During a recent Cabinet meeting, US Health and Human Services Secretary Robert F. Kennedy Jr. attempted to downplay the severity of what is now identified as the second-worst measles outbreak in the United States since the disease was declared eliminated in 2000. Despite his claims that measles cases have “plateaued,” data from federal agencies contradicts this assertion. The situation has escalated, particularly in Texas, which is at the epicenter of this outbreak.
On Friday, Texas health officials reported a staggering 232 new measles cases over the past three weeks, marking a 42% increase compared to the previous three-week period. New outbreaks have been confirmed in Indiana and Ohio, contributing to a total of at least 735 cases across 24 states in 2023, as reported by CNN. However, many experts believe the actual number of cases could be in the thousands.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, emphasized the lack of full situational awareness regarding the outbreak. “You can’t say something is flattening if you don’t actually know the denominator of cases or have an understanding you’re getting the full capture of the cases,” he stated. This uncertainty raises significant concerns among health professionals.
Experts suggest that the number of measles-related deaths indicates that cases are likely being undercounted. The measles fatality rate typically stands at up to 3 deaths per 1,000 cases, yet three deaths have already been reported in this outbreak—two children in Texas and one adult in New Mexico. This occurs despite the official case count being reported as fewer than 650 across Texas, New Mexico, Oklahoma, and Kansas.
Dr. Nina Masters, a senior research scientist at Truveta, highlighted that underreporting complicates efforts to predict the outbreak's trajectory and duration. Accurate data is essential for public health officials to allocate resources effectively and understand the factors influencing case numbers.
The current measles outbreak has predominantly affected individuals who are unvaccinated or whose vaccination status is unknown. Dr. Masters noted that targeted outreach efforts could significantly enhance vaccination rates in communities with low immunization levels. The measles-mumps-rubella (MMR) vaccine has proven to provide rapid and effective protection against measles, particularly when administered swiftly in outbreak areas.
In a previous outbreak in a Chicago migrant shelter, mass vaccination efforts dramatically curtailed the number of cases. Dr. Masters recalled that her models predicted 250 cases without immediate vaccination efforts, but thanks to the rapid administration of vaccines, only 57 cases were reported.
Reflecting on the modeling efforts from 2019, Dr. Mark S. Roberts, a distinguished professor at the University of Pittsburgh, noted that predictions about potential measles cases in Texas closely mirrored the current situation. However, some counties have reported even higher case counts than anticipated. For instance, Gaines County, Texas, has seen 355 cases as of April 11, with numbers expected to rise.
This surge in cases has sparked frustration among public health experts, especially given that measles was effectively eradicated in the U.S. just over a decade ago. “It’s freaking 2025, and a child has died of measles,” Dr. Roberts lamented, expressing his disappointment regarding the preventable nature of these cases.
Dr. Masters pointed out that underreporting may stem from several factors, including reluctance to seek medical care or testing. In particular, the Mennonite community in Texas, central to the outbreak, has shown a strong preference for self-reliance and home remedies over conventional medical treatment.
Furthermore, massive federal funding cuts for public health have exacerbated the situation. The CDC's withdrawal of over $11 billion in grants that were previously allocated during the Covid-19 pandemic has left state and local health departments struggling to respond to ongoing public health threats, including measles.
As measles is known to spread predictably, Dr. Masters warned that the current situation is concerning. Vaccination rates have significantly decreased since 2020, with only 68.5% of children in the U.S. receiving their first dose of the MMR vaccine by 15 months of age in 2024. This figure is alarmingly below the federal goal of 95% vaccination coverage needed to prevent outbreaks.
In counties like Gaines, nearly 1 in 5 incoming kindergartners have not received their MMR vaccine, while other affected areas show similarly low vaccination rates. For example, the Sublette Unified School District in Kansas reports a vaccination rate of just 44% among kindergartners.
While Secretary Kennedy has advocated for the MMR vaccine, he has also asserted that vaccination should be a personal choice. This stance has contributed to hesitancy in communities experiencing high case numbers. Experts stress the importance of a clear and unified message regarding the necessity of vaccination—not just for individual health but also for community protection.
“Not vaccinating your child doesn’t only put your child at risk, it puts other children at risk,” Dr. Roberts emphasized, highlighting the urgent need for public health initiatives to combat misconceptions surrounding vaccinations.
