Wow you have this exactly BACKWARDS. The “1–3 deaths per 1,000” figure is a CDC figure generally applied to measles in the United States/developed-country setting, and there is an important denominator problem, but it's in the OPPOSITE DIRECTION. CDC’s current public-facing page states that “1 to 3 of every 1,000 children who become infected with measles will die.” However, CDC’s own Manual for the Surveillance of Vaccine-Preventable Diseases states the estimate more precisely as “two to three deaths … for every 1,000 reported measles cases.” (CDC) Those are not equivalent denominators. The historical U.S. data make the distinction obvious. In the decade before vaccine licensure, CDC reports about 549,000 reported cases and 495 reported deaths annually, while estimating that 3–4 million Americans were actually infected each year. (CDC) Thus: Using reported cases: 495 / 549,000 ≈ 0.90 deaths per 1,000 reported cases. Using estimated infections: 495 / 3–4 million ≈ 0.12–0.17 deaths per 1,000 infections, or roughly 1 death per 6,000–8,000 infections. There is a period in which the upper end of the CDC figure is directly supported by U.S. surveillance. A CDC-affiliated analysis of U.S. measles mortality during 1987–1992 found 2.54–2.83 deaths per 1,000 reported cases. That period included substantial outbreaks and a case population detected through surveillance, rather than the millions of largely unreported infections characteristic of the pre-vaccine era. CDC itself historically (INCORRECTLY) described the figure as applying “even in developed countries like the United States”, saying that one to three children per 1,000 who get measles may die. But when one examines CDC's underlying historical numbers, 1–3/1,000 is much more defensible as a case-fatality estimate among reported/recognized cases than as an infection-fatality rate among all measles infections. Globally, the situation is different again. WHO states that more than 95% of measles deaths occur in countries with low per-capita incomes and weak health infrastructure, with malnutrition and impaired immunity markedly increasing mortality. (World Health Organization) Therefore, a single “1–3 per 1,000” figure should not be treated as a universal measles infection-fatality rate. CDC commonly cites approximately 1–3 deaths per 1,000 measles cases in the United States, although CDC surveillance documents describe this denominator as reported cases. Historical pre-vaccine U.S. estimates of total infections imply a substantially lower death-to-infection ratio—approximately 0.12–0.17 deaths per 1,000 infections. That distinction is consequential and should be made explicit. With universal knowledge and clinical action on the fact that CDC also recommends two high doses of VitA, deaths - and serious illness - could fall to zero. Then there is the questionable practice of vaccinating people with active infections. Oops. No science on that showing safety. popularrationalism.substack.…