A significant measles outbreak is currently affecting children in west Texas, leading to at least one reported death — the first known fatality from the disease in the United States since 2015. Measles is a highly contagious respiratory infection characterized by symptoms such as high fever, cough, runny nose, rash, and red, watery eyes, as outlined by the Centers for Disease Control and Prevention (CDC). The CDC has indicated that one infected person can spread the disease to up to 90% of unvaccinated individuals in close proximity.
Individuals who have contracted measles gain lifelong immunity; however, in rare instances, the disease can lead to severe complications, including pneumonia and encephalitis, a serious brain inflammation. Certain populations are particularly vulnerable, including pregnant women, immunocompromised individuals, and unvaccinated children — the latter typically receiving their first dose of the vaccine between 12 and 15 months of age.
Thanks to widespread vaccination efforts, measles was declared eliminated from the United States in 2000, signifying that it had not been transmitted domestically for over a year. However, the CDC reports a decline in measles vaccination rates among kindergarten-age children, particularly since the onset of the COVID-19 pandemic. In some regions, vaccination rates have dropped below the 95% threshold necessary to prevent outbreaks.
As of Tuesday, there have been 124 reported cases of measles in Texas, primarily concentrated in west Texas. Health officials suspect the actual number of cases may be higher, given the disease's contagious nature and the likelihood that many infected individuals have not been tested. A neighboring county in New Mexico has documented nine additional cases. This current outbreak represents Texas's worst incidence of measles in three decades, with nearly 80% of those infected being children.
At Covenant Children’s Hospital in Lubbock, Texas, around 20 patients have been hospitalized, with the child who succumbed to measles this week being among them, according to Chief Medical Officer Lara Johnson. The hospitalized patients, ranging from infants to older children, have been experiencing respiratory issues. Johnson noted, “Of the patients who have been hospitalized, they’ve all been unvaccinated.”
Secretary of Health and Human Services Robert F. Kennedy Jr., a well-known vaccine skeptic, mentioned during a recent Cabinet meeting that outbreaks of measles are not unusual in the country, a statement that has drawn criticism from health officials. Phil Huang, Dallas County’s health chief, responded, stating, “That’s exactly the kind of messaging that is detrimental to public health. We just had a kid die.”
A measles outbreak is defined as three or more related cases. Since the Texas outbreak began in late January, there have been more reported cases than the total for the entire United States from 2020 to 2023. In 2022, there were 285 measles cases recorded nationwide. Epidemiologist Katelyn Jetelina highlighted in her newsletter that there have been four outbreaks exceeding 100 cases in the last decade, marking 2025 as a particularly unusual year for measles.
If an individual has received two doses of the measles vaccine, they are 97% protected; one dose offers 93% protection, according to the CDC and various public health officials. When the measles vaccine was approved in the U.S. in 1968, only one dose was recommended. However, in 1989, the CDC began advocating for two doses to ensure better immunity over time. Dr. Johnson remarked that those with two vaccine doses face an “extremely low” risk of complications from measles, emphasizing that the real danger lies with the unvaccinated population, where the virus spreads rapidly.
Children typically receive their first dose of the measles vaccine after their first birthday, with a second dose administered between ages 4 and 6, usually just before entering kindergarten. In endemic areas, children may be eligible to receive a second dose sooner, as noted by vaccine scientist Peter Hotez.
“For instance, a 3-year-old in west Texas, where there’s significant virus transmission, who has already received one dose, might not need to wait until they are 4 to 6 to get the second dose,” Hotez explained.
The necessity of a measles vaccine booster for adults is determined on a case-by-case basis, considering factors like age and geographic location. Residents of west Texas who have received only one dose of the vaccine have “good protection” but may want to consider an additional dose, according to Hotez. Those born before 1957 are generally considered immune, while individuals born in the late 1950s and 1960s should get tested for immunity, as many lack documentation of vaccination.
Individuals born in the 1970s and 1980s, who likely received a single dose during childhood, should contemplate getting a booster if they reside in an area with heightened transmission. For those born after the late 1980s who have received two doses, no further action is needed. To check vaccination status against measles, individuals can undergo a test measuring the level of antibodies in their blood, indicating protection. Alternatively, receiving a booster shot may be a more convenient option.
If exposed to measles and unable to receive the live-virus vaccination, Hotez suggests considering a measles immune globulin, an injection providing antibodies for short-term prevention, which must be administered within six days post-exposure.
