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WHY THE TEXAS MEASLES OUTBREAK WAS ‘INEVITABLE’  
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Joseph Choi
February 21, 2025
The Hill
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_ Critics of Kennedy accused him of fostering anti-vaccine sentiment
in Samoa, months before an outbreak ultimately resulted in 83
measles-related deaths and more than 5,600 infections. _

Health care workers conducted drive-through measles tests outside a
hospital in Seminole, Texas, on Friday., Julio Cortez/Associated Press


 

An outbreak of measles is wreaking havoc in the South Plains region of
Texas, where nearly 60 children have been confirmed to be infected.
Physicians in the state say the current situation was “inevitable”
due to the low rates of vaccination among the largely Mennonite
community.  

As of Feb. 21, the Texas Department of State Health Services
has confirmed
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of measles with 16 patients hospitalized. Five of the cases are
vaccinated while the rest are not. The department has stated there are
likely more measles cases that have yet to be confirmed due to the
highly contagious nature of the virus.

The outbreak comes as Robert F. Kennedy Jr., a leading vaccine
skeptic, takes over the Department of Health and Human Services,
spurring fears he will further fuel vaccine skepticism, an issue
already politicized by the COVID-19 pandemic. 

The South Plains region is home to an insular community of Mennonites,
a conservative Christian sect dating back to 15th century, among whom
vaccinations are not as popular as in the general population.

The ideal coverage for measles, mumps and rubella (MMR) vaccinations
is 95 percent. The vaccination rate in Gaines County, the epicenter of
the Texas outbreak, is closer to 80 percent
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About 91 percent of Texas children born in 2020 have received at least
one dose of the MMR vaccination, according to data from the Texas
Department of State Health Services (TDSHS).

Linda Yancey, an infectious disease specialist at the Memorial Hermann
Health System in Texas, said the current situation was
“inevitable,” since anything shy of the ideal vaccination rate
leaves communities vulnerable.

“Once a community falls below that 95 percent protection rate, it is
like dry kindling just waiting for that first spark,” Yancey told
The Hill.  

“And once you get that one case of measles in a vulnerable
community, it spreads like wildfire. Any community with a less than 95
percent immunity rate is an outbreak waiting to happen with
measles,” Yancey added. “These counties that have low immunity
rates are going to have measles outbreaks. It is not a matter of if
but when.” 

Undervaccinated community

A TDSHS spokesperson confirmed to The Hill that most of the measles
cases have occurred in the Mennonite community of the South Plains
region but emphasized lifestyle choices and not religion led to low
immunizations in this community. 

“Most of the cases are in a close-knit, under vaccinated Mennonite
community in Gaines County. The important nuance here is that it is
their lifestyle and not the church that is the reason for many people
being unvaccinated,” the spokesperson told The Hill in a
statement. 

“The Mennonite church allows for free choice on vaccination and it
is not widely against vaccination,” they added. “Mennonite
families don’t seek traditional health care regularly so they are
not prompted to vaccinate their children on a schedule and many attend
small private schools in their community so they are not required to
get vaccinated for school.” 

According to Texas health officials, part of the current response
involves communicating the importance of immunizations to the affected
communities.

“The Mennonite community speaks Low German, Spanish and English so
we’ve been working on developing informational messaging in all
three languages,” the spokesperson noted. 

The TDSHS is in contact with the Centers for Disease Control and
Prevention (CDC), and the agency’s field officer assigned to Texas
has been deployed to the region to assist with epidemiology. 

TDSHS data for the 2023-24 school year indicated that in one of the
three school districts in Gaines County, where 45 of the 58 cases have
been confirmed, nearly half of all students had exemptions for
vaccines. The Loop Independent School District reported 47.95 percent
of K-12 students had a conscientious exemption for immunizations. 

More frequent measles outbreaks

The U.S. has held the distinction of being a country where measles is
considered eliminated since 2000. But in recent years, measles
outbreaks across the country have become increasingly common,
threatening that status. 

“Where we would hear, you know, an outbreak every year, every two
years. Now it’s every other month,” said Luis Ostrosky, chief of
infectious disease at UTHealth Houston. “The pattern is very
similar. It’s very tight-knit communities with low vaccination rates
where you introduce a case of measles, and it goes like wildfires
throughout community and spills into adjacent communities.” 

In 2024, the CDC reported 16 measles outbreaks. Two outbreaks have
been reported this year. 

Given the apparent uptick in localized measles outbreaks, Ostrosky
said the U.S. losing its elimination status is “a real
possibility.” 

“It would be so sad and so shameful that a country that has been a
leader in public health for so many decades would be losing that
edge,” he added. 

Yancey, who herself has yet to encounter a measles patient in nearly
20 years of practicing medicine, said Texas is well-equipped to handle
an outbreak, despite how relatively uncommon measles still is. 

“If the pandemic taught us nothing else, it is that we can handle
almost anything. Would I like it if we had more public health
resources? Of course. But we have the capacity to handle this and,
sadly, after the pandemic, the practice,” she said.

While there are no therapeutics or antivirals for measles, most people
who contract measles make a full recovery. But 1 in 5 children who get
the virus will be hospitalized, 1 in 20 will develop pneumonia, and 1
in 1,000 develop encephalitis that could lead to permanent
disabilities.

Yancey advised concerned parents to isolate if they are in communities
with widespread measles transmission and to ensure that members of
their household are vaccinated against the virus.

RFK Jr.’s past with measles vaccine

Kennedy carries a controversial history regarding measles outbreaks.

In 2019, Kennedy traveled to Samoa while the country was dealing with
widespread concerns over measles vaccinations after two babies died
due to improperly prepared vaccines. The island’s government
suspended measles vaccinations in response, but when the suspension
was lifted, parents were still reluctant to get their children
immunized. 

Critics of Kennedy accused him of fostering anti-vaccine sentiment in
Samoa, months before an outbreak ultimately resulted in 83
measles-related deaths and more than 5,600 infections.  

Kennedy has consistently denied any responsibility for the measles
outbreak in Samoa, though correspondence to former Samoan Prime
Minister Tuilaʻepa Saʻilele Malielegaoi showed Kennedy cast doubt on
the efficacy and safety of what he referred to as “a defective Merck
vaccine” after a state of emergency had already been declared on the
island. 

Democrats hammered Kennedy about his involvement in Samoa during his
confirmation hearings, with Sen. Elizabeth Warren (D-Mass.) saying,
“There’s a measles outbreak, and children start dying, but you
double down. You didn’t give up.”

“You launched the idea that a measles vaccine caused these
deaths,” Warren added. When she asked Kennedy if he accepted any
responsibility for the drop in MMR vaccinations in Samoa and if he
would do anything differently, he responded, “Absolutely not.” 

The HHS did not respond to repeated inquiries by The Hill regarding
the measles outbreak in Texas and what the department may do to assist
in the response.

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