The Atlantic’s Elizabeth Bruenig on her “hypothetical,” heavily reported measles essay

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Feb 13, 2026 - 16:00

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The Atlantic’s Elizabeth Bruenig on her “hypothetical,” heavily reported measles essay

“The birthday-party invitation said ‘siblings welcome,’ which means you can bring your 11-month-old son while your husband is out of town,” Elizabeth Bruenig’s piece begins.

“This is how a child dies of measles” was published by The Atlantic on Thursday afternoon and is currently the most popular story on site. It’s written in the second person, from the point of view of a woman whose two unvaccinated children get measles — with ultimately horrific long-term consequences for her son.

The story is filled with details of modern everyday life (“You plant her on the couch with a blanket and put Bluey on the TV while she drifts in and out of sleep,” “While the kids are napping, you tap a list of your daughter’s symptoms into Google and find a slew of diseases that more or less match up”), juxtaposed with descriptions of a disease that was considered eliminated in the U.S. in the year 2000 — but reached its highest levels in three decades in 2025. (“Her cough wracks her whole body, rounding her delicate bird shoulders. She does not sleep well. And as you lift up her pajama top to check her rash one morning, you see that her breathing is labored, shadows pooling between her ribs when she sucks in air.”) There have been five measles outbreaks in the U.S. so far in 2026, according to the CDC.

When I initially read Bruenig’s story, I was stunned: An Atlantic staff writer’s unvaccinated child had died of measles in the 2020s, and now she was writing about it? At the end of Bruenig’s piece, though, there’s an editor’s note: “This story is based on extensive reporting and interviews with physicians, including those who have cared directly for patients with measles.” That was the point when I sent a gift link to my mom group: “as far as I can tell this piece is fiction. What do we think about this choice? I am very conflicted!!!” My conflict stemmed from my concern that, though the piece was heavily researched, it was not a true story. I wondered if the key people whose minds might be changed by it — people who don’t vaccinate their kids — would brush it off as fiction, or fake.

Some Atlantic readers seem to share my sense of conflict — or missed the editor’s note and thought it was true. “Thank you to this mom for the incredible generosity of sharing this story — nothing could be more tragic. I’m so sorry,” one commenter wrote.

Another reader commented: “Beautiful, powerful writing! This is not the reporter’s personal story, correct? Is it one family’s true story or a composite based on her reporting? I find it very compelling and potentially persuasive to families who question vaccines. I would love to know more about how the piece came together.”

I wanted to know that too, so I asked Bruenig some questions via email. (By the way, if you like learning about how reported stories come together in general, you should check out our sister publication Nieman Storyboard. And if you want to see another time that Nieman Lab asked a reporter questions like this, check out my colleague Sarah’s interview with Rachel Aviv or Neel’s interview with Sarah Zhang.) Our conversation, very lightly edited for clarity (and I added the links to statistics cited) is below. The piece is here.

Laura Hazard Owen: How do you describe the category for “This is how a child dies of measles”? My understanding is that it is fictional and, according to the note at the bottom, “based on extensive reporting and interviews with physicians, including those who have cared directly for patients with measles” — but at the end of the day, realistic fiction.

Elizabeth Bruenig: It is a hypothetical account of a very real phenomenon based on careful reporting. I would place it somewhere on the creative nonfiction spectrum.

Owen: That is a really fascinating choice. How did you decide on that and how did you pitch it to your editor? How did you decide to write it in the second person? How did you and your editor talk back and forth about what category it would be in on the site and where the “disclaimer” would be? Do you think it’s ultimately an opinion (or, in The Atlantic’s categorization, “Ideas“) piece?

Bruenig: I collaborated closely with my editors on this piece, and we were attracted to the idea of providing a play-by-play of the progression of measles in granular detail. It seemed like the best way to lay it all out was to spin a narrative that touches on every important aspect of a measles infection, from the biological processes inside the body, to the governmental response, to an outbreak.

Writing in the second person made sense to me because it’s a hypothetical addressed to parents weighing these decisions or facing outbreaks in their communities. I write nonfiction either in the first person or third, so this felt like a way to signal that this is a different kind of story. On the other hand, writing in the second person always feels a little bit goofy.

We included an editor’s note to remove any possibility of confusion. And yes, it does make sense to me to describe it as a story about ideas.

Owen: Tell me more about the research that you did for the piece, and who you talked to.

Bruenig: I spoke with doctors working at several universities whose specialties include pediatric infectious diseases, epidemiology, and management of highly communicable diseases. Some of them have treated measles firsthand — one doctor had actually suffered measles as a child, and we discussed that experience as well as the science behind it. The doctors I spoke with also directed me to research material used in the medical field that provided a very clear picture of how measles invades the body.

Owen: Who was the mom character you imagined in your head, and how did you write her? How were you thinking about her and the kids? (I know you’re a mom — how old are your kids?) I know you write that the piece is based on extensive interviews with doctors, but did you talk to other moms, too, including those who choose not to vaccinate, or did you have other experiences with them?

Bruenig: I based the mom on myself and my feelings about my own children, who are 9 and 6. (My children are fully vaccinated, but I wanted to try to put myself in the shoes of a mom who was very hesitant about vaccines.) She makes some mistakes that I can see myself making — specifically, confusing measles for a common cold or chicken pox, and misjudging when to call the doctor.

I also thought about the conversations I’ve seen play out in moms groups, both in person and on social media, which informed my ideas about where this mom may have encountered anti-vax views. So many parenting decisions are based on different forms of anxiety, in my experience, so I feel a lot of solidarity with parents striving to do what is best for their kids, even if I find their conclusions questionable. I didn’t want this mom to be aggressively confident or evangelical in her vaccine skepticism, because I didn’t want her to be a caricature. I did not want the piece to come off as mocking or shaming. I didn’t want to judge her, and I didn’t want to imply that she does not love her children. I wanted her to feel human.

Owen: I sent this to (mom, vaxxing) friends who were kind of stunned to realize at the end that it was fictional (or semi-fictional or whatever we’re calling that). Reactions to that really ranged. I’m conflicted about it. I had one friend who texted “it feels kinda sensationalist in a way that’s maybe damaging but I am not the American public so it’s not really aimed at me.” It seems clear that a lot of people in the comments think it’s real or aren’t sure.

How were you thinking about this? I imagine you thought about it a lot. As a very pro-vaccinating mom, I am so split on this. On the one hand it’s a new way to reach people who just wouldn’t read pro-vaccination content otherwise. On the other hand, did you worry they’ll blow it off or think it is sensationalized?

Bruenig: I completely agree that this story is dramatic, and I can see how people might construe it as sensational. But measles itself is a dramatic and damaging disease, and there’s no way to lay that out faithfully without exploring those frightening and dangerous elements. About 40% of measles infections result in complications, ranging from diarrhea to pneumonia to ear infections to encephalitis or blindness. One researcher I spoke with told me that between 50 and 60 percent of measles cases will result in pneumonia. One in 5 unvaccinated people infected with measles will require hospitalization, and children under 5 are especially vulnerable. There is no way to be sure who will become catastrophically ill with measles, though the very young and immunocompromised are at greatest risk. I wanted the story to closely examine a couple of those complications in detail.

Because the measles virus in the United States has been suppressed for so long by vaccinations, it is easy to forget that this is a serious illness. I was surprised by several things I learned in the course of this reporting. (I had no idea, for instance, that measles suppresses the immune system, providing ideal conditions for secondary infections.)

Owen: I was super shocked by the end. How did you learn about those long-term effects of measles and do you know how common this outcome is? How did you decide to end it that way?

Bruenig: I was also shocked to learn about SSPE, a degenerative brain disorder caused by measles between 7 and 10 years after initial infection. Prior to this reporting, I had no idea such a condition existed. But the first doctor I spoke to explained to me that SSPE is a rare and devastating complication of the virus, affecting about 1 in 1,000 pediatric cases. I wanted to highlight this complication specifically because I sense that there’s widespread belief among anti-vax parents that since most healthy children will survive a measles infection, there are no important long-term consequences. But that’s simply not the case. Measles can seriously damage the body, and in rare and tragic cases, can result in death many years after the symptoms pass.

Owen: Where do you expect this piece to be shared and who do you expect to read it? Do you think people who choose not to vaccinate their kids will read it, and if so, how will they come across it? Have you heard any reactions from readers so far?

Bruenig: I have heard from several readers, one of whom had a heartbreaking experience with measles involving a family friend who died of the virus. People have been generally very encouraging! I have no doubt that there are a lot of people out there who are unhappy with the story or reject its premises, and they are entitled to their interpretations. I get it.

But my job is to report the truth about the world — and I use all kinds of literary, and narrative devices to do that. I do it because telling the truth is important in its own right, whether or not anyone finds it persuasive.

I hope there’s a sliver of a chance this reaches people who are really weighing these issues and making decisions about their children’s health in real time, or people who have friends and family weighing whether to vaccinate, or people living in communities currently managing outbreaks. I’m not very confident that it could persuade people who have very firm anti-vax convictions — as you point out, it seems pretty likely they would just blow it off. That’s always a risk anytime you write with a hint of persuasion in mind. But if the story makes even a little bit of a difference in even one person’s decision making where it comes to vaccines, then it was a success.