Measles Resurgence: A Public Health Crisis in the US

The United States is grappling with a severe measles outbreak, potentially the worst it has seen this century. What began as a localized issue within a small religious community in West Texas in January has rapidly spread, impacting four states in the Southwest and raising serious concerns about public health. The consequences have already been devastating, with two school-aged children and one adult succumbing to the disease. Reported cases are on track to exceed 1,000 this week, and the actual number is likely much higher due to reporting lags and undetected infections.

The re-emergence of measles in 2025 presents challenges significantly different from those faced before the introduction of the measles vaccine in the 1960s. Prior to vaccination, measles was a highly contagious and dangerous virus, particularly for young children, and defenses were limited. Today, a highly effective vaccine offers a powerful shield against measles, boasting a 97 percent efficacy rate. This surpasses the effectiveness of vaccines against diseases like the flu or COVID-19. The means to eliminate measles are readily available.

However, the US is failing to utilize this crucial tool, largely due to an anti-science movement fueled by vaccine skepticism. This movement has gained traction with the rise of figures like Robert F. Kennedy Jr., who now leads a key health agency. This situation has created a dangerous reversal of decades of progress in combating measles.

The Scale of the Outbreak

The current measles outbreak is the largest since the United States declared measles eradicated in 2000, meaning the disease’s natural spread within the country had been halted. As of May 6th, Texas has reported a staggering 702 cases, followed by New Mexico with 67, Kansas with 46, and Oklahoma with 17, totaling 832 cases.

Since eradication, the majority of measles cases in the US have been linked to international travelers. In 2019, the US experienced 1,274 measles cases, but this was the result of multiple smaller outbreaks originating from international travelers and affecting Orthodox Jewish communities in New York City.

The current trajectory indicates that 2025 will likely surpass 2019, becoming the worst year for measles in the United States since at least 1992, when approximately 2,100 cases were recorded.

Initial Expectations and Current Reality

Infectious disease experts initially expressed concern but not panic when the outbreak began to spread in February. They anticipated the outbreak would remain localized within isolated communities and that the case count would be limited to a few hundred. However, the situation has far exceeded these initial estimates, and the spread of the virus continues to accelerate.

There is often a considerable delay in confirming measles cases, but the latest data indicates that the situation is worsening. The Centers for Disease Control and Prevention (CDC) reported 111 new infections in the week starting March 30th, marking the worst week for new measles cases in the US since the 1990s.

Erosion of Vaccine Consensus

In 2000, when the US declared measles eradicated, there was near-universal agreement among Americans that vaccinating children against diseases like measles was essential. However, this consensus has since eroded. The appointment of Robert F. Kennedy Jr. underscores the changing national sentiment. Kennedy has spent the last 25 years promoting the debunked claim that childhood vaccinations cause autism. A fringe viewpoint has now reached the highest levels of power.

In his role as the head of US Health and Human Services, Kennedy has been more of a hindrance than a help. While he has made official statements acknowledging the value of vaccines, he continues to express doubts about their safety in interviews and promote unproven, sometimes dangerous, alternative treatments. Kennedy recently announced that the health department would investigate new therapeutics for measles, rather than focusing on promoting the MMR vaccine, which is highly effective in preventing the disease and improves outcomes for patients who receive it even after infection.

Declining Vaccination Rates

Vaccination rates are declining in tandem with these changing attitudes, falling far short of the "herd immunity" threshold necessary to contain the virus. Experts recommend a vaccination rate of 95 percent or higher among schoolchildren to prevent widespread measles outbreaks. In the 2019-2020 school year, over 95 percent of kindergartners nationwide were vaccinated. However, this number has since dropped below 93 percent.

The national figure of 93 percent is also misleading. Only a handful of states exceed the 95 percent threshold, and in certain communities, the proportion of vaccinated school-age children is significantly lower. In some schools in Gaines County, Texas, where the current outbreak originated, only about half of the students were protected against measles.

Steps to Take

Adults who believe they were vaccinated against measles but are concerned about their immunity can take steps to verify their protection. Parents of young children should consult with their doctors about the possibility of early vaccination. The author of the original article notes that they will have their 3-year-old twins receive their second dose of the MMR vaccine a year ahead of schedule on the advice of their pediatrician.

This type of precaution would have been unimaginable – and entirely unnecessary – a decade ago. However, the circumstances have changed. This resurgence of measles is the new reality we must confront.