Texas is facing the worst measles outbreak in decades, as it jumped from two to 146 people in just a month. The children are dead and another 20 people are hospitalized, and the worst is likely still ahead of the curve, public health experts say the decline in vaccination rates in Texas is leaving the nation’s belt, which is currently exposed to the most infectious virus humans.
State and local health officials have set up vaccine clinics and encourage people to get shots.
But neither Gov. Greg Abbott nor lawmakers from the most intense Hit region have been made public in press conferences, social media posts, or public calls for people to consider vaccinating. West Texas states and local governments have yet to enact more important measures adopted by other locations during the outbreak.
Experts say Texas’ response to its first major public health crisis is being shaped by the long-term outcome of the pandemic, and experts say it will strengthen its vaccine hesitancy, reduce confidence in science and authorities, and do not want the reluctance from politicians to actively promote public health measures such as vaccination and quarantine.
“Everyone is very sensitive to vaccine topics for Covid,” said Ector County Judge Dustin Fawcett. “We need to be very careful about how we deal with this topic. Our job is to provide resources, not to tell people what they need to do.”
Catherine Troisi, an infectious disease epidemiologist at Uthealth Houston, has long disappeared in Texas if there was an appetite for a more aggressive government response to the outbreak of illness.
“I think there’s less political will right now,” she said, more than before Covid. “Texas is such an independent nation. People don’t want to tell you what to do. Measles is an example.”
Public Health Procedures
When Clark County, Washington, identified the third measles incident in January 2019, the county quickly declared a public health emergency. The state soon followed suit.
“We need to jump on this,” said Dr. Alan Melnick, director of public health. “Measles is something you have to jump straight away, and it’s a deck with all your hands.”
The county ordered all Vacutiba students in the county to stay home from school for 21 days, regardless of whether they were exposed or not. Melnick said this was a difficult decision, but he thought it was the only way to stop the highly contagious disease from spreading like wildfires through school.
“It doesn’t matter whether it’s in the country or the city. If you have a meeting setting and you have people who are susceptible to and exposed, you have to do that,” he said. “Or I’m not going to control this.”
The Clark County outbreak ended four months later, with a total of 71 cases and no deaths. Public health response is $2.3 million. Melnick said Texas’ rapidly rising case counts worried him, and was shocked that unvaccinated students in the area were still allowed to go to school.
“I was just blown away,” he said. “This is not politics. I’m just talking about science and medicine here.”
Texas school districts should rule out unvaccinated students for at least 21 days after being exposed to measles. Lala Anton, a spokesman for the Texas Department of Health, said measles is highly contagious and allows cases to stay in the air for up to two hours after leaving the area, which could leave many students at once.
But to actively rule out unvaccinated students before they are known to be exposed, Texas health commissioners must declare a public health emergency. This can be activated in the event of a health threat that could pose a risk of death or severe illness or harm to the public. Anton said he has no plans to declare a state of emergency at this time, saying that more than 90% of Texans have been vaccinated for measles.
State and local governments also recommend unvaccinated people who have been exposed to measles quarantine at home for 21 days. But that quarantine period has not been mandatory or tracked, Anton said.
In Ector County, where there were two confirmed cases, Fawcett said states or local governments pursuing widespread closures like Covid did not expect.
In the case of the county outbreak, he said, “we’re probably not really given guidance on what to do.” “My best guess is to provide resources and information. I won’t call quarantine or any of them unless there’s an outbreak at a particular educational facility.”
In a statement, Abbott spokesperson Andrew Mahalleris said Texas is ready to “develop all the resources needed to ensure Texans’ safety and health,” and said the DSHS has supported local governments with epidemiology, vaccinations and specimen collection, and has revitalized the state’s medical work centers to coordinate responses.
House Speaker Dustin Burrows, a Republican from Lubbock, said in a statement that he was closely monitoring the situation and praying for families who tragically lost their children.
“At this point, there are no unmet local needs, but we are still vigilant and we will respond as needed,” he said.
Rep. Ken King, a Republican representing Gaines County, and state Sen. Kevin Sparks, did not respond to requests for comment on the measles outbreak. Neither they, Abbott or Burrows have publicly posted about the outbreak.
Reluctance to vaccinate
The past few weeks have felt like Deja Vu to Dr. Ron Cook, Lubbock Public Health Authority. Fatal illnesses lie in battle. There are vaccines that can save lives. But if he’s too much in his community, he simply won’t accept it.
“There are people who say that all kinds of social media, anecdotal treatments, or “Let’s have a Measles Party.”
Not only will Cook and his team have to fight against years of misinformation about the measles vaccine, he said, as well as new concerns from people who have developed anti-vaccine views during the pandemic. The number of people requesting vaccine exemptions for their children has almost doubled since 2018 and in 2024 to almost 100,000 families.
Troyge said that when communities fall below the 95% vaccination status, they are vulnerable to measles outbreaks. Gaines County, the epicenter of the outbreak, had one of the state’s lowest vaccination rates at 82% in 2024, but half of Texas counties are below the recommended vaccination rate.
It’s a lot of people who might get measles, Trois said.
“This is due to a completely low vaccination rate. Measles spreads because children are not vaccinated,” she said. “And the kids are not vaccinated because there is so much misinformation there. There’s a lot of distrust of the government.”
The only answer, except to tear the entire community of children who are not vaccinated with measles, is to increase vaccination rates, Troyge said. Lubbock City Public Health Director Katherine Wells said he vaccinated more than 100 people over the weekend. Many said they felt that measles was not a threat to ever get a shot.
Previous outbreaks have seen some areas take more extreme steps to vaccinate by revoking religious exemptions or by uncomplicated $1,000 fines in New York in 2019. The Orthodox Jewish community at the heart of the outbreak challenged the order in court, but was supported by a judge.
“Firemen don’t need to obtain owner informed consent before putting out a home fire,” Judge Lawrence Nypel wrote in his ruling. “Vaccinations are known to put out infection fires.”
However, Troisi and other public health experts do not anticipate similar behavior in Texas. Since the pandemic, Texas elected leaders have shown opposing vaccine orders and opposing support for loosening Texas vaccine exemption rules. There is a bill that has proposed this session and prohibits schools from opting out of vaccines and excluding schools during an outbreak like the one Texas is currently facing.
It remains to be seen whether the current measles outbreak will affect the direction of these bills, but Dr. Peter Hotes, a leading vaccine expert and dean at Baylor School of Medicine’s National Tropical Medicine School, said he is not optimistic that this will be a turning point.
“There was no automatic correction after 40,000 Texans died unnecessary due to rejecting the Covid vaccine,” he said. “It spilled more on vaccinations as a child. So I don’t know exactly what brings us back.”
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