was sold. Now we pay lots of money for a vaccine. The state lab’s vaccine manufacturing capacity was present for a long, long time. It really was a good thing for the state.”  


Rylee Barnsdale is a Michigan native and longtime Washtenaw County resident. She wants to use her journalistic experience from her time at Eastern Michigan University writing for the Eastern Echo to tell the stories of Washtenaw County residents that need to be heard.

Yours, Mine, and Ours — Public Health project editor Estelle Slootmaker contributed to this story.

Photos by Doug Coombe.
Matthew Budd photo courtesy subject.

The Yours, Mine, and Ours — Public Health series highlights how our state's public health agencies keep us healthy, safe, and informed about issues impacting physical and mental health in our communities, homes, workplaces, and schools. The series is made possible with funding from the Michigan Association for Local Public Health.