A Preventable Tragedy: The Resurgence of Measles and the Imperative for Public Health Investment
In 2000, a monumental achievement in public health was celebrated: the elimination of measles in the United States. This victory, a testament to the power of vaccination and a robust public health infrastructure, offered the promise of a future free from the threat of this once-common and potentially devastating disease. However, that promise has been tragically broken. In 2025, a grim reality emerged: an unvaccinated child succumbed to measles during an outbreak in Texas, marking the first such death in the nation since 2015.
As leaders of local health departments in Texas, we are grappling with a mixture of grief and frustration. The death of a child from a preventable illness is a profound tragedy, a stark reminder of the human cost of complacency and misinformation. Our devastation is compounded by the knowledge that measles is a disease that can be effectively prevented through a safe and readily available vaccine.
Our anger stems from the insidious forces that have eroded the progress made in eliminating measles. The path from elimination to outbreak is paved with disinformation about vaccines, a deliberate and calculated effort to undermine public trust in science and medicine. This disinformation, amplified by social media and other platforms, has fostered vaccine hesitancy, leading to a decline in vaccination rates and a resurgence of measles.
Coupled with this epidemic of misinformation is a longstanding and systemic disinvestment in our nation’s public health system. For decades, public health has been relegated to a secondary role, underfunded and understaffed, leaving us ill-equipped to address emerging health threats. This chronic underfunding has weakened our ability to detect and respond to outbreaks, to educate the public about the importance of vaccination, and to combat the spread of misinformation.
The Centers for Disease Control and Prevention (CDC) identified three key factors that contributed to the eradication of measles in the United States in 2000. These factors serve as a roadmap for containing the current outbreak in Texas, preventing similar outbreaks in the future, and restoring our nation to a state where measles no longer poses a threat to our children.
The first factor is the availability of a highly effective measles vaccine. This vaccine, which has been available since 1963, provides 97% protection against measles infection over a lifetime. Prior to its introduction, measles infected 3 to 4 million people each year, resulting in tens of thousands of hospitalizations and hundreds of deaths. The vaccine dramatically reduced these numbers, offering a safe and effective means of preventing measles infection.
Communities with a 95% measles vaccination rate achieve herd immunity, a phenomenon where the vast majority of the population is protected, thereby safeguarding even those who cannot be vaccinated due to medical reasons. This underscores the importance of widespread vaccination in protecting the entire community from measles.
In response to the current outbreak in Texas, we are implementing strategies to increase measles vaccination rates, including sending mobile vaccine clinics to neighborhoods and partnering with schools to identify and reach out to unvaccinated students and their families. These efforts are yielding positive results, with dozens of previously unvaccinated children receiving the protection offered by the measles vaccine. We are working to ensure that parents have access to accurate information from medical and public health professionals, enabling them to make informed decisions about their children’s health.
The second factor is a strong vaccination program that achieves high vaccine coverage in children. While childhood vaccination rates in the United States remain relatively strong overall, they are declining. Measles vaccination coverage among U.S. kindergartners dropped from 95% during the 2019-20 school year to 92.7% in the 2023-24 school year. This seemingly small decline has significant implications for the spread of measles, a highly contagious disease.
Even a slight dip in vaccination rates can create vulnerabilities that measles can exploit. When measles finds larger pockets of unvaccinated individuals, as seen in Gaines County, Texas, where nearly 1 in 5 children were not vaccinated against measles before the outbreak, it spreads rapidly. This highlights the critical importance of maintaining high vaccination rates to prevent outbreaks.
Measles outbreaks are becoming increasingly common, occurring in various states across the country. This underscores the need for a renewed commitment to vaccination and public health. Health officials at all levels of government must consistently promote vaccination, increase access to vaccines, and provide additional resources to local health departments to effectively identify and respond to outbreaks.
The third factor is a strong public health system for detecting and responding to measles cases and outbreaks. Unfortunately, our nation’s public health system is severely underfunded, making it challenging to effectively prevent and control measles outbreaks.
Prevention is always more effective and less expensive than responding to outbreaks. However, for every health care dollar spent in the United States, only a small fraction is allocated to public health and disease prevention. This chronic underfunding contributes to declining life expectancy rates, rising chronic disease rates, and more frequent outbreaks of vaccine-preventable diseases.
Local health departments are on the front lines of responding to measles outbreaks, but their ability to do so is often constrained by limited resources. Funding for public health often relies on federal support, and any freezes, cuts, or uncertainty surrounding essential programs can jeopardize our ability to respond effectively.
The recipe for eradicating measles and addressing other communicable disease outbreaks remains the same as it was in 2000: maintain high vaccination rates, combat misinformation, and invest in a strong public health system. What is needed now is a redoubling of efforts to get back to where we once were, to prioritize the health and well-being of our communities.
No child should die from measles. With the right commitment and approach from policymakers, we can ensure that such tragedies do not happen again. We must work together to strengthen our public health infrastructure, combat vaccine misinformation, and promote the importance of vaccination to protect our children and communities from preventable diseases like measles. The health of our nation depends on it.
