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Tag: Measles
How stagnant vaccine funding caused measles to explode in Texas – National
The measles outbreak in West Texas didn’t happen just by chance.
The easily preventable disease, declared eliminated in the U.S. in 2000, ripped through communities sprawling across more than 20 Texas counties in part because health departments were starved of the funding needed to run vaccine programs, officials say.
“We haven’t had a strong immunization program that can really do a lot of boots-on-the-ground work for years,” said Katherine Wells, the health director in Lubbock, a 90-minute drive from the outbreak’s epicenter.
Immunization programs nationwide have been left brittle by years of stagnant funding by federal, state and local governments. In Texas and elsewhere, this helped set the stage for the measles outbreak and fueled its spread. Now cuts to federal funding threaten efforts to prevent more cases and outbreaks.
Health departments got an influx of cash to deal with COVID-19, but it wasn’t enough to make up for years of neglect. On top of that, trust in vaccines has eroded. Health officials warn the situation is primed to get worse.
Recent cuts by the Trump administration have pulled billions of dollars in COVID-19 related funding — USD $2 billion of it slated for immunization programs for various diseases. Overseeing the cuts is Health Secretary Robert F. Kennedy Jr., who rose to prominence leading an anti-vaccine movement. While Kennedy has said he wants his agency to prevent future outbreaks, he’s also declined to deliver a consistent and forceful message that would help do so — encouraging people to vaccinate their children against measles while reminding them it is safe.
At the same time, lawmakers in Texas and about two-thirds of states have introduced legislation this year that would make it easier to opt out of vaccines or otherwise put up barriers to ensuring more people get shots, according to an analysis by The Associated Press. That further undercuts efforts to keep infectious diseases at bay, health officials said.
The more than 700 measles cases reported this year in the U.S. have already surpassed last year’s total. The vast majority — more than 540 — are in Texas, but cases have popped up in 23 other states. Two Texas children have died. A 6-year-old girl from Gaines County, the center of the outbreak, died in February, the first measles death in the U.S. in a decade. An 8-year-old girl from the same town, Seminole, died earlier this month.
Children in the U.S. are generally required to be vaccinated to go to school, which in the past ensured vaccination rates stayed high enough to prevent infectious diseases like measles from spreading. But a growing number of parents have been skipping the shots for their kids. The share of children exempted from vaccine requirements has reached an all-time high, and just 92.7 per cent of kindergartners got their required shots in 2023. That’s well below the 95 per cent coverage level that keeps diseases at bay.
Keeping vaccination rates high requires vigilance, commitment and money.
Though the outbreak in Texas started in Mennonite communities that have been resistant to vaccines and distrustful of government intervention, it quickly jumped to other places with low vaccination rates. There are similar under-vaccinated pockets across the country that could provide the tinder that sparks another outbreak.
“It’s like a hurricane over warm water in the Caribbean,” said Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development in Houston. “As long as there’s warm water, the hurricane will continue to accelerate. In this case, the warm water is the unvaccinated kids.”
![Click to play video: 'Health Matters: RFK Jr. visits Texas amid measles outbreak']()
Flatlined vaccine funding in Texas
Lubbock receives a USD $254,000 immunization grant from the state annually that can be used for staff, outreach, advertising, education and other elements of a vaccine program. That hasn’t increased in at least 15 years as the population grew.
It used to be enough for three nurses, an administrative assistant, advertising and even goodies to give out at health fairs, Wells said. “Now it covers a nurse, a quarter of a nurse, a little bit of an admin assistant, and basically nothing else.”
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Texas has among the lowest per capita state funding for public health in the nation, just USD $17 per person in 2023, according to the State Health Access Data Assistance Center.
Vaccines are among the most successful tools in public health’s arsenal, preventing debilitating illnesses and lowering the need for expensive medical care. Childhood vaccines prevent 4 million deaths worldwide each year, according to the U.S. Centers for Disease Control and Prevention, which says the measles vaccine will save some 19 million lives by 2030.
U.S. immunization programs are funded by a variable mix of federal, state and local money. Federal money is sent to every state, which then decides how much to send to local health departments.
The stagnant immunization grant funding in Texas has made it harder for local health departments to keep their programs going. Lubbock’s health department, for example, doesn’t have the money to pay for targeted Facebook ads to encourage vaccinations or do robust community outreach to build trust.
In Andrews County, which borders Gaines County, the biggest cost of its immunization program is personnel. But while everything has gotten more expensive, the grant hasn’t changed, Health Director Gordon Mattimoe said. That shifts the burden to county governments. Some kick in more money, some don’t. His did.
The problem: keeping people safe from outbreaks requires high vaccination rates across a broad region, and germs don’t stop at county borders.
Andrews County, population 18,000, offers a walk-in vaccine clinic Monday through Friday, but other West Texas communities don’t. More than half the people who come to the clinic travel from other counties, Mattimoe said, including much larger places and Gaines County.
Some had to drive an hour or more. They did so because they had trouble getting shots in their home county due to long waits, lack of providers and other issues, Mattimoe said.
“They’re unable to obtain it in the place that they live. … People are overflowing, over to here,” Mattimoe said. “There’s an access issue.”
That makes it more likely people won’t get their shots.
In Gaines County just 82 per cent of kindergartners were vaccinated against measles, mumps and rubella. Even in Andrews County, where, at 97 per cent, the vaccination rate is above the 95 per cent threshold for preventing outbreaks, it has slipped two percentage points since 2020.
![Click to play video: 'Measles outbreaks renew push for Ontario vaccine registry']()
The health departments millions of Americans depend on for their shots largely rely on two federal programs: Vaccines for Children and Section 317 of the Public Health Services Act. Vaccines for Children mostly provides the actual vaccines. Section 317 provides grants for vaccines but also to run programs and get shots into arms.
About half of kids qualify for Vaccines for Children, a safety-net program created in response to a 1989-1991 measles epidemic that sickened 55,000 people and killed 123. Section 317 money sent to state and local health departments pays for vaccines as well as nurses, outreach and advertising.
Health departments generally use the programs in tandem, and since the pandemic they’ve often been allowed to supplement it with COVID-19 funds.
The 317 funds have been flat for years, even as costs of everything from salaries to vaccines went up. A 2023 CDC report to Congress estimated USD $1.6 billion was needed to fully fund a comprehensive 317 vaccine program. Last year, Congress approved less than half that: USD $682 million.
This, along with insufficient state and local funding, forces hard choices. Dr. Kelly Moore, a preventive medicine specialist, said she faced this dilemma when directing Tennessee’s immunization program from 2004 to 2018.
“What diseases can we afford to prevent and how many people can we afford to protect? Those decisions have to be made every year by every state,” said Moore, who now runs the advocacy group Immunize.org.
A rural clinic may have to be closed, or evening and weekend hours eliminated, she said. “It becomes difficult for them to staff the clinics they have and difficult for the people in those communities to access them, especially if they’re the working poor.”
At the same time, health officials say more funding is needed to fight misinformation and mistrust about vaccines. In a 2023 survey by the National Association of County and City Health Officials, 80 per cent of local health departments reported vaccine hesitancy among patients or their parents in the previous year, up from 56 per cent in 2017.
“If we don’t invest in education, it becomes even more difficult to get these diseases under control,” Moore said.
![Click to play video: 'Alberta on high alert as measles cases climb']()
Facing these headwinds, things got much worse in March when Kennedy’s health department canceled billions of dollars in state and local funding. After 23 states sued, a judge put a hold on the cuts for now in those states but not in Texas or other states that didn’t join the lawsuit.
But local health departments are not taking chances and are moving to cut services.
HHS said the money, allocated through COVID-19 initiatives, was cut because the pandemic was over. But CDC had allowed the money to be used to shore up public health infrastructure generally, including immunization programs.
Before he was confirmed as health secretary, Kennedy vowed not to take vaccines away. But in Texas, his department’s cuts mean state and local health departments are losing USD $125 million in immunization-related federal funding as they deal with the measles outbreak. A spokesperson for the federal health department did not respond to an AP request for comment.
Dallas County, 350 miles from where the outbreak began, had to cancel more than 50 immunization clinics, including at schools with low measles vaccination rates, said Dr. Philip Huang, the county’s health director.
Near the center of the outbreak, Lubbock’s health department said seven jobs are on the line because they were paid by those grants. Included in the affected work are immunizations.
Across the border in New Mexico, where the outbreak has spread, the state lost grants that funded vaccine education.
Kennedy’s cuts also hit vaccination programs in other states
It’s still unclear how the recently announced USD $2 billion in cuts will affect immunization programs across the country, but details are starting to trickle out from some states.
Washington state, for example, would lose about USD $20 million in vaccination-related funding. Officials were forced to pause mobile vaccine efforts on their “Care-A-Van,” which has administered more than 6,800 COVID-19 vaccines, 3,900 flu vaccines and 5,700 childhood vaccines since July. The state also had to cancel more than 100 vaccine clinics scheduled through June, including more than 35 at schools.
![Click to play video: 'Measles outbreak in Canada']()
Connecticut health officials estimate if the cuts stand, they will lose USD $26 million for immunization. Among other reductions, this means canceling 43 contracts with local health departments to increase vaccination rates and raise confidence in vaccines, losing vaccination clinics and mobile outreach in underserved neighborhoods, and stopping the distribution of vaccine-related educational materials.
Several of the 23 states suing the federal government, including Minnesota, Rhode Island and Massachusetts, cite losses to vaccine programs.
As the cuts further cripple already struggling health departments, alongside increasingly prominent and powerful anti-vaccine voices, doctors worry that vaccine hesitancy will keep spreading. And measles and other viruses will too.
“My whole life’s purpose is to keep people from suffering. And vaccines are a tremendous way to do that,” Moore said. “But if we don’t invest in them to get them in arms, then we don’t see their benefits.”
Your questions on measles, symptoms and the MMR vaccine, answered by experts
Measles is still making headlines in 2025, prompting questions about the life-threatening disease and how to prevent it. Here’s what to know as the U.S. grapples with its biggest measles outbreak in years.
Measles outbreak
The largest measles outbreak so far this year has been in West Texas, where health officials have confirmed more than 500 cases since late January. State and local health officials say the Texas outbreak is primarily affecting children and teenagers, nearly all of whom were unvaccinated or have an unknown vaccination status.
In late February, a child died of measles after being hospitalized in that outbreak. State and local health officials said the patient who died was an unvaccinated school-aged child. A second child, an 8-year-old girl who was also unvaccinated, died from measles in early April.
Measles cases have also been reported in more than 20 other states.
An unvaccinated adult in New Mexico tested positive for measles after their death, health officials announced in March, but said the official cause of death is still under investigation.
How deadly is measles?
Without vaccination, measles can be dangerous or even deadly. While most people’s symptoms improve, 1 in 5 unvaccinated people who catch measles will be hospitalized, 1 out of every 1,000 will develop brain swelling that can lead to brain damage, and up to 3 of every 1,000 will die.
The measles virus is airborne and extremely contagious. Before the first measles vaccine became available in the 1960s, almost everyone would catch it at some point during childhood, and between 400 and 500 Americans — mostly children — died every year from measles.
Measles symptoms
Symptoms typically begin about seven to 14 days after a person is exposed to the measles virus. The Centers for Disease Control and Prevention notes that the initial symptoms may appear similar to those of many other common viral illnesses, including:
- Fever
- Cough
- Runny nose
- Red eyes
Another characteristic sign is a rash that begins to develop a few days later. A patient’s fever may spike to 104 degrees Fahrenheit or higher, the CDC says.
In some cases, serious complications can develop, including pneumonia or encephalitis, a swelling of the brain. Encephalitis may lead to convulsions and can cause deafness or leave a child with a lifelong intellectual disability, health officials warn.
As many as 1 out of every 20 children with measles will develop pneumonia, which the CDC says is the most common cause of death from measles in young children.
“The predominant issues that we talk about, and that have led patients to be admitted to the hospital, are those respiratory issues, and so that is a frequent cause of death,” Dr. Lara Johnson, the chief medical officer at Covenant Children’s Hospital in Lubbock, Texas, said at a news conference on Feb. 26. At the time, she said, the hospital had seen about 20 patients admitted with confirmed measles cases, including several who needed intensive care.
“There are also neurological issues that can happen acutely — encephalitis, swelling of the brain, blindness, other issues along that line that can also be a part of acute measles,” Johnson said.
She added, “There are lots of childhood rashes and fevers, and as parents, we all know that our kids get these here and there. This is not that. This is a much more serious illness that has much greater risk of serious complications.”
Measles rash
Several days after the first symptoms begin, characteristic tiny white spots develop inside the mouth, and a facial rash spreads to the rest of the body.
On “CBS Mornings,” Dr. Céline Gounder, CBS News medical contributor and editor-at-large for public health at KFF Health News, described the rash as a “flat, blotchy red rash.”
Measles immune amnesia
Measles can also impact someone’s immunity long after the infection is gone in a process called “immune amnesia,” which can last months to a couple of years.
The virus can damage the immune system, Gounder recently explained, raising the risk of other infections even after the person has recovered.
“Measles infects immune cells, and when it does so, it damages immune cells and it partially wipes out your immune system’s memory to certain infections, so that leaves you more susceptible to getting some of those infections,” she said. “The best thing is not to get measles in the first place, and the best way to do that is to get vaccinated.”
Why is there a measles outbreak?
With safe, effective vaccines available, experts are pointing to lower vaccination rates as a reason why we’re seeing these increasing cases. Health officials confirmed that nearly all of the patients in the Texas outbreak were not vaccinated or had an unknown vaccination status.
“It is troubling, because this was completely preventable,” Dr. Amesh Adalja, an infectious disease physician and senior scholar at Johns Hopkins, recently told CBS News. “What we’re seeing is, one of the places in Texas — it has the lowest vaccination rates, the highest school exemption rates from measles vaccination — having a measles outbreak, including hospitalizations of individuals who’ve been infected with measles.”
Measles vaccine
While measles is one of the most contagious infectious diseases, doctors and public health officials say the vaccine is safe and highly effective. It is normally given in two doses as part of the combination measles-mumps-rubella (MMR) vaccine, which has been used for decades.
But nationwide, at least 10 states have seen childhood vaccination rates decline, jeopardizing communities’ herd immunity from widespread outbreaks.
Like Texas, some Florida schools — such as an elementary school in Broward County last year — have seen measles outbreaks. The vaccination rate for Florida kindergartners has fallen to 88.1%, according to the CDC, the lowest in decades.
As concerns grew about the latest outbreak, Health and Human Services Secretary Robert F. Kennedy Jr., who has a history as a vaccine skeptic, voiced support for the measles vaccine.
“We encourage people to get the measles vaccine,” Kennedy said in an interview with CBS News chief medical correspondent Dr. Jon LaPook on April 8.
Asked by LaPook what the federal government’s official position on the vaccine is, Kennedy reiterated, “The federal government’s position, my position, is that people should get the measles vaccine,” but added, “The government should not be mandating those.”
RFK Jr., measles and Vitamin A
Kennedy has previously shared some misleading information about the potential role of vitamins in measles treatment and prevention.
In some studies, Vitamin A has been shown to reduce the severity of measles and the risk of death from the virus — but these studies were among highly malnourished populations in low-income countries. Research shows Vitamin A supplements are not a substitute for measles vaccination, even among severely malnourished groups.
“Vitamin A reduces the risk of some complications among severely malnourished kids who have Vitamin A deficiency. It does not prevent measles or the damage the infection does to the immune system,” Gounder said. “Vitamin A is not a substitute for measles vaccination.”
In the U.S., Vitamin A deficiency is rare, affecting less than 1% of the population. Too much Vitamin A can also lead to the risk of liver toxicity.
When do you get the measles vaccine?
The American Academy of Pediatrics recommends children get vaccinated with two doses of the MMR vaccine, with their first dose between the ages of 12 to 15 months.
“That’s after the antibodies you get from your mom, through the placenta and through breast milk, have faded away, so that the vaccine will actually work — so there’s a logic to when we vaccinate,” Gounder explained.
Then the second dose is recommended at about 4 to 6 years of age.
One dose is 93% effective against measles and the recommended two doses is 97% effective, research shows. The vaccine also protects against mumps and rubella, also known as German measles, which are caused by different viruses.
Studies have also shown that the MMR vaccine, which was first introduced in 1971, may be given safely and effectively in combination with other vaccines.
But according to recent KFF polling, about 17% of parents say they have skipped or delayed a vaccine dose for their children.
“This is up from about 10% just two years ago. So we’re really seeing a lot of exemptions [and] concerns about vaccination that are not warranted,” Gounder said.
How long does the measles vaccine last?
For most people, the MMR vaccine will protect you for life, Gounder said.
“If somebody is fully vaccinated against measles and has a normal immune system, they don’t need to worry about measles,” said Adalja. “You’re not going to be at risk for contracting measles because the vaccine is very, very effective.”
Who should get a measles booster?
While most people have protection that lasts for life after getting vaccinated in early childhood, people born after 1957 but vaccinated before 1968 should consider a booster shot, Gounder said.
“That group is unlikely to have robust immunity from infection, because at that point in time, they were using less effective vaccines,” she said.
There are also other people who could potentially benefit from getting a booster, she added, including those working in health care, overseas or in places where there is an active measles outbreak.
If you’re unsure if or when you were vaccinated against the measles, start by tracking down your vaccination records if possible, Gounder advised. But, if you can’t find those records, there is “no harm in getting an extra dose,” she said, adding that no blood test confirmation is needed.
“That’s actually what we would advise to do, as opposed to getting a blood test to see if there are antibodies — just get a booster if you’re in doubt,” she said.
Taylor Johnston
contributed to this report.
