One year ago this week, a case of measles was recorded in Gaines County, Texas.

It was the start of an outbreak that killed two children and sickened at least 760 people. Thousands more in the U.S. have contracted measles since.

In April, the Pan American Health Organization, an offshoot of the World Health Organization, will determine whether the same virus strain first recorded in west Texas on Jan. 20, 2025, has been transmitted without interruption in the 12 months since.

If it has, the U.S. will officially lose the measles elimination status that the organization conferred in 2000.

Meeting those requirements “took several decades of really hard work,” said Dr. John Swartzberg, an infectious disease specialist and emeritus professor at UC Berkeley. “Losing that distinction is an embarrassment for the United States. It’s another nail in the coffin for the credibility of this country.”

In public health terms, elimination means that a disease has become rare enough, and immunity to it widespread enough, that local transmission dwindles quickly if a case or two emerges.

Scientists from the U.S. Centers for Disease Control are studying virus sequences from multiple sites around the U.S. to determine whether more recent measles cases are descended from the original outbreak or were introduced from other locations, a distinction that could affect whether the U.S. keeps its status.

Regardless of the international committee’s ultimate ruling, what is clear is that a highly contagious, vaccine-preventable disease kept largely in check for a quarter of a century is surging back.

There were 4,485 confirmed measles cases in the U.S. between Jan. 1, 2000, and Dec. 31, 2024, according to the Centers for Disease Control. In 2025 alone, there were 2,242 — the highest annual case count since the early 1990s.

“Measles is incredibly contagious, and it is the thing that comes first when you take your foot off the gas, in terms of trying to keep vaccination levels up,” said Dr. Adam Ratner, a New York-based pediatric infectious disease specialist and author of the book “Booster Shots: The Urgent Lessons of Measles and the Uncertain Future of Children’s Health.”

“It didn’t have to turn out this way,” he said. “It doesn’t help us that there haven’t been clear messages from HHS.”

In March, after the first child death from measles in more than a decade in the U.S., Health and Human Services Secretary Robert F. Kennedy Jr. issued a statement that noted vaccines’ effectiveness in preventing measles’ spread, but stopped short of outright recommending that parents vaccinate their children.

A month later, he posted on X: “The most effective way to prevent the spread of measles is the MMR vaccine,” outraging many of his anti-vaccine supporters.

Yet as the year went on, Kennedy and the agencies he leads upended the nation’s vaccine delivery system, while publicly sharing misleading and inaccurate information about immunizations.

Kennedy dismissed the members of a key vaccine advisory committee to the CDC and replaced them all with handpicked appointees, many of whom have been openly critical of vaccines or have spread medical misinformation.

Late last year, the CDC altered its website on vaccines and autism to include inaccurate statements linking immunizations to the neurodevelopmental disorder. Earlier this month, the CDC abruptly slashed the number of diseases it recommends children be vaccinated against from 17 to 11.

While the CDC has not officially changed MMR vaccine recommendations, the agency’s conflicting actions and confusing statements have only further depressed vaccination rates, experts said.

“The messages that are coming out of this CDC are crazy. It’s hard for pediatricians. It’s hard for parents,” Ratner said. “Nothing has changed about how safe the MMR vaccines are … or how well they work. It is all the messaging. And I’m very concerned that that is speeding up, not slowing down.”

Vaccination rates in the U.S. were already dipping before Kennedy’s appointment to Health and Human Services. Only 10 U.S. states — including California — meet the 95% vaccination threshold required to prevent community transmission of measles.

Forty-five states reported confirmed measles cases last year, and at least nine states have logged cases in January alone.

“If you go to cdc.gov, you would expect to see a huge banner saying, ‘Measles outbreak, get your vaccine now,’” said Dr. Jeff Goad, a Chapman University School of Pharmacy professor and president of the National Foundation for Infectious Diseases. “And it’s not there.”

The Pan American Health Organization will review data from the U.S. and Mexico on April 13 to determine whether those two countries will endure the same fate as Canada, which lost its measles elimination status in November.

“Whether or not we officially lose elimination status is an academic exercise at this point,” said Mathew Kiang, an assistant professor of epidemiology and population health at Stanford University. “The reality is that without concentrated efforts to ramp up vaccination, we will continue to have these long, extended outbreaks across the U.S. We’re witnessing the results of a years-long effort to disassemble the vaccine infrastructure in the U.S. that has been accelerated by the current administration.”

The meat industry’s celebration of the Trump administration’s Dietary Guidelines for Americans should be a clear sign that these new guidelines aren’t for the people.

It’s true that “the United States is amid a health emergency,” as Secretaries Robert F. Kennedy Jr. and Brooke Rollins state. However, in claiming to be an answer to the diet-related diseases plaguing our nation, their guidelines are an alarming dismissal of actual science. They not only flip the food pyramid on its head, encouraging us to consume more full-fat dairy products, but they even promote red meat. The truth hasn’t changed: Consuming more red meat and dairy leads to more chronic disease, not less.

Eating red meat — even unprocessed varieties — has been found by Oxford researchers to increase the risk of heart disease. And according to the World Health Organization, some studies show processed red meat to be a carcinogen, potentially leading to colorectal cancer.

Protein consumption “at every meal” is emphasized in the latest guidelines, and although protein intake is indeed a crucial part of any diet, experts widely believe that it’s been overemphasized in this country. Most Americans already consume far more protein than they need. Furthermore, plant foods such as edamame, lentils, peas, nuts, seeds and legumes offer a healthy source of protein that’s free from the cholesterol found only in animal products.

Whole-food plant proteins are also typically very low in saturated fats, which have long been linked to an increased risk of heart disease and high cholesterol. Although previous USDA Dietary Guidelines recommended limiting saturated fat to just 10% or less of one’s daily calories, Kennedy continues to promote its consumption. The new guidelines go so far as to label beef tallow a “healthy fat,” despite its risks. Full-fat cow’s milk, too, is high in saturated fat, and dairy has been tied to a higher risk of certain types of cancer, including breast and prostate cancer.

Meanwhile, plant-based diets have been associated with a lower risk of cardiovascular disease and death, and those high in fiber have been shown to reduce cancer risk. The American Cancer Society actually links low consumption of fruits and vegetables to nearly one-third of mouth, throat, esophageal and laryngeal cancers.

The government’s guidelines should not ignore years of nutrition science to prop up the meat and dairy industry. Thankfully, other institutions provide more evidence-based and responsible recommendations. For example, the New American Plate from the American Institute for Cancer Research recommends that two-thirds or more of one’s plate be filled with vegetables, fruits, beans and whole grains, and that animal-based proteins take up one-third or less. The American Heart Assn. “encourages adults to get most of their protein from plants.” The World Health Organization suggests shifting away from saturated fats, which should be “less than 10% of total energy intake,” and notes that consuming at least five portions of fruits and vegetables each day lowers one’s risk of heart disease, diabetes, stroke and cancer.

Meanwhile, according to the Food & Drug Administration, sales of antibiotics for use in farm animals increased by 16% in 2024 compared with the previous year. More and more of these drugs are being funneled into factory farms, where 99% of U.S. farmed animals are raised. When used in excess, these drugs — along with hormones used to promote animal growth — eventually end up in the meat consumed by the public, resulting in the development of antibiotic-resistant bacteria that kill about 35,000 Americans annually, according to the Centers for Disease Control and Prevention.

“For decades, federal incentives have promoted low-quality, highly processed foods and pharmaceutical intervention instead of prevention,” write Kennedy and Rollins. But make no mistake: These guidelines demonstrate that the federal government continues to promote unhealthy food, benefiting agribusiness and putting public health at risk.

Mentions of vegetarian and vegan diets are saved for a small section at the end that focuses primarily on “nutrient gaps” rather than suggesting the ways a healthy plant-based diet can meet one’s nutritional needs and even promote better health.

The new guidelines feature several positive recommendations, including “eat real food” (whole, unprocessed) and limiting one’s consumption of highly processed foods, sugar and alcohol. Instead of stoking fear over plant-based meat alternatives or repeating buzz phrases like “ultra-processed foods,” which should be limited in any diet, our government should be recommending a diet backed by science.

“Together, we can shift our food system away from chronic disease and toward nutrient density, nourishment, resilience, and long-term health,” write Kennedy and Rollins. Yes, we can — if the federal government shifts its funding and promotion away from unhealthy, animal-based products to whole, plant-based foods.

Gene Baur is president and co-founder of Farm Sanctuary.

Melani Sanders is over it.

She’s over meticulously applying makeup before leaving the house or, even, having to wear a bra when running errands. She’s over wasting time plucking chin hairs, searching for brain fog-induced lost reading glasses and — most of all — withholding her opinions so as not to offend others.

As a 45-year-old perimenopausal woman, Sanders is no longer searching for outside validation and is over people-pleasing.

The dedication page in her new book sums it up best: “To the a— who told me I had a “computer box booty.”

Who is this dude, and is Sanders worried about offending him?

She doesn’t care.

That’s Sanders’ mantra in life right now. Last year, the West Palm Beach, Fla.-based mother of three founded the We Do Not Care Club, an online “sisterhood” into the millions of perimenopausal, menopausal and post-menopausal women “who are putting the world on notice that we simply do not care much anymore.” Sanders’ social media videos feature her looking disheveled — in a bathrobe and reading glasses, for example, with additional pairs of reading glasses hanging from her lapels — while rattling off members’ comments about what they do not care about anymore.

“We do not care if we still wear skinny jeans — they stretch and they’re comfortable,” she reads, deadpan. “We do not care if the towels don’t match in our house — you got a rag and you got a towel, use it accordingly.”

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Sanders’ online community of fed up women grew rapidly. She announced the club in May 2025, and it has more than 3 million members internationally; celebrity supporters include Ashley Judd, Sharon Stone and Halle Berry. It’s a welcoming, if unexpected, space where women “can finally exhale,” as Sanders puts it. The rallying cry? “We do not give a f—ing s— what anyone thinks of us anymore.”

That’s also the message of Sanders’ new book, “The Official We Do Not Care Club Handbook: A Hot-Mess Guide for Women in Perimenopause, Menopause, and Beyond Who Are Over It.” The book is part self-help book, with facts about the perimenopause and menopause transition; part memoir; part practical workbook with tools and resources; and part humor book, brimming with Sanders’ raw and authentic comedic style. (It includes a membership card for new club inductees and cutout-able patches with slogans like “lubricated and horny” or “speaking your truth.”)

We caught up with Sanders while she was in New York to promote her book and admittedly “overstimulated from all the horns,” she said. But she just. Did. Not. Care.

This interview has been edited for length and clarity.

The We Do Not Care Club came about after you had a meltdown in a supermarket parking lot. Tell us about that.

I was in the parking lot of Whole Foods. I needed Ashwagandha — that was my holy grail at the time for my perimenopause journey, and I was out of it. I got back in my car and looked at myself in the rear view mirror. I had on a sports bra that was shifted to one side. My hair was extremely unstructured. I had a hat on and socks mismatched — I was a real hot mess. Nothing added up. But in that moment, I realized that I just didn’t care much anymore. I just said, “Melanie, you have to take the pressure off, girlfriend. It’s time to stop caring so much.” I decided to press the record button and see if anyone wanted to join me in starting a club called the We Do Not Care Club. I released the video and drove home, which took about 20 minutes, and by the time I got home it had [gone viral].

You got hundreds of thousands of new followers, internationally, within 24 hours. Why do you think the post resonated so greatly at that moment?

I had to dissect that because it was kind of unreal. Like, what is it about country, old Melanie that hit record and asked about a little club that she thought maybe 20 or 30 women would want to join? Over the summer, I studied this and did more videos and I listened. It was the relatability. It was the understanding. It was just letting my guard down and just saying it out loud. Speaking my truth. Also, for many women, we have this silent pressure to get it all done. But we’re at capacity. In the book, I talk about how, once I was in perimenopause, I didn’t want to have sex with my husband. I didn’t want to see my kids — like, everyone just close the door! And that’s kind of shameful, you know? It’s not like I don’t love my family. I really do. But I can’t do it all anymore. And I just think that resonated with a lot of sisters throughout the world. It was like: Now is the time for us to just explode and I think we all did it at once.

“The Official We Do Not Care Club Handbook.”

(William Morrow)

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You entered perimenopause (or “Miss Peri,” as you call it) at age 44, after a partial hysterectomy. How did your life change after that?

I did not expect it. I knew that I had fibroids and I was uncomfortable because of that. So when I had the hysterectomy, I was expecting to now be a whole person again afterwards. But I just went into this dark place. It was like you’re fighting against yourself to just be normal again. And your body is changing in so many ways. For me, that was the hot flashes, the insomnia, the depression, the rage. My joints were really, really stiff all of a sudden. It’s like, ‘wait a minute, how and why?!!’ And [I got] frozen shoulder. Frozen shoulder was how I discovered I was in perimenopause because I was not told by my doctor who performed my hysterectomy that this could happen. And I didn’t know where to turn or where to go because I was just being told everything was normal. I was so frustrated with the process, the lack of education, the lack of resources. The lack of compassion, I would even say.

Your book and social media videos are so funny. Do you have a comedy background?

I don’t, and I get asked that often. I just say what’s on my mind and sometimes, I guess, it comes out funny — but I’m not trying. The [wearing multiple pairs of] glasses: I do that because, with perimenopause, my eyesight went bad really quickly. I was out in public one day and I could not read. I was just traumatized. So every time I would see glasses, I would just put them on me because I don’t want to get stuck without them. That neck pillow, when I got frozen shoulder, I was using it a lot. Then one day when I hit record, I had the neck pillow on and I just didn’t care. And it stuck.

You’ve appeared on TV, been featured in publications, and People magazine named you creator of the year for 2025. What has this sudden fame been like for you?

It’s surreal. I have not completely processed it yet. It’s a lot to take in. I’m just an everyday woman that decided to press record and accidentally started a movement. Impostor syndrome is there from time to time. But I’m just trying my best to accept everything that’s going on — and keep just being Melani.

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Has the overwhelming response from new members fueled your own resolve to be true to yourself or otherwise changed you personally?

It absolutely has. It’s the strength that the sisterhood gives me. Because I’m very scared. You know, the book is coming out. And the tour is sold out in several cities. This is all within an eight-month span. It’s a lot. But when everyone is saying they love you, and when you have a group of women that understands you and feels the way that you feel, absolutely, there’s strength in numbers. Now I don’t care about making mistakes.

You live in a very male household. What do your sons and husband think of all this?

Once I decided that I didn’t care anymore, I just expected for them to kind of allow things just to go to hell around the house — but it was quite the opposite. All three of my sons and my husband, they’re just very supportive. Because it was very sad for me. It was very hard to not want to watch movies or anything and just be by myself. But they rose to the occasion and they make sure things are done when they’re home. They really show how they love their mom during this time.

How can other men become allies to the women they love during the menopause transition?

Just either get out of our way or, you know, just kind of read the room! Because we don’t know who we are from day to day. We don’t know what’s gonna ache. We don’t know what’s going to hurt or what’s going to itch or what’s going to be dry. And if it’s an off day, then darling, it’s just an off day — and it’s OK.

What are some things that you do still care about greatly?

I care about sisterhood. Because when women bind together, it’s a game changer. We will move mountains. I just think that, in this world, there’s so much pressure, so much overstimulation. So I care about being able to live authentically. To feel free. To be OK with who you are. Within WDNC, the two things that I definitely want to convey that I care about is: that you are enough. And you are not alone. And of course I love my kids. I love my family immensely.

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Where does the WDNC go from here? What’s the future?

Retreats. That is definitely a dream. To have a weekend retreat where women can come and the only thing that you need to bring is some clean underwear and some pantyliners! (You can’t have a good, hard laugh or a good sneeze or a good cough without pissing your pants.) No makeup, no nothing, just come and be free. I want three different rooms. One will be the rage room and you’ll go in there and just throw stuff around and scream and punch, whatever you want. Then a quiet room. No talking, no nothing, just silence. And the last room will be the “Let that s— go room.” That’s where we’ll put everything that we have in us, that we’re holding onto that’s keeping us from living a blissful and peaceful life, and write it down and let it go. I just want to touch sisters and let them know it is OK. We are OK. I have my s— I go through. You have your s— you go through. It’s OK. Let’s live.