From eradicated to epidemic: Why measles has made a comeback in US

Texas has reported over 500 confirmed measles cases, with most patients unvaccinated. Health officials are pushing emergency vaccinations to curb the escalating outbreak

The Texas Department of State Health Services (DSHS), has raised alarm over the worst measles outbreak in the US in decades. As of April 8, DSHS had confirmed 505 cases, although media reports suggest the number may is close to 600 now. The outbreak has resulted in three deaths including two school-going children and one adult, all of whom were unvaccinated.

 

Health officials attribute the rapid spread of the disease to declining vaccination rates in certain communities, thereby reigniting discussions about the critical role of vaccines and booster doses. According to the United States Centers for Disease Control and Prevention (CDC), measles was declared ‘eliminated’ in the US in 2000.

 

 

The resurgence, which began in late January, has spread to multiple counties, with significant clusters reported in Houston, Dallas, San Antonio, and several rural areas with low immunisation coverage. Gaines County, identified as the epicentre, has a vaccine exemption rate of nearly 18 per cent among children — substantially higher than the national average of 3 per cent. This decline in vaccination coverage has left communities vulnerable to preventable diseases such as measles.

Unvaccinated children account for majority of Texas measles cases: DSHS

According to DSHS, children under the age of 17 account for 351 of the reported cases. However, adults have not been spared, with over 130 cases reported among them. Data up to April 4 show that only seven of those infected had received at least two doses of the measles vaccine, while three had received just one dose. A staggering 495 individuals were either unvaccinated or had no documented immunisation history.

 

The CDC reiterates that the measles-mumps-rubella (MMR) vaccine remains the most effective defence against the disease, offering approximately 97 per cent protection with two doses. 

Despite this, vaccine hesitancy persists in parts of the country, driven by misinformation and scepticism about vaccine safety.

 

US health secretary reverses his stance on vaccination

United States Health Secretary Robert F Kennedy Jr, previously known for his anti-vaccine stance, has acknowledged the effectiveness of the MMR vaccine amid the ongoing crisis. Calling it the “most effective way to prevent the spread of measles”, Kennedy has also made claims about meeting with two physicians who have ‘treated and healed’ about 300 children infected with measles in the Mennonite community with aerosolised budesonide, which is a steroid used to reduce inflammation in the lungs, and clarithromycin, an antibiotic used to treat bacterial infections.

 

In Seminole, Texas, with Jake and Tina Fehr whose 2-year-old daughter, Helena was just discharged after three weeks in the ICU, Peter and Eva Fehr whose daughter, Kayley, 6, passed in February, and Pete and Eva Hildebrand whose daughter, Daisy, 8, we buried this afternoon. I also… pic.twitter.com/BjErlRkCJX

— Secretary Kennedy (@SecKennedy) April 7, 2025

In response to the outbreak, DSHS has launched an emergency immunisation campaign. Mobile vaccine clinics have been deployed to affected communities and schools, and free MMR shots are now being offered at various public health centres across Texas.

 

DSHS, in collaboration with the CDC, has also dispatched immunisation teams to the most impacted regions. Authorities are urging that infants aged 6 to 11 months in affected regions immediately receive an early dose of the MMR vaccine. Children aged one year and above with no documented vaccination history to receive two doses at 28 days apart. Even adults, without proof of vaccination history, should also receive two doses 28 days apart.

 

According to World Health Organization (WHO), it is important to maintain high vaccination coverage to prevent disease resurgence. The CDC advises that individuals without evidence of immunity receive the MMR vaccine, especially those residing in outbreak areas or planning international travel.

India’s measles burden and immunisation efforts

India reported 65,150 measles cases in 2023, making it the second-most affected country globally during that year, according to WHO and CDC data. To address the risk, the government continues to combat the disease through the Universal Immunisation Programme (UIP), launched in 1985, which offers free vaccines, including Measles-Rubella (MR) vaccine, to all children up to two years of age and to pregnant women. In 2014, the Ministry of Health and Family Welfare (MoHFW) also launched ‘Mission Indradhanush’ to enhance vaccination coverage and achieve 90 per cent ‘full immunisation’ nationwide, targeting children in high-risk areas who missed essential vaccines.

 

According to the National Family Health Survey (NFHS-5, 2019–21), full immunisation coverage stood at 76.1 per cent in the country. The Health Management Information System (HMIS) data for 2021–22 reported a higher rate of 89 per cent. WHO and the United Nations International Children’s Emergency Fund (Unicef) estimate that the number of zero-dose children in India dropped from 2.7 million in 2021 to 1.1 million in 2022.

What is measles?

Measles is a highly contagious viral disease that can lead to severe complications, especially among unvaccinated individuals.

 

Measles symptoms typically begin 7–14 days after exposure and include high fever, cough and runny nose, red, watery eyes, rash that spreads from the face to the rest of the body. The disease can cause serious complications, including pneumonia, brain inflammation, and even death, particularly in children and immunocompromised individuals.  For more health updates and wellness insights, follow #HealthWithBS