Public health officials declared that measles had been eliminated from the United States after only 15 measles cases were reported between 1998 and 2001 and 90 percent of schoolchildren had been inoculated against the disease. Yet, in 2014, there were more than 660 documented measles cases in the country, the most in 20 years. This uptick started in the late 1990s, when a growing number of parents began refusing to inoculate their children with some or all of the recommended vaccines. Various factors fed their decision: an increase in the number of vaccines given in the first year of life, questions about the safety of vaccines and distrust of pharmaceutical companies and their influence on government-mandated vaccination.