Measles Outbreak in Texas Raises Concerns Over Vaccine Hesitancy and Public Health Infrastructure

As of May 23, 2025, the Texas Department of State Health Services (DSHS) reported 728 measles cases statewide, an increase of six since the previous update. Gaines County remains the epicenter, accounting for 408 infections. Nationally, the United States has recorded 1,046 confirmed measles cases across 31 jurisdictions, marking the first time in five years that cases have surpassed 1,000. Three measles-related deaths have been confirmed. Notably, 96% of these cases involved individuals who were unvaccinated or had unknown vaccination status. The outbreak has also spread to neighboring states such as New Mexico, Oklahoma, and Kansas. Scientists warn that the U.S. might be approaching the re-establishment of endemic measles, which was declared eradicated in 2000, and are urging public health officials to strongly promote vaccination.

Measles is a highly contagious respiratory disease caused by the measles virus. It spreads through the air when an infected person coughs or sneezes and can lead to severe complications, especially in children. The measles, mumps, and rubella (MMR) vaccine is 97% effective after two doses and generally provides lifelong protection. The CDC recommends children receive the first MMR shot between 12-15 months old and a second dose between 4-6 years old. Despite the vaccine’s proven efficacy, vaccination rates have declined since the COVID-19 pandemic, contributing to the resurgence of measles.

The resurgence of measles has significant social implications, particularly in communities with low vaccination rates. The outbreak has been notably severe in undervaccinated Mennonite communities, where containment is challenging due to the rural, multi-state nature of the outbreak. Health experts warn that if the outbreak extends beyond January, it could compromise the United States’ status of having eliminated measles. Efforts to boost immunization are ongoing, particularly in areas like Gaines County, Texas, where vaccination rates are critically low.

Health experts have raised concerns over insufficient government advocacy for vaccination and misinformation about alternative treatments, contributing to the rising measles infections. The CDC states that the measles vaccine is 97% effective after two doses.

The outbreak has intensified debate over vaccination policies, particularly as Health Secretary Robert F. Kennedy Jr., known for his previous skepticism about vaccines, acknowledged in April that vaccines are the most effective method to prevent measles. Despite this concession, Kennedy recently instructed the CDC to explore alternative treatments, including the use of existing drugs supplemented with vitamins and other methods.

The Trump administration confirmed plans to eliminate funding created to respond to the COVID-19 pandemic, which had been used to pay for infrastructure to respond to infectious diseases other than COVID, including measles. This funding cut is expected to impact local health departments' ability to respond to the outbreak.

The current outbreak is the most significant in the U.S. since 2019, when 1,282 cases were reported. The U.S. had declared measles eliminated in 2000, meaning the disease was no longer constantly present. The resurgence threatens this status, with scientists warning that the U.S. might be approaching the re-establishment of endemic measles.

The 2025 measles outbreak underscores the critical importance of vaccination and robust public health infrastructure. Addressing vaccine hesitancy, ensuring adequate funding for public health initiatives, and maintaining high vaccination coverage are essential to prevent future outbreaks and protect public health.