A number of private institutions have closed their doors in response to a severe measles outbreak in West Texas. Local health agencies are currently overwhelmed, having to suspend other critical activities to focus on containing this highly infectious disease.

As reported by the Texas health department, there have been 90 confirmed cases of measles with 16 requiring hospitalization since the outbreak started three weeks ago, as of February 21. The majority of those affected are children under 18. It is also believed that nine additional cases in New Mexico, just across the border from Gaines where the outbreak is concentrated, may be related. Investigations are ongoing to verify this potential link.

Health authorities are concerned about cases that may be going undetected. Hidden cases are troublesome for the community as containing the outbreak is impossible without knowing who is infected.

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“We’re only seeing the beginning of this,” stated Rekha Lakshmanan, the chief strategy officer at The Immunization Partnership based in Houston, which promotes vaccine access. “It’s likely going to worsen before it improves.”

Katherine Wells, the public health director in Lubbock, Texas, mentioned that some parents might not be taking their ill children to get tested. “If the kids are responding to fever reducers and stay hydrated, some parents prefer to keep them at home,” she explained.

Measles is incredibly contagious, especially among those who are not vaccinated. The virus can remain airborne indoors for two hours, and those infected can begin spreading the disease before they even exhibit symptoms. Approximately one in five measles patients ends up in the hospital, one in ten children could develop ear infections leading to permanent hearing loss, and about one in a thousand may die from complications such as respiratory and neurological conditions.

In Gaines, a significant Mennonite community often opts out of vaccinations. “We respect everyone’s choices whether to vaccinate or not,” Albert Pilkington, CEO of the Seminole Hospital District in Gaines, told Texas Standard. “That’s part of being American, isn’t it?”

Efforts are being made by local health officials to encourage parents of unvaccinated children to get them immunized at temporary vaccine clinics.

“We’re seeing people who previously were hesitant about measles vaccines for their children reconsider and choose vaccination,” said Wells.

Local health departments have also launched mobile testing units at schools to identify infections early and prevent further spread. They are operating clinics to offer preventive treatments to infants who have been exposed to measles but are too young to be vaccinated. Moreover, they are advising daycare facilities on protective measures for young children and infants, and they are training school nurses to recognize symptoms of the disease.

“About 75% of my team is dedicated to managing this outbreak,” Wells noted. Although Lubbock is not the epicenter, it has treated people who were infected. “If an infected person was in the emergency room, we need to track down everyone who was there within two hours of their visit, check their vaccination status, and follow up accordingly.”

Rural health departments, known for their limited funding, are struggling. Wells indicated that significant resources are being diverted from other programs, including substance abuse education, to manage the outbreak.

Zach Holbrooks, executive director of the South Plains Public Health District encompassing Gaines, mentioned that following CDC guidelines from the previous year, schools are advised to keep unvaccinated children at home for 21 days if they were in the same room or cafeteria with an infected person. This could force many parents to take leave from work to care for their children.

“Numerous private schools have had to shut down due to the high number of sick children,” Holbrooks remarked.

The financial and social costs of measles outbreaks are steep. A 2018 outbreak in Washington state with 72 cases incurred about $2.3 million in containment costs, $76,000 in medical expenses, and an estimated $1 million in economic losses from sickness, quarantines, and caregiving.

Public health experts anticipate that outbreaks will become larger and more frequent due to a plethora of new and pending legislation across the U.S. that allows parents to exempt their children from school vaccination requirements, thereby reducing overall vaccination rates.

This situation is exacerbated by misinformation about vaccines, now endorsed at high levels of government. The newly appointed director of the Department of Health and Human Services, Robert F. Kennedy Jr., has controversially linked vaccines to autism based on discredited theories, despite extensive scientific evidence proving otherwise.

In his first week in office, Kennedy delayed a critical meeting of the CDC’s Advisory Committee on Immunization Practices and removed a CDC template letter from the agency’s website that advised school principals on handling unvaccinated children exposed to measles. An outdated version of the letter remains in the site’s archive.

To ensure community protection, a vaccination rate of at least 95% is necessary. This high threshold helps safeguard infants too young for the vaccine, individuals who cannot be vaccinated for medical reasons, and those who do not develop a full immune response. Last year, the rate of kindergartners exempted from vaccination reached an all-time high, according to the Centers for Disease Control and Prevention.

In Gaines, exemptions were significantly above the national average, reaching nearly 20% in 2023-24. Gaines has one of Texas’s lowest childhood vaccination rates. In the Loop community’s public school district, only 46% of kindergartners are vaccinated against measles.

As the current outbreak highlights the severe consequences of low vaccination rates in certain American communities, Texas legislators have introduced about 25 bills this session that could further restrict vaccinations. Lakshaman urges the public, most of whom support measles vaccination, to voice their concerns to their representatives about the risks these legislative actions pose. Her organization offers resources for those looking to get involved.

“We are seeing children hospitalized, and yet some lawmakers continue to push for policies that will lower vaccination rates,” she stated. “It’s absolutely astonishing.”

KFF Health News, formerly known as Kaiser Health News (KHN), is a prominent national newsroom that produces comprehensive journalism on health issues. It is a key program of KFF — an independent entity dedicated to health policy research, polling, and journalism.