Healthbeat

Exclusive data: More than 74,000 older adults seek measles immunity tests amid U.S. outbreaks

2026-07-29T20:40:13+00:00

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Measles was surging in West Texas as Nancy Churnin eagerly awaited the birth of two grandchildren. She was sure she had been vaccinated decades ago, but she wanted to confirm she was still protected.

She didn’t want to risk spreading the highly contagious disease to vulnerable newborns, so she got a simple blood test last year.

“I wanted to double-check my immunity,” said Churnin, a children’s book author who lives in Plano, Texas, near Dallas.

Churnin is among more than 74,000 U.S. adults over age 50 who have received blood tests checking their measles antibody status from January 2025 through March of this year, according to an exclusive analysis of medical records data conducted in response to questions from Healthbeat.

The rates of older adults seeking measles immunity tests spiked across the country during last year’s West Texas measles outbreak and again earlier this year as South Carolina’s measles outbreak became the nation’s largest in decades, according to the analysis by a research team at Truveta, a healthcare data and analytics company that receives patient care data from major health systems that serve about one in three U.S. residents.

Truveta’s research team said its analysis suggests that public awareness of high-profile local measles outbreaks might be influencing more people across the country to seek the immunity tests, which are called titer tests.

Nina Masters, the principal applied research scientist at Truveta who led the analysis, said she was struck by the spikes in titer testing during outbreaks because historically, the standard recommendation has been to just vaccinate people who don’t have proof of immunity.

“To me, that suggests outbreaks are influencing healthcare-seeking behavior and reflects growing concern among Americans who want to understand their immunity status and protect themselves and their loved ones amid rising measles activity,” said Masters, a former Centers for Disease Control and Prevention epidemiologist who has deployed to multiple measles outbreaks.

As the U.S. this month broke last year’s record number of measles cases, people who are infected are increasingly exposing others to the virus in a wide range of public settings from schools and churches to restaurants, stores, and airports. The virus spreads through the air and can linger in a room for two hours after the infectious person has left, putting anybody who goes through the area at risk if they lack immunity.

The result is large numbers of people need to quarantine at home for up to 21 days if they are not vaccinated against measles or cannot provide proof of their immunity through previous vaccination or illness.

“We think it’s important for people to know their immunity status,” said Dr. Emma Doran of the North Carolina Department of Health and Human Services, which recommends titer tests as one of the ways people can check their immunity before they are exposed.

Titer tests can be particularly helpful for older adults who were vaccinated against measles long before electronic medical records and state immunization registries and no longer have their paper vaccination records. The measles vaccine provides lifelong immunity for most people. Two doses of the combination measles-mumps-ruebella shot is 97% effective against measles, and one dose is 93% effective.

“There is a good chunk of the population there that, unfortunately, if somebody didn’t hold on to that paper, they don’t have it,” said Doran, who is the medical director of the department’s Vaccine Preventable and Respiratory Diseases Medical Consultation Unit.

Immunity tests spiked in U.S. during Texas, South Carolina outbreaks

The new data on titer testing provides a window into one of the many ways the return of measles in the United States is impacting people’s lives. The disease was declared eliminated from the country in 2000. In November, an international public health body will review whether the disease has once again become endemic to the United States.

During 2025 — as a major measles outbreak was underway in West Texas — more than 62,000 older adults across the country went to doctors’ offices to get measles titer tests, the Truveta analysis found.

The surge in testing was dramatic, and not just in Texas.

Nationwide, adults 50 and older received measles immunity testing last year at nearly seven times the rate they had in recent years. From 2021 through 2024, a typical month saw about 50 people get tested for measles immunity for every 100,000 adults who had an outpatient doctors’ visit. But in 2025, that figure reached nearly 341 tests per 100,000 adults.

The rate of titer testing within the state of Texas was particularly high, peaking at 627 tests per 100,000. But even when data from Texas was excluded, the data for the rest of the United States still showed a spike in testing at nearly 309 tests per 100,000.

A similar pattern played out during the first three months of this year, when more than 12,000 U.S. adults over 50 received titer tests as the South Carolina measles outbreak became the nation’s largest in 35 years. The analysis showed an even larger spike in testing rates in 2019, when measles outbreaks also fueled an earlier record number of cases.

The analysis involved an examination of electronic health record data from nearly 30 million patients over 50 who had outpatient visits from January 2018 through March. The data is provided to Truveta by the company’s health system members. The researchers looked at data for older adults to try to focus on those seeking the tests long after childhood vaccination or illness, as well as to reduce the inclusion of routine prenatal testing.

Truveta conducted the analysis after Healthbeat asked the company whether its data could provide any information about whether more people were seeking titer tests amid the recent measles outbreaks.

While the data does not say why the individuals received measles titer tests, Masters and her research team said the spikes in titer testing during outbreaks likely reflect a combination of patient concern, vigilance by healthcare providers, exposure-related evaluations, and adult uncertainty about immunization status. Media coverage might also play a role.

There could be many reasons why an adult might want to check their immunity amid increased spread of measles, the researchers said. They include grandparents seeking to confirm they are protected before visiting infant grandchildren, as well as adults who are worried about the risk of living in or traveling to an outbreak area.

Before her grandson, Ezra, was born last year, Nancy Churnin of Plano, Texas, had her blood tested to make sure she was immune to measles. She didn't want to put him at any risk. Churnin was surprised to discover she wasn't immune, prompting her to get an additional dose of MMR vaccine.

Protecting her newborn grandbabies was Nancy Churnin’s motivation in getting a measles titer test last year before they were born. The babies’ parents were also seeking to safeguard their infants against infectious diseases.

“Anybody who wanted to see the baby was on notice: Get all your shots or we can’t let you around the baby unless you’re fully, fully vaccinated,” recalled Churnin.

When Churnin’s titer test result came back, she was surprised to learn she was not immune to measles. She was certain she had been vaccinated as a child, but she was born in 1957 and she has no access to her records, and her parents aren’t around to ask. After the test, she got vaccinated.

“I was very, very glad I got the test. I’m very, very glad I got immunized,” Churnin said. “I don’t want to do anything to endanger those babies, anybody’s babies.”

Should you get a titer test? Cost, doctors’ views shape decisions.

Most older adults are likely to be protected against measles either because they were vaccinated as children or had the disease before vaccines became available.

Adults born before 1957 are officially presumed to be immune to measles because they were likely infected when they were children, according to the Centers for Disease Control and Prevention. Vaccines against measles have been available in the United States since the early 1960s, with an improved version of the vaccine distributed since 1968.

Should those who can’t find their vaccination records ask their doctors for titer tests?

The CDC recommends that adults born during or after 1957 who can’t find their immunization records get the MMR vaccine. But the CDC guidance also says they can get a measles titer test to determine if they need the vaccine. “There is no harm in getting another dose of MMR vaccine if an individual may already be immune,” the CDC says.

There are several factors to consider in whether to do a titer test or just get another MMR shot, experts said.

Dr. Margot Savoy, chief medical officer of the American Academy of Family Physicians, told Healthbeat that it’s not common for patients to ask for a titer test unless they work in a healthcare field where the test is required.

“The question that they normally ask is: How do I know if I’m protected?” she said.

“For most family physicians, and most physicians in general, their answer would be, I don’t know that I would draw titers on most people. If we’re at all worried that you might not be protected, we would just give you another MMR” vaccine, she said.

Savoy said the time and cost of getting a titer test is not worth it for the average patient, because the test may show the person needs to get vaccinated anyway.

Unlike the MMR vaccine, which is routinely covered by insurance plans without patient cost-sharing, there are no requirements for insurance coverage of titer tests, although insurers can choose to cover them. In addition to getting the tests through a doctor’s office, many direct-to-consumer labs and walk-in clinics also will do the tests without a prescription, but the costs can range from $40 to $150 or more.

Individual patients may weigh the costs and benefits differently when deciding between just getting an MMR shot or getting tested, said Doran.

“I think there’s no one-size-fits-all approach for whether to do an MMR vaccine if you don’t have the records or whether to get a titer first,” she said.

Editor’s note: This story has been updated to reflect that, as of late July, there have been more measles cases in 2026 than in all of 2025.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Inside the largest U.S. measles outbreak in decades: Records reveal spread in vaccine-hesitant community

2026-05-19T09:00:00+00:00

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Case #1 in what would become the largest U.S. measles outbreak in decades was a parent in South Carolina’s Upstate Region near Spartanburg.

The next seven people to fall ill were all children. Three of them were being cared for at home – limiting their ability to spread the highly contagious measles virus to others.

But the children who became Cases 5, 6, 7, and 8 were infectious while they mingled with other children at school and in daycare, according to internal records obtained by Healthbeat from the South Carolina Department of Public Health.

By the second week of the outbreak, the number of known infections had grown to 12. The internal records, obtained under the state’s public records law, reveal all of them lived in just four households.

At the center of the nearly seven-month South Carolina measles outbreak – from beginning to end – was a close-knit, vaccine-hesitant Ukrainian- and Russian-speaking community in and around Spartanburg County, according to South Carolina state health officials.

By the time the outbreak was declared over on April 27, the handful of cases that were first identified among a couple of families in October 2025 had resulted in 997 documented measles infections.

How the South Carolina measles outbreak began

A breakdown of the first eight cases:

South Carolina DPH estimates about 90% of these outbreak cases were among members of the area’s Ukrainian- and Russian-speaking community, which has around 15,000 people in Spartanburg County, the department said in emailed responses to Healthbeat’s questions.

“This community was at the center of the outbreak for its whole course,” said the department, which did not grant an interview.

The South Carolina outbreak is the latest example of a trend the Centers for Disease Control and Prevention has documented for decades: Nearly all large U.S. measles outbreaks since 2000 – when the country attained measles-free status – have involved various types of close-knit groups with low vaccination rates.

As measles makes a major comeback across the country, a Healthbeat examination of the challenges encountered controlling the South Carolina outbreak highlights the need for public health officials to understand the specific and sometimes differing reasons for vaccine hesitancy within individual groups.

It also illustrates the importance of identifying at-risk pockets of unvaccinated people and building trusted relationships before outbreaks happen. All are complex tasks made more difficult amid heightened public distrust in the wake of the Covid-19 pandemic and during a time of cuts to public health staffing and funding.

“Waiting for infectious disease to start spreading is too late. It is significantly more effective to prevent an outbreak than to contain it,” said Dr. Eliza Varadi, a Russian-speaking pediatrician in Charleston, S.C.

“Even in a state where most people are vaccinated, those small pockets, that’s where diseases will spread,” said Varadi, the immunization representative for the South Carolina chapter of the American Academy of Pediatrics, who worked with DPH officials during the outbreak and provided advice on culturally sensitive outreach and education.

Close-knit groups have fueled U.S. measles outbreaks since 2000

South Carolina’s outbreak is a case study in how years of declining immunization rates – especially among children obtaining religious and non-medical exemptions from school vaccination requirements – is making localized communities of various types across the country vulnerable to the spread of infectious diseases, according to Varadi and other health experts.

Dr. Satish Pillai, the CDC’s incident manager for the 2025-26 national measles response, noted the role of close-knit groups in “nearly all” measles outbreaks with more than 50 cases since 2000 during a presentation to local public health officials earlier this month.

Outbreak was concentrated in a close-knit community

From October 2025 through March 2026, the outbreak caused 997 known measles infections in and near Spartanburg County. State health officials estimate about 90% were members of the area’s Ukrainian- and Russian-speaking community.

These outbreaks include those that have occurred in New York during 2018-19 largely in an Orthodox Jewish community; in Washington state in 2019 among a Ukrainian- and Russian-speaking community; in central Ohio in 2022 primarily among children of Somali descent; in Chicago during 2024 within a shelter for migrants who were mostly from Venezuela; in Minnesota in 2024 where a Somali community was disproportionately impacted; and in West Texas in 2025 among a rural Mennonite community.

In recent months, Pillai noted, the types of close-knit groups driving measles outbreaks has been evolving. Large outbreaks this year have occurred on the campus of Ave Maria University in Florida and at a federal detention facility in Texas.

“Having large college outbreaks and large detention facility outbreaks at these levels are unprecedented since 2000,” Pillai said.

Meanwhile, lower vaccination rates throughout communities have begun allowing outbreaks that begin in close-knit communities to start spreading widely across populations, as has happened in the ongoing outbreak in Utah, he said.

Schools, families, churches contributed to virus spread in S.C.

South Carolina DPH officials told Healthbeat they do not know the infection source that led to the initial cases in the state’s measles outbreak. They said this indicates unrecognized spread of the virus was already occurring by the time cases started being reported to public health.

Measles poses a significant outbreak threat for unvaccinated, socially, and geographically connected people because it is so contagious and spreads through the air, where it can linger for up to two hours in enclosed spaces.

Families drive early infections

By Oct. 15, state investigators had identified 12 outbreak cases. All were members of just four households.

To prevent ongoing transmission of measles within communities, 95% of people need to be fully vaccinated against the disease, according to the CDC.

Some of the earliest cases in the South Carolina outbreak last October involved Global Academy of South Carolina. The Spartanburg County public charter school was founded by educators from Ukraine whose “passion to help families of immigrants” have prompted them to open tuition-free schools in California, Florida, and most recently South Carolina, according to the schools’ websites.

When the outbreak started, Global Academy’s student body had one of South Carolina’s lowest levels of vaccination coverage: Only 21% of its students were up-to-date on their school vaccinations during the 2025-26 school year, state data show. Even fewer of the school’s students – just 17% – were fully vaccinated during the previous school year.

Only 21% of the students at Global Academy in Spartanburg County were up-to-date on their school vaccinations during the 2025-26 school year, state data show.

Officials with Global Academy of South Carolina, its board of directors, and founders have either declined to be interviewed, did not respond to interview requests, or could not be reached during and after the outbreak.

As the measles cases continued to spread within households, some of those infected were unvaccinated children and teens who unknowingly brought measles into other schools – exposing scores more students who also weren’t vaccinated.

“We know that some schools with a high percentage of children from Ukrainian- or Russian-speaking families have been impacted and a number of public exposures have been reported in churches attended by these community members,” DPH said in response to Healthbeat’s questions.

In low-vaccination communities, one person can expose dozens

Because the initial symptoms of measles – such as a cough, runny nose, red eyes, and fever – can appear like those of a common cold or the flu, people can spread the disease before they know they have it. They are contagious beginning four days before the tell-tale measles rash appears on their face and body.

Further complicating public health efforts to control the virus’ spread is that there can be a significant lag time from when someone is exposed to the virus and when they start feeling ill. Symptoms often develop seven to 14 days after exposure, but it can sometimes take up to 21 days.

Internal South Carolina state health department records obtained by Healthbeat provide a window into how a single contagious person can expose dozens.

How measles can spread

How Case #44 in South Carolina’s outbreak exposed 66* close contacts to the virus who were unvaccinated or lacked immunity through previous infection.

*One individual was both a household member and Lyman Elementary School student.

Outbreak Case #44, identified by state health officials in mid November, exposed 66 close contacts to measles who were unvaccinated or lacked immunity to the virus through previous infection. They included three household members, four patients at a doctor’s office, 58 individuals at Lyman Elementary School (including one of the household members), and two school bus riders from D.R. Hill Middle School, according to an email update from DPH to the South Carolina governor’s office on Nov. 17.

As state public health officials investigated outbreak Case #45, they identified an initial 61 close contacts who had been exposed and weren’t protected against measles. They included four household members and 57 individuals from Boiling Springs Middle School. The person, while infectious, also attended a church with about 250 people in its congregation, according to DPH emails to the governor’s office on Nov. 19 and 20 that do not name the church, but say notification letters in multiple languages were provided for distribution.

As the outbreak continued, infected people participated in services and other activities at several Slavic churches, where services are held in the Russian or Ukrainian languages, including Slavic evangelical and Pentecostal churches.

At one of these churches, the Way of Truth Church in Inman, S.C., a person who was infectious attended on the evening of Nov. 7 and morning of Nov. 9, exposing others who weren’t vaccinated. Over the weeks that followed, at least 30 infections were linked to the church.

Of the 14 newly identified measles cases announced on Dec. 2 by state health officials, eight were people exposed at Way of Truth Church. Over the next week, 16 more people fell ill with measles from exposures at the church. Five more cases linked to the church were announced on Dec. 16, plus one more on Dec. 19.

During late December and into January, state health investigators tracing the movements of people recently diagnosed with measles identified additional exposures that had occurred at several other Slavic churches, including Tabernacle of Salvation Church, Ark of Salvation Church, and Slavic Pentecostal Church of Spartanburg. Church leaders could not be reached or did not respond to Healthbeat’s interview requests during and after the outbreak.

Slavic churches unwilling to host vaccination events during outbreak

Varadi, the state American Academy of Pediatrics representative who worked with South Carolina DPH during the outbreak, told Healthbeat that vaccine hesitancy within the membership of some Spartanburg-area churches was a key challenge in stopping the outbreak.

“The center of the outbreak was not the entire Russian-speaking or Ukrainian-speaking community. It was a small subset that may have been related to specific churches,” Varadi told Healthbeat.

“It’s not that the church leadership was discouraging vaccinations, they just were not encouraging,” Varadi said. “We wish that there would have been a better partnership to work together to encourage vaccination.”

DPH officials, who told Healthbeat that Varadi provided them with “valuable insights and assistance,” acknowledged that no church from within the area’s Ukrainian- or Russian-speaking community agreed to host a vaccination event during the outbreak.

“As is often the case, church leaders made decisions about whether to interact with DPH based largely on the wishes and feelings of their congregations,” the department said in its written responses to Healthbeat’s questions. “While some were willing to discuss outreach and education opportunities, others were not. Importantly, none were forced to meet with DPH to discuss any of these topics.”

Tabernacle of Salvation Church in Spartanburg, South Carolina, was among several Slavic churches that had measles exposure incidents during the outbreak.

One of the close-knit community’s “prominent churches” did voluntarily agree to meet with DPH leadership during the outbreak, the department said, “and that conversation was informative.” DPH declined to name the church.

From the beginning of the outbreak, DPH officials in press briefings emphasized the importance of vaccination in stopping the outbreak. They separately made information about measles available in the Ukrainian and Russian languages on the DPH website and to churches and other groups.

Two doses of the measles-mumps-rubella (MMR) vaccine are 97% effective in protecting against measles, and even one dose is 93% effective, according to the CDC.

While the Ukrainian- and Russian-speaking community remained a vaccination challenge, by January – as the outbreak spiked – the department started seeing wider increases in measles vaccination across Spartanburg County and the state. This increase, combined with the large number of people who became immune to measles through illness, helped end the outbreak, they said.

Dr. Brannon Traxler, the South Carolina DPH’s deputy director and chief medical officer, in response to Healthbeat’s questions during the department’s last media briefing on the outbreak on April 27, said it is important to understand the community’s history and reasons for being hesitant about vaccines.

“We recognize and appreciate there is history there that didn’t occur in South Carolina, often even before they came to the United States, that has led to very legitimate fears of government and of government health,” said Traxler, who last week was named the department’s acting director. “They have a reason to have the doubts that they do.”

How the South Carolina measles outbreak grew from 5 to 997 cases

Traxler did not elaborate. DPH, in response to Healthbeat’s questions, declined to discuss the reasons public health workers have been given by community members for not vaccinating their families against measles.

“Those reasons are theirs to communicate, not ours,” DPH said by email. “Our role in every communication was to provide the best factual information possible with which families could make informed decisions.”

Vaccination programs and government trust have a complicated history in Ukraine and Russia.

The more distant history includes the former Soviet Union’s mandatory and coercive national immunization programs and ongoing vaccine hesitancy and concerns about vaccine safety.

There also was a history in former Soviet republics of some measles vaccines having lower levels of effectiveness in preventing outbreaks that has been attributed to poor manufacturing quality control and improper vaccine storage and handling practices.

While the Russian Federation is estimated by the World Health Organization and UNICEF to have had high levels of measles vaccination coverage for many years, that has not been the case in Ukraine.

In Ukraine, the country’s vaccination coverage dropped dramatically after the high-profile death in 2008 of a Ukrainian teenager, an event later determined to be unrelated to being vaccinated against measles as part of a large immunization campaign.

According to the WHO, 95% of children in Ukraine in 2008 were fully vaccinated against measles. But by 2016, just 42% were protected with one dose of measles vaccine and 31% with two doses. And during 2017-19, the country experienced a measles epidemic that resulted in more than 115,000 reported cases.

Since then vaccination coverage has increased. As of 2024, about 91% of 1-year-old Ukrainian children and about 83% of 6-year-olds were vaccinated against measles, according to information released by UNICEF Ukraine last year.

In South Carolina, DPH officials said members of the Ukrainian- and Russian-speaking community cooperated with the department’s recommendations for isolating and quarantining at home to prevent spreading measles to others.

Quarantines, which could last up to 21 days, had a significant impact on these families’ daily lives, education, and finances, with children having to stay out of school and adults missing work.

DPH said its community health workers, when asked, helped these families identify social service resources, including for food and utility support

Community members are key to building trust in public health

Public health officials at the Washington State Department of Health found themselves facing similar challenges in 2019, following a measles outbreak among a Ukrainian- and Russian-speaking community.

“We didn’t have a lot of connection with that community or a lot of resources for them in their language,” said Danielle Koenig, the department’s health promotion supervisor.

In the wake of the outbreak, Koenig helped secure a CDC grant that for six years funded a project to better understand the needs of the community, build trust, and provide health resources. The grant ended last summer.

The South Carolina Department of Public Health had disappointing turnouts for its mobile vaccination clinics during the outbreak. Churches serving the Ukrainian- and Russian-speaking community at the center of the outbreak declined to host vaccination events, the department said.

The department found that a cornerstone of building trust is partnering with leaders and organizations from the impacted community, listening and responding to their needs – and also hiring members of the community – like Vadim Gaynaliy – to help lead the outreach.

Gaynaliy, a health educator at the department who speaks Ukrainian and Russian and is from a large Ukrainian community in northeast Portland, said his background and those of others involved in the project provided insights into the community’s values and how it functions.

“We’re not even talking about a single community here. There’s obvious political tensions between Russian and Ukrainian communities, there’s different religions and denominations. So we try to address them as different communities who will have different needs,” Gaynaliy told Healthbeat.

The project resulted in the creation of the Nashi Immigrants Health Board – now an independent nonprofit organization run by and for the Ukrainian- and Russian-speaking community that provides a range of resources and support programs beyond just information about vaccination.

“Trust is the biggest ingredient,” said Tamara Cyhan Cunitz, the board’s co-founder, executive director, and a registered nurse and educator whose relatives came to the United States after escaping the Soviet Union during World War II. “People who are from a cultural community will pay attention and connect better with someone who knows their culture and language.”

S.C. gets 5 months of funding to launch outreach project

The huge measles outbreak in the Spartanburg area is finally over, but the area remains at risk of future outbreaks because it continues to have large pockets of people who are not vaccinated against the disease – including in the Ukrainian- and Russian-speaking community.

To help address this, DPH told Healthbeat it is beginning a new partnership with two nonprofit public health organizations to hire community health workers to do education and outreach in two or three areas within Spartanburg County that face higher risks from measles and other vaccine-preventable diseases.

The CDC Foundation, a nonprofit organization that supports the CDC and public health, has agreed to provide five months of funding for the project, the groups said.

“The idea is to reach the specific Slavic community, that from a health department perspective, they have had struggles with reaching over the years and to really make inroads around vaccines and vaccine education,” said Scott Thorpe, executive director of the Southern Alliance for Public Health Leadership, which is one of the project’s partners. “Doing this work outside of a crisis is really, really important.”

Terri Jowers, executive director of the South Carolina Community Health Workers Association, the project’s other nonprofit partner, said the project plans to hire three community health workers, with two of them coming from within the Russian- and Ukrainian-speaking community.

Jowers said the project will develop training for this soon-to-be hired team on how to better engage with communities through conversations about why they are hesitant or concerned about vaccines, what they have heard, and ways to work together to find sources they trust to figure out the facts. The training will also be made available to other community health workers in Spartanburg County and across the state, she said.

“The goal is to really start training people by the end of June so that community health workers feel more comfortable having these conversations,” she said.

Five months is not a lot of time to build trust and Jowers said she is hoping that the project will be able to identify additional funding for a year beyond the initial grant. “You have to build those trusted relationships,” she said.

The CDC Foundation, which told Healthbeat it is providing more than $100,000 for the project, said that trusted messengers are critical. The foundation said the project’s limited timeframe is based on funding availability. “If additional funding becomes available, we would consider extending the timing,” it said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Measles concern at Newark airport. NYC fire safety. What to know about medspa peptides.

2026-05-01T16:13:38+00:00

This article originally appeared at Your Local Epidemiologist New York. Sign up for the YLE NY newsletter here. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

Despite my allergy-induced congestion and mildly itchy eyes (yes, pollen is still quite high), I’ve been LOVING the weather this week. I hope you’ve all had a chance to get outside and enjoy it (and remember to do your tick checks 😉).

For public health news this week, I’m covering a measles exposure at Newark Airport and a local pediatric emergency room, the importance of closing doors for fire safety, and peptides being sold at New York City medspas. With the seasonal change, I’m taking a break from reporting on respiratory viruses, but I’ll be back if anything important comes up. Okay, let’s get to it.

Measles exposure at Newark Airport

New Jersey has reported a possible measles exposure at Newark Airport last week. Anyone who visited these locations during these dates and times may have been exposed:

Newark Liberty International Airport, Terminal B. April 14, 5:30 a.m.-9 a.m. Monitor for symptoms until May 11.
Pediatric Emergency Department, Hackensack University Medical Center, 30 Prospect Ave., Hackensack, New Jersey. 11:15 p.m. April 17 through 3:15 a.m. April 18. Monitor for symptoms until May 11.

Potentially exposed people should contact their health care practitioner if they develop measles symptoms, which usually start like a cold and progress to a rash.

So far, no cases have been identified following these two exposure events. If you do develop symptoms, it’s important to call your doctor or clinic before you visit in person so special precautions can be taken to prevent further spread.

What this means for you:

The best thing to do is to make sure you and your children are vaccinated.
- Kids under 6 months old. Not yet eligible for the measles, mumps, rubella vaccine. If mom was vaccinated, then babies under 6 months should have some protection from immunity passed from mother to baby. This immunity wanes within the first 6 months.
- Kids 6 months to 1 year. Early vaccination can be considered, especially if there’s upcoming travel planned. However, since this is an isolated case in New Jersey and not an outbreak (which is defined as three or more cases), health officials aren’t specifically recommending early vaccination.
- Kids 1 year and older. Follow the standard MMR vaccine schedule, typically administered at 1 year and again between ages 4 and 6.
- Adults. If you have not been vaccinated or are unsure of your vaccination status, it’s a good idea to discuss getting a shot with your doctor.

I’ve seen a lot of people asking about titer tests to confirm immunity. While titers measure antibodies in the blood, they do not account for T cell and B cell immunity, which also offer protection. The main reason to get titers would be as a matter of insurance coverage for a booster, as some plans won’t cover the cost unless titers to one of the MMR viruses come back negative. We can’t give medical advice, but if you’re concerned about whether you are still immune, ask your doctor about getting your titers checked or getting a booster.

To dive deeper, YLE National has a great measles FAQ post.

Building fire codes and violations can mean life or death — here’s how to check yours

Tragically, two people died in a five-alarm fire in the Bronx last week. This week, FDNY investigators said that the outcome could have been different if doors weren’t left open during the fire, allowing it to spread and the stairwell to fill up with smoke, where the two victims were found.

This is not the first time New York City has seen this scenario play out. The January 2022 Twin Parks fire in the Bronx — the deadliest New York City fire in decades, which killed 17 people — was also linked to doors that failed to close, allowing smoke to fill the stairwell of a 19-story building.

I probably learned these lessons when I was in elementary school during fire drills, but nothing sticks like seeing the tragic outcomes play out in real time. The lesson is stark, yet simple: A closed door is a fire barrier. It buys time and saves lives.

What to do:

Heaven forbid there’s a fire in your building, close every door behind you when evacuating — don’t prop building entrances or stairwell doors. And remember: If your apartment door feels hot, do not open it — seal gaps with towels, go to a window fire escape, and signal for help if you need it.
This week, walk your building’s fire escape route so you know it before you need it.
If self-closing doors in your building are broken, report it to your super or call 311. (You can also look up previous building violations and complaints here.) Self-closing doors on stairwells are a legal requirement. Doing this prompted me to talk to our super about a stairwell door that wasn’t fully closing.
Now is also a great time to check your smoke detectors and make sure the batteries still have juice.
This is the kind of risk where preparation genuinely changes outcomes.

NYC medspas are offering clients experimental peptides that have not been FDA-approved

Peptides are getting a ton of attention.

I’ve seen them all over my social media, often promoted by wellness influencers for faster recovery, better skin, and reduced inflammation. But it’s no longer just online. They’re showing up in New York City medspas now, too.

A recent Gothamist report found that Apollo House, a medspa near Union Square, offers a “peptide stack membership” that includes injections of BPC-157, TB-500, and GHK-Cu. These are marketed for healing, recovery, and anti-aging. But they have never been Food and Drug Administration-approved for these uses, and the human evidence for their injection is limited. Several other medspas offer similar packages.

I’m not going to do a full peptide deep dive here, as YLE National just covered that last week. If you want to understand what peptides are and where they stand with FDA, I recommend starting there.

For New Yorkers, there are a couple of issues at play.

New York has already raised concerns about medspas. A recent investigation found unlicensed medical procedures, sanitation violations, expired or unlabeled products, and other safety issues in medspas across the city. (I covered that here.)

When you add on this peptide layer, it gets even murkier. Gothamist reported that the New York state department that oversees compounding pharmacies (special pharmacies that custom-make drugs for patients and often market peptides) has not issued guidance on peptides or where the FDA stands on them.

This is concerning when these peptides are being used in medspas in ways that aren’t FDA-approved. This means that New Yorkers are being left to sort through the noise on their own, trying to sort fact from fiction about the safety of peptides.

We’re also hearing of people self-sourcing and injecting peptides from overseas wholesalers or online vendors, marketing them for “research purposes, not for human consumption.” This can be even more concerning because it may happen without clinical oversight or a reliable way to determine what is actually in the purchased vial.

I want to be clear that I don’t mean to fearmonger. Not all peptides are dangerous. Insulin and GLP-1 medications like semaglutide (Ozempic) are peptides with clinical trial data and FDA approvals for specific use cases. The concern is the growing gray market for unapproved injectable peptides, which leaves purity, dosing, clinical oversight, and potential long-term effects to chance.

What this means for you:

Do not self-inject peptides sourced online or from overseas vendors. There is no way to verify the purity, dosing, or potential for harmful effects.
If you are curious about peptides, discuss them with your primary care clinician. It’s better to talk to a clinician who knows your history than someone at a wellness spa who doesn’t have that context. And if you’re already using peptides, it’s a good idea to tell your doctor.
Watch for updates. I’ll be keeping an eye on the FDA advisory committee meeting in July and sharing anything I learn.

Bottom line

You’re caught up on New York’s public health news. If there are other topics you’d like to see covered here, please drop me a comment here. See you next week!

Love,

Your NY Epi

Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health advocate. She specializes in infectious diseases, outbreak response, and emerging health threats. She has led multiple outbreak investigations at the California Department of Public Health and served as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Donnelly is also an epidemiologist at Biobot Analytics, where she works at the forefront of wastewater-based disease surveillance.

How the South Carolina measles outbreak grew from 5 to 997 cases

2026-04-27T23:55:10+00:00

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The South Carolina measles outbreak is one of the largest in the United States in decades.

It started with just five known cases in October, but by January exploded to 847 – becoming larger than last year’s deadly outbreak in Texas. By mid March, the outbreak had further grown to 997 known cases.

Along the way, hundreds of additional people in South Carolina – many of them children at schools with low vaccination rates – have had to stay in home quarantine for up to 21 days because they aren’t immunized and have been exposed to contagious people.

South Carolina’s state epidemiologist, Dr. Linda Bell, has said there also were likely many more people who weren’t in quarantine, but should have been. They were unaware they had been exposed during the normal course of their lives: Going to work, school, and church, shopping for groceries, dining in restaurants, and visiting museums.

Measles spreads through the air and can linger in a room for two hours after an infectious person has left. The people who are spreading the disease often don’t know they have it: They are contagious for four days before they develop the virus’ hallmark rash.

A Healthbeat review of the outbreak’s history provides a detailed timeline of how the South Carolina Department of Public Health worked to trace and contain new infections. For a while, the outbreak smoldered with few new cases. Then the holiday season supercharged the spread in January.

The South Carolina outbreak was declared over on April 27.

Here is how it happened.

October 2, 2025 - South Carolina announces measles outbreak

Total outbreak cases: 5.

The South Carolina Department of Public Health announces it has confirmed a measles outbreak in the Upstate region, the northwest part of the state that includes Spartanburg County. During 2025, the state had only identified three earlier measles cases: two in July and one in early September – and those were linked to exposures during international travel, plus one close contact of a traveler who became infected. “We now have identified five cases in a little more than a week,” Bell said. “This sharp uptick in cases and the unknown source of two of the recent cases indicates unrecognized community spread.”

October 7, 2025 - Two schools have early outbreak cases

Total outbreak cases: 7. New cases: 2.

Two additional cases of measles are identified in Spartanburg County, raising to seven outbreak cases that had been reported since Sept. 25. None have an identified source, state health officials said, “suggesting that measles is circulating in the community.” Two schools – Global Academy of South Carolina, a public charter school where state data show only 21% of students had all their school vaccinations, and Fairforest Elementary, a public school where 82% of students were up-to-date on their school shots – are locations with confirmed measles cases. Health officials identified 153 unvaccinated students at the two schools who were exposed and at risk of measles infection, resulting in their required exclusion from classes until the 21-day period of potential disease transmission was over. The school exclusion periods were over on Oct. 21 for the Global Academy students, and on Oct. 22 for the Fairforest students.

Vaccination coverage of 95% is needed in local communities to stop the spread of measles. Across Spartanburg County, the state health department estimates that just 90% of school-age children are fully vaccinated. Rates at some schools are even lower, state data show.

Global Academy of South Carolina, a public charter school in Spartanburg, S.C., was one of two schools that had some of the earliest confirmed cases of measles linked to the outbreak.

October 9, 2025 - A child in Greenville County has measles

Total outbreak cases: 8*. New cases: 1.

State health officials announce another case of measles, a child in Greenville County, which borders the west side of Spartanburg County. While it was not immediately clear whether the child’s illness was related to the Spartanburg County outbreak, health officials eventually included the case in the outbreak count. “What this case tells us is that there is active, unrecognized community transmission of measles occurring in the Upstate, which makes it vital to ensure that the public have received their measles vaccinations,” the state health department said. The department would later identify the Crunch Fitness gym at 1332 S. Pleasantburg Dr. in Greenville as the source of the child’s exposure on Sept. 30.

(*) Total case count includes this Greenville County child, whose measles case was later determined to be an outbreak case on Oct. 21.

October 13, 2025 – Quarantines appear to be working

Outbreak investigators from the state health department are optimistic about their efforts to control the spread of measles at Global Academy of South Carolina and Fairforest Elementary, according to internal health department records obtained by Healthbeat. “The quarantine of students from Global Academy and Fairforest Elementary appears to be working. The recent confirmed cases in those exposure groups did not lead to additional case investigations because they were already in quarantine,” according to an Oct. 13 email obtained by Healthbeat that the state health department sent to staff in the governor’s office.

October 14, 2025 - School exposures result in more cases

Total outbreak cases: 13*. New cases: 5.

Five new measles infections are confirmed among unvaccinated students who were already in quarantine at home because of previously reported school exposures. The department previously identified exposures at Global Academy of South Carolina and Fairforest Elementary. “Because they were quarantining before they became infectious, no additional exposures occurred with these new cases,” state health officials said. The state health department announces the next day that it will be sending its mobile measles vaccination unit to hold five events at four locations in Spartanburg County – including churches, a community center, and a library.

(*) Total case count includes a Greenville County child whose measles infection was announced on Oct. 9 as being under investigation, and was later determined to be an outbreak case on Oct. 21.

October 17, 2025 - Three cases among contacts in quarantine

Total outbreak cases: 16*. New cases: 3.

Three new cases are identified among close contacts of people with measles who were already in quarantine at home. State health officials said the new cases show how early quarantine after an identified exposure “is highly effective in preventing community spread.”

(*) Total case count includes a Greenville County child whose measles infection was announced on Oct. 9 as being under investigation, and was later determined to be an outbreak case on Oct. 21.

October 21, 2025 - Four new cases in Spartanburg County

Total outbreak cases: 20. New cases 4.

Two new cases are confirmed among close contacts of people already in home quarantine. And two additional measles cases are identified in association with a business in Spartanburg that had “no public exposures,” health officials said. They also announce that the Greenville County child exposed at a gym whose case was announced on Oct. 9 is now being considered an outbreak case “due to ongoing unrecognized community transmission.”

October 24, 2025 - Two more sickened with measles

Total outbreak cases: 22. New cases 2.

Two new measles cases are confirmed in Spartanburg County; both are linked to close contacts of people with measles who had been in quarantine at home, state health officials announced.

October 28, 2025 - Mobile clinics give 24 shots as more fall ill

Total outbreak cases: 30. New cases: 8.

As state health officials announce eight new measles cases in Spartanburg County among close contacts of people already in home quarantine, they continue to send their mobile vaccination clinic to offer free measles shots at more locations. Multiple vaccination events have been offered in the community since Oct. 16, but only 24 vaccines have been administered: 19 to adults and five to children, state health officials said.

October 31, 2025 - State emphasizes isolation, quarantine

Total outbreak cases: 34. New cases: 4.

Four new measles infections were confirmed in Spartanburg County. All were linked to close contacts of previously known cases. “No public exposures have been identified from these cases,” state health officials said. “We continue to rely on isolation and quarantine measures for those who have been exposed and are unvaccinated to prevent the spread of measles in the community to contain this outbreak.” The state health department added that its “additional response” to the outbreak “is to encourage protection with the measles-mumps-rubella (MMR) vaccine for those who are not immune.” With free mobile vaccination clinics ongoing, just 28 doses of MMR vaccine – 23 to adults and five to children – have been administered since the outreach events began on Oct. 16.

November 4, 2025 – No new cases as holiday season looms

Total outbreak cases: 34. New cases: 0.

No new measles cases were identified by health officials since the previous Friday. Yet they cautioned that 34 people were still in quarantine because they were unvaccinated and had been exposed to someone who was contagious. The latest end date for those in quarantine to no longer be at risk of developing measles is Nov. 24. “We are reminding people that travel for the upcoming holidays increases the risk of exposures greatly for those traveling and for those accepting visitors,” the state health department said. “Consider getting vaccinated now to prevent measles from disrupting your holiday plans.”

November 7, 2025 – Another case confirmed, more expected

Total outbreak cases: 35. New cases: 1.

State health officials announce they have identified one new measles case and are still investigating how many people may have been exposed to the virus by this person. “We also expect more cases to come in the days ahead from exposed family members of known previous cases,” the state health department said, noting that there are 31 people in quarantine.

November 10, 2025 – Restaurant mistakenly flagged for exposure

While investigating the ongoing outbreak, state health officials put out a press release saying a person who was infectious with measles was at the Kanpai of Tokyo restaurant at 2300 Winchester Pl. in Spartanburg on Nov. 2 from 3 to 6 p.m.; they urged anyone who believes they were exposed – particularly those without immunity – to contact their health care providers. But a mistake was made, and the health department said it had been given the wrong date: The person actually dined at the restaurant in late October – at a time when they weren’t infectious.

“Our business went down for a good two months. We lost sales, we lost wages,” general manager Nick Nakincheng told Healthbeat. “People thought we closed, and then people were just scared to even come at all.” Business is finally returning, he said in January. But the state health department, while acknowledging the error to the Post and Courier in December, still had not corrected its press release as of Jan. 26. The department declined to answer Healthbeat’s questions about the error or explain why the press release remained posted on its website without correction – even though it had corrected at least one other outbreak press release. After Healthbeat published this timeline, the department added a correction to its Kanpai of Tokyo press release.

The general manager of Kanpai of Tokyo said the Spartanburg restaurant lost business after the state health department publicly warned in November 2025 that an infectious person had dined there. It later turned out that outbreak investigators were given a wrong date – and the person wasn’t contagious when they were at the restaurant.

November 12, 2025 – Eight new measles cases identified

Total outbreak cases: 43. New cases: 8.

Of the eight new measles cases announced by state officials, six were household members of known cases who were in quarantine. But the source of the infection for the other two cases, who were people from the same household, is unclear. “The unidentified source of the two new cases reinforces our concern about potential ongoing community transmission,” the state health department said.

November 14, 2025 – One new measles case

Total outbreak cases: 44. New cases 1.

Just one new measles case has been identified since the state’s last update and the extent of others exposed to the person is still under investigation, state health officials said; 18 people are currently in quarantine because of outbreak exposures.

November 18, 2025 – More cases, more public exposures

Total outbreak cases: 49. New cases: 5.

While two of the five new cases are household members of known measles cases in quarantine, the source of the infection of the other three people is unknown, state health officials said. “The initial investigation of contacts of the new cases has determined potential exposures in public settings. Additional information will be provided once more details are obtained,” the department said, noting that 84 people are in quarantine and that direct contacts and facilities that have been impacted are being notified about the potential exposures.

November 21, 2025 – School, church, airport exposures

Total outbreak cases: 52. New cases: 3.

State health officials announce the confirmation of three new measles cases – and that as a result of contact tracing by health workers, there are now 137 people in quarantine because they are unvaccinated and have been exposed, plus one person in isolation because of infection. Many of these people are from schools in Spartanburg County: 57 are from Lyman Elementary School (where 89% of students were up-to-date on school vaccines); 55 are from Boiling Springs Middle School; and one attends D.R. Hill Middle School (where 88% of students were up-to-date on vaccines). Health officials also warned that an employee at the Greenville-Spartanburg International Airport who was infected with measles may have exposed airport visitors between 9 a.m. and 7 p.m. on Nov. 10 and 11. They also said an infectious person attended the Way of Truth Church in Inman, S.C., which is in Spartanburg County, from 7 to 11 p.m. on Nov. 7 and from 10 a.m. to 2 p.m. on Nov. 9.

State health officials linked multiple outbreak cases to exposures that occurred at the Way of Truth Church in Inman, S.C., which is in Spartanburg County.

November 25, 2025 – Public exposure at county treasurer’s office

Total outbreak cases 55. New cases: 3.

On the Tuesday before Thanksgiving, the state health department announces they have identified three additional measles cases. Two of the people are household members of known cases. The source of the third person’s infection is still being investigated. Meanwhile, the department warns of another public exposure location: An infectious person was at the Spartanburg County Treasurer’s Office on Nov. 17 and 18 during the hours the office was open.

November 28, 2025 – Public exposure event at Costco

Total outbreak cases: 62. New cases: 7.

Of the seven new measles cases announced, six were household members of known cases who were in quarantine, and one was a person exposed in a school setting who also was in quarantine. Total people currently in quarantine: 144; six in isolation. State health officials also warn there was a potential measles exposure event at a Costco store and tire center at 211 W. Blackstock Rd. in Spartanburg on Nov. 18 between 9:30 a.m. and 1 p.m.

As the outbreak grew, state health officials warned of infectious people potentially exposing others while shopping at a range of retail stores. One incident occurred at the Costco store and tire center at 211 W. Blackstock Rd. in Spartanburg on Nov. 18, 2025.

December 2, 2025 - More school exposures, 14 new cases

Total outbreak cases: 76. New cases: 14.

Eight of the 14 new measles cases announced by state health officials were the result of the previously reported exposure at the Way of Truth Church in Inman. Three of the new cases were exposed in a school setting, and the other three are still under investigation. Based on public health investigations of the new cases, the public was alerted that four Spartanburg County schools were the sites of additional measles exposures, requiring dozens of unvaccinated students to be excluded from school and quarantined. The schools involved: Hendrix Elementary School, where state data show 87% of students are up-to-date on school vaccines (40 students in quarantine); Mabry Middle School, where 81% of students are up-to-date on vaccines (13 students in quarantine); Chapman High School, where 87% of students are up-to-date on vaccines (5 students in quarantine); and Tyger River Elementary School, where 89% of students are up-to-date on vaccines (17 students in quarantine).

December 5, 2025 – Measles quarantines hit more schools

Total outbreak cases: 84. New cases: 8.

Eight new measles cases are announced by state health officials, but the number of people in quarantine and at risk of developing measles has jumped to 281. Based on public health investigations of the new cases, the public was alerted to new measles exposures at four additional Spartanburg County schools: Fairforest Elementary School, where 82% of students were up-to-date on their school vaccines (44 students in quarantine); Rainbow Lake Middle School, where 82% of students were up-to-date on vaccines (61 students in quarantine); Fairforest Middle School, where 90% of students are up-to-date on vaccines (fewer than 5 students in quarantine); Dorman Freshman Campus, where 93% of students are up-to-date on vaccines (15 students in quarantine). This is the second round of quarantines at Fairforest Elementary, which was one of the earliest sites of known measles cases in early October.

December 9, 2025 – Earlier church exposure fuels new infections

Total outbreak cases: 111. New cases: 27.

Of the 27 new measles cases announced, 16 resulted from previously reported exposure incidents in November at Way of Truth Church in Inman. Eight of the new infections were among household members of known cases. One infection was from a school exposure, one had an unknown source, and one was from an exposure in a health care setting. State health officials said the new cases have resulted in additional public exposures at Inman Intermediate School, where state data show 83% of students were up-to-date on vaccines (43 students in quarantine). Officials continue to encourage those who may have been exposed to measles to alert their health care provider in advance of going to their office, so that measures can be taken to protect against additional exposures.

December 12, 2025 – More than 300 in quarantine, 15 new cases

Total outbreak cases: 126. New cases: 15.

As state health officials investigate the contacts of 15 new measles cases, they identified two more Spartanburg County schools where public exposures have occurred: Campobello Gramling School, where state data show 80% of students are up-to-date on school vaccines (67 students in quarantine), and Boiling Springs Elementary School, where 80% of students are up-to-date on vaccines (16 students in quarantine). Overall, 303 people are in quarantine, many of them students at 11 schools. The large number in quarantine is a potential warning sign of the magnitude of future measles cases because there is a lag time between when people are exposed and when they start feeling sick – typically seven to 10 days, but sometimes as long as 21 days.

Of the 15 new cases, 13 involved exposures within households with known measles cases; one infection involved a neighborhood contact; and the source of one is unknown and under investigation.

Boiling Springs Elementary, a public school operated by Spartanburg County School District Two, is among several schools in South Carolina’s Upstate region that have had multiple rounds of quarantines.

December 16, 2025 - Nine new cases, another school exposure

Total outbreak cases: 135. New cases: 9.

Of the nine new measles cases announced, five were the result of a previously reported exposure at Way of Truth Church in Inman. Three cases involved known household exposures and one involved a neighborhood contact. Investigations of the new cases identified an additional Spartanburg County school with public exposures: Berry Shoals Elementary School, where 93% of students are up-to-date on school vaccines (44 students in quarantine).

December 19, 2025 – Another school with measles exposures

Total outbreak cases: 144. New cases: 9.

State health officials announce nine new measles cases: Four were infections of household members of known cases; one was from a previously identified school exposure; one was from a previously identified exposure at Way of Truth Church in Inman; and the source of three infections is unknown. Contact investigations for the new cases identified an additional school where measles exposures have occurred: New Prospect Elementary School in Inman, where 82% of students are up-to-date on school vaccines (56 students in quarantine).

December 23, 2025 – Nine new measles cases identified

Total outbreak cases: 153. New cases: 9.

Of the nine new cases announced, five resulted from household exposures to known cases; two involved a previously known school exposure; the source of one is unknown; and another is still being investigated.

December 26, 2025 – Three new measles cases identified

Total outbreak cases: 156. New cases: 3.

Amid the holiday season, three new measles cases were reported between Tuesday and Friday. All were the result of a previously reported school exposure, state officials said. There are 252 people in quarantine and three in isolation. The latest end date for those in quarantine is Jan. 15.

December 29, 2025 – School contact tracing delayed by holidays, resistance

Although it was not made public at the time, internal health department records later obtained by Healthbeat under South Carolina’s public records law show how efforts to quickly quarantine schoolchildren exposed to measles before winter break were hampered by school closures, as well as resistance from one school. With students continuing to fall ill with measles in late December, outbreak investigators couldn’t reach anyone at multiple Spartanburg schools to get contact information for classmates, staff and others who had been exposed before the two-week break. The schools where state records show contact-tracing delays occurred included: Global Academy of South Carolina, Sugar Ridge Elementary, Boiling Springs Elementary, and Jesse S. Bobo Elementary. The result: During this critical period in the outbreak, as cases were rising and more people were socializing and traveling, public health officials were not able to warn potentially infected people they needed to quarantine at home.

“Our inability to get contact information for potentially exposed students and notify those families resulted in some people being out and about in the community without knowing that they were infectious,” Bell would later tell Healthbeat. “The consequences being new cases due to additional exposures from people who would have otherwise been in quarantine had we been able to make contact.” At one school that health officials were able to reach by email on Dec. 29 – Westgate Christian School in Spartanburg – the principal refused to provide required information about students who had been exposed to measles. “We will not provide personal details and immunization status information for the students in our school,” the principal replied the next day. After state health officials sent Westgate a “final notice” letter in early January that threatened enforcement actions and potential fines, the school provided the information.

December 30, 2025 – As cases rise, 3 hospitalized from measles

Total outbreak cases: 176. New cases: 20.

Since Friday, state health officials identified 20 new measles cases and learned of three people – including adults and children – who required hospitalization because of complications from the disease. Citing patient privacy, health officials would not provide additional details about the hospitalized cases. The measles virus can cause serious complications such as pneumonia, brain inflammation, risks of premature births for pregnant mothers and it also can weaken a person’s immune system. Of the new cases, seven involved household exposures, five involved a previously known school exposure, two involved a church exposure, and one resulted from an exposure at either school or church, the state health department said.

January 2, 2026 – Nine more measles cases identified

Total outbreak cases: 185. New cases: 9.

Of the nine new cases detected, four were household exposures of known measles cases; one involved a previously reported school exposure; one case is still being investigated; and the source of three cases is unknown. The number of people in quarantine because they lack immunity and have been exposed: 223; three are in isolation for infections.

January 3, 2026 – Exposures at Best Buy, restaurant, library

The state health department announces that a person who did not know they were infectious with measles visited multiple public locations during the previous week. On Dec. 24, they visited the Nose Dive Restaurant, a gastropub at 116 S. Main St. in Greenville, then went to a Best Buy store at 1125 Woodruff Rd. in Greenville. A few days later, on Dec. 27, they attended an afternoon planetarium show about solar superstorms at the Spartanburg County Public Libraries headquarters library in downtown Spartanburg, which in October opened a new planetarium learning center with a 135-seat domed theater. Todd Stephens, the county’s librarian, said a public health official called him the day before the state’s press release went out and let him know someone with measles had been in the library’s theater a week earlier. “We have a response plan on Covid. We don’t have a document like that for this,” Stephens told Healthbeat. “But I can say we applied some of those principles that we’ve learned.” He said he’s not received any calls or concerns from library patrons about the potential exposure and he is not aware of anyone becoming infected.

A person who didn’t know they were infectious with measles attended an afternoon show in the Spartanburg County Libraries 135-seat domed planetarium theater on Dec. 27, 2025 in downtown Spartanburg, according to state health officials.

January 5, 2026 – S.C. outbreak exposes other states

People infected in South Carolina’s outbreak have exposed others while traveling, including at sites in Kentucky, North Carolina, Texas, Georgia, and New Mexico, according to a Jan. 5 memo the South Carolina Department of Public Health sent to staff at the South Carolina governor’s office. “The three latter sites are all associated with one case,” said the memo, which Healthbeat obtained with a public records request. “We sent an exposure notifications [sic] to all U.S. jurisdictions regarding the potential for exposure at the out-of-state-sites.”

January 6, 2026 – Public exposures at more schools, churches

Total outbreak cases: 211. New cases: 26.

Among the 26 new cases identified by state health officials, 19 involved exposures in households with known cases and at schools with previously announced exposures. Four of the new infections resulted from an exposure at church. One case has an unknown source, and two are still being investigated. Another 144 people without immunity are in quarantine because of exposures. Investigations of recent cases identified multiple locations of public exposures. Nine students are in quarantine at two Spartanburg County schools where these exposures occurred: Sugar Ridge Elementary, where 78% of students are up-to-date on vaccines, and Boiling Springs Elementary, where 80% of students are up-to-date on vaccines. It was the second time during the outbreak that students at Boiling Springs Elementary had to be quarantined; the previous quarantines were in December. Churches where public exposures occurred, health officials said, included: Tabernacle of Salvation Church, Slavic Pentecostal Church of Spartanburg, Ark of Salvation Church, and the Unitarian Universalist Church of Spartanburg.

January 7, 2026 - Health alert sent to providers, facilities

The state department of public health sent out a statewide alert to all health care providers and facilities about the importance of having “heightened awareness” for measles and providing advice on the recommended measures for the use of masks and rapid isolation of people suspected of having measles infections to protect others in health care settings from being exposed.

January 9, 2026 – Measles cases spike with 99 new infections

Total outbreak cases: 310. New cases: 99.

Between Tuesday and Friday this week, state health officials identified 99 new cases of measles. They said another 200 people were in quarantine because of exposures. Dr. Linda Bell, the state epidemiologist, warned it was becoming increasingly difficult to identify likely sources of infection because of the increasing number of public exposure sites. “The number of those in quarantine does not reflect the number actually exposed,” Bell said. “An increasing number of public exposure sites are being identified with likely hundreds more people exposed who are not aware they should be in quarantine if they are not immune to measles.” The department flags one new public exposure site: Jesse S. Bobo Elementary School, where state data show 94% of students are up-to-date on school vaccines.

Jesse S. Bobo Elementary School, a public school in Spartanburg County School District Six, had a measles exposure incident that state health officials announced on Jan. 9, 2026.

January 12, 2026 – Measles exposures at BMW, Michelin plants

Although not publicly known at the time, internal South Carolina Department of Public Health records obtained by Healthbeat show that large manufacturing plants for BMW and Michelin in Spartanburg were the sites of measles exposure incidents in January. While the health department alerted staff at the South Carolina governor’s office about the plant exposures in a Jan. 12 email, these exposures at large, prominent manufacturing plants weren’t publicly announced. When Healthbeat later revealed the exposures, BMW said it kept its workforce informed about measles cases at the plant and that the company was providing on-site access to vaccinations. Michelin declined to answer questions about what actions it took.

January 13, 2026 - Surge continues with 124 new measles cases

Total outbreak cases: 434. New cases: 124.

Health officials announce another surge in cases, with 124 new infections identified in recent days. They said another 409 people are in isolation because they were exposed and lacked vaccination or immunity from previous infection; 17 were in isolation. Investigators have learned of more than 30 public locations where infectious people have potentially exposed others to measles in recent days, Bell said. Besides schools, these locations have included churches, restaurants, and many health care settings, she said. But the department is only naming locations where details about exposure dates and times are available to allow the public to take informed actions, she said.

Adding to concerns: Health officials learned that a person who didn’t know they were infectious had visited the South Carolina State Museum in Columbia – the state’s capital city, which is about 95 miles southeast of the outbreak area in Spartanburg County. No measles cases have been identified outside the Upstate region, officials said. “Circulation of the measles virus is increasing in numerous community settings in the Upstate, and the risk of infection to those who are not immune to measles by vaccination or previous disease is increasing,” Bell said. “This includes people who may be traveling to the upstate region. So [the Department of Public Health] strongly encourages those who are not protected to consider getting vaccinated now to protect against unexpected exposures, against illness, and possible complications.”

January 15, 2026 – S.C. residents spark Washington, N.C. cases

The Snohomish County Health Department in Washington state announces that an infectious family from South Carolina who was visiting the area two weeks ago is now connected to three new measles cases among local children. The three cases are considered an outbreak and a sign the virus is spreading in the community, the department said. The South Carolina family members, one adult and two children, were infectious while visiting multiple locations in Everett, Marysville, and Mukilteo – including schools – from Dec. 27, 2025 through Jan. 1, 2026. They also flew through Seattle-Tacoma International Airport. “We are hoping to contain it, but unfortunately there have been a number of exposure sites already and there are likely more cases in the community that we do not know about yet,” said Dr. James Lewis, the Snohomish County health officer.

In North Carolina, state health officials announce that the South Carolina outbreak is connected to two cases of measles in unvaccinated siblings Buncombe County, N.C.

January 16, 2026 – Schools hit with repeated quarantines

Total outbreak cases: 558. New cases: 124.

Another 124 new measles cases are announced by state health officials; 531 people are in quarantine; and 85 are in isolation. The outbreak continues to be centered around Spartanburg County, they said.

Based on investigations of the newest cases, health officials said public exposures have occurred at nine schools: Holly Springs-Motlow Elementary, where state data show 80% of students are up-to-date on school vaccines (53 students in quarantine); Campobello Gramling School, where 80% of students are up-to-date on vaccines (46 students in quarantine – and the school’s second round of quarantines); Crestview Elementary, where 90% of students are up-to-date on vaccines (22 students in quarantine); Libertas Academy, where 74% of students are up-to-date on their vaccines (15 students in quarantine); Fairforest Elementary, where 82% of students were up-to-date on their school vaccines (14 students in quarantine – and the third round of quarantines at this school); Berry Shoals Elementary, where 93% of students are up-to-date on school vaccines (14 students in quarantine – and the school’s second round of quarantines); Oakland Elementary, where 83% of students are up-to-date on vaccines (6 students in quarantine); Mabry Middle School, where 81% of students are up-to-date on vaccines (6 students in quarantine – and the school’s second round of quarantines); and Landrum High School, where 94% of students are up-to-date on vaccines (5 students in quarantine).

Additional public exposures occurred during certain hours at: Walmart at 203 Cedar Springs Rd. in Spartanburg on Jan. 3; Wash Depot at 2177 S. Pine St. in Spartanburg on Jan. 3 and 4; and at Bintime Spartanburg at 445 S. Blackstock Rd. in Spartanburg on Jan. 7.

Fairforest Elementary, a public school in Spartanburg, S.C., was one of two schools that had some of the earliest confirmed cases of measles linked to the outbreak.

January 20, 2026 – Exposures at schools, Clemson University

Total outbreak cases: 646. New cases: 88.

“As we continue to watch this daily surge in cases, DPH strongly encourages those who are not protected to take advantage of the opportunity to get protected,” Dr. Linda Bell, the state epidemiologist, says at a press briefing about the outbreak numbers released on Jan. 20.

In recent days, state health officials identified 88 new measles cases. They said 538 people are in quarantine and 33 in isolation. Bell said that since the outbreak began,10 people, including adults and children, have required hospitalization for measles complications.

Through investigations of the latest cases, health officials have identified six additional schools where public exposures have recently occurred: Starr Elementary, where 96% of students are up-to-date on school vaccines (17 students in quarantine); Global Academy of South Carolina, where 21% of students are up-to-date on vaccines (13 students in quarantine – and this school’s second round of quarantines); Boiling Springs High School, where 92% of students are up-to-date on vaccines (11 students in quarantine); Chapman High School, where 87% of students are up-to-date on vaccines (fewer than 5 students in quarantine – this is the school’s second round of quarantines); Boiling Springs Elementary (students in quarantine to be determined – this is the school’s third round of quarantines); Rainbow Lake Middle School, where 82% of students were up-to-date on vaccines (quarantine numbers still being determined – this is the school’s second round of quarantines).

Public exposures have also been identified at Clemson University (where 34 students were in quarantine) and Anderson University (where 50 students were in quarantine). While both universities are in South Carolina’s Upstate region, they are in counties west and southwest of the Spartanburg County area where the outbreak has been centered.

Additional public measles exposures were announced as occurring during certain hours at two grocery stores: a Publix at 2153 E. Main St. in Duncan on Jan. 16; and a Food Lion at 11153 Asheville Hwy. in Inman on Jan. 11 and 12.

January 23, 2026 – Cases reach 700, plus 485 in quarantine

Total outbreak cases: 700. New cases: 54.

The number of known cases in South Carolina’s measles outbreak is approaching the total cases in the huge Texas outbreak last year. When the Texas outbreak was declared over in August 2025, the state health department had confirmed 762 measles cases since late January 2025. Two school-age children died and 99 people required hospitalization. The South Carolina Department of Public Health announces it has identified 54 new measles cases in the Upstate region – raising the total outbreak cases to 700. There are an additional 485 people in quarantine and 10 people are in isolation, the department said. Since the outbreak began, 12 people have required hospitalization.

Case investigations have identified additional public exposures at multiple schools: Cooley Springs-Fingerville Elementary, where 77% of students are up-to-date on their school vaccines (22 students in quarantine); Cannons Elementary, where 95% of students are up-to-date on vaccines (8 students in quarantine); Abner Creek Middle School, where 89% of students are up-to-date on vaccines (the number of students being quarantined is still being determined); Mayo Elementary, where 89% of students are up-to-date on vaccines (student quarantines still being determined); and Sugar Ridge Elementary, where 78% of students are up-to-date on vaccines (student quarantines still being determined, this is the second round of quarantines at this school).

Additional public exposure locations occurred during certain hours at: Anytime Fitness at 3621 Boiling Springs Rd. in Boiling Springs on Jan. 13; the U.S. Post Office at 504 Pennsylvania Ave. in Greer on Jan. 13; Goodwill at 1333 W. Wade Hampton Blvd. in Greer on Jan. 13; and Aldi at 1560 W. Floyd Baker Blvd. in Gaffney on Jan. 17.

January 27, 2026 – S.C. outbreak exceeds Texas outbreak

Total outbreak cases: 789. New cases: 89.

State health officials announce they have confirmed 89 new measles cases, and that there are 557 people in quarantine and 20 in isolation. Outbreak investigators also have identified more public measles exposures that have occurred at several schools: Dorman High, where 96% of students are up-to-date on school vaccines; Inman Intermediate, where students have previously been quarantined and 83% of students are up-to-date on vaccines; and New Prospect Elementary in Inman, where students have previously been quarantined and where 82% of students are up-to-date. The state health department said the number of students that need to quarantine at each of these schools is still being determined. The newly identified cases raise the South Carolina outbreak’s total to 789 – surpassing the number sickened in the deadly Texas outbreak last year. In Texas, 762 cases of measles were confirmed in an outbreak that began in late January 2025 and was declared over in August 2025.

January 30, 2026 – Surge puts 443 in quarantine

Total outbreak cases: 847. New cases: 58.

Numbers released by the state health department show 58 new measles cases have been identified. There are 443 people in quarantine who have been exposed, who lack immunity, and who are at risk of developing the disease in the coming days and weeks. Twenty people are in isolation because of illness. Public health investigators have identified a school and a fast food restaurant with recent public exposures because of the presence of an infectious person. Health officials are still determining how many students need to be quarantined and excluded from class at the school, Lyman Elementary, where state records show 89% of students are up-to-date on school vaccines. The school was involved in a previous exposure situation announced on Nov. 21. The other public exposure event involves a Burger King restaurant at 6196 US-221 in Roebuck, S.C., that occurred on Jan. 28 between 11:30 a.m. and 2:30 p.m.

February 3, 2026 – Fewer infections – but one in Sumter County

Total outbreak cases: 876. New cases: 29.

The state health department announces 29 new cases of measles in the ongoing outbreak in South Carolina’s Upstate region, in and near Spartanburg County. They also said a measles case has been confirmed in a resident of Sumter County – which is located in South Carolina’s Pee Dee Region, southeast from where the outbreak has been occurring. “At this point in the investigation, it is not yet clear whether this new case is linked to the Upstate outbreak centered around Spartanburg County or if the case may have been exposed where measles is occurring in other locations,” the department said. The department said public exposures to measles have occurred during certain specific hours at three locations in Sumter, S.C.: Mariachis Mexican Restaurant at 1072 Broad St. on Jan. 23; Food Lion at 5700 Broad Street Ext. on Jan. 24; and the Walmart Neighborhood Market at 343 Pinewood Rd. on Jan. 25. The health department said there are currently 354 people in quarantine who have been exposed to measles and lack vaccination or immunity; 22 people are ill and in isolation.

February 6, 2026 – Vaccination is up significantly

Total outbreak cases: 920. New cases: 44

State health officials announce 44 new measles cases, plus another 277 people who are in quarantine because they were exposed and are unvaccinated or lack immunity from prior infection; eight people are in isolation because of illness. They also announce new locations of public exposure incidents during certain specific time periods at a Social Security Administration office at 145 N. Church St. in Spartanburg on Jan. 29; Boost Mobile at 1515 Asheville Hwy. in Spartanburg on Jan. 29; Rick Erwin’s Level 10 Restaurant at 225 W. Main St. in Spartanburg on Jan. 29; and the Target store at 6025 Wade Hampton Blvd. in Taylors on Jan. 30.

During a media call earlier in the week, Bell said state health officials are encouraged by increases in measles vaccination during January. In Spartanburg County, the number of measles vaccines given last month was up 162% over January 2025, an increase of more than 1,000 doses, she said. Statewide, measles vaccination was up 72%, with about 7,000 more doses given across South Carolina last month than were administered in January 2025. “So far, this is the best month for measles vaccination during this outbreak,” Bell said.

While complications from measles aren’t reportable to state health officials, Bell said the department has learned of some serious complications among 19 people – children and adults – who have been hospitalized since the outbreak began in October. “Some of these complications include measles encephalitis, or inflammation of the brain in children, and pneumonia.”

In addition, Bell said, several pregnant women were exposed to measles and required administration of immune globulin to protect against the high risk of complications measles poses to pregnant women and their newborns. Bell declined to provide additional details about the exposures of the pregnant women. Earlier in the week, Healthbeat revealed a measles exposure incident had occurred on a labor and delivery unit at Prisma Health Greer Memorial Hospital.

February 10, 2026 – Fewer new cases, but one in Lancaster County

Total outbreak cases: 933. New cases: 13

Just 13 new measles cases are announced in the state health department’s update; 235 people are in quarantine because of exposures, and six are in isolation because of illness. The department noted that a measles infection has been confirmed in a resident of Lancaster County; the source of the person’s exposure is still under investigation. The outbreak has not previously had any cases in Lancaster County, which is in north-central South Carolina. Two schools in Spartanburg County have been the sites of recent public exposures: Libertas Academy, where 74% of students are up-to-date on their school vaccines (nine individuals in quarantine); and Inman Intermediate, 83% of students are up-to-date on vaccines (fewer than five individuals in quarantine). People also remain in quarantine from an earlier public exposure at Lyman Elementary School, where 89% of students are up-to-date on vaccines (23 individuals remain in quarantine).

February 13, 2026 – Concerns linger about undetected cases

Total outbreak cases: 950. New cases: 17

The number of new measles cases announced today continues to be well below the numbers during the January surge. The state health department said 17 new cases of measles have been identified and there are another 186 people in quarantine because of exposures; nine people are in isolation because of illness. The recent identification of measles cases in Lancaster and Sumter counties – with no identified source of exposure – indicate that unrecognized transmission of measles is occurring in the community, Bell told reporters this week. “That can result in more and more transmission if we don’t stay on top of those cases, find out where that transmission is occurring, and implement our disease control measures,” Bell said. The outbreak continues to be centered in Spartanburg County, she said, and about 95% of those who have been infected are unvaccinated. The department announced three locations where public exposures have occurred recently during defined time periods: Children’s Medical Center, 841 S. Buncombe Rd. in Greer, all day on Feb. 4 and 6; Itto Ramen Bar, 1807 Poinsett Hwy. in Greenville, on Feb. 5 from 12:30 p.m. to 3:30 p.m.; and HomeGoods, 1125 Woodruff Rd. in Greenville, on Feb. 5 from 10 a.m. to 12:45 p.m.

February 17, 2026 – Most new infections involve known cases

Total outbreak cases: 962. New cases: 12.

State health officials announce 12 new cases and said there are an additional 127 people in quarantine because of exposures; eight people are in isolation because of symptoms. “The majority of cases are close contacts of known cases,” the state health department said. “However, the number of public exposure sites indicates that measles is circulating in the community, increasing the risk of exposure and the risk of infection for those who are not immune due to vaccination or natural infection.” The department said it is aware of 20 hospitalizations, involving children and adults, since the start of the outbreak. Libertas Academy has been the site of a recent public exposure event (17 individuals in quarantine). This school, where 74% of students are up-to-date on their school vaccines, has had previous exposure events, state records show. The department also announced a public exposure event occurred at Walmart – Powdersville, 11410 Anderson Rd. in Greenville on Feb. 8 from 4 to 8 p.m.

February 20, 2026 – Church, school, community college exposures

Total outbreak cases: 973. New cases: 11.

Health officials announce the identification of 11 new measles cases, and say there are 105 people in quarantine because of exposure and seven in isolation because of illness. “We are seeing a slowing, but it is too soon for us to say when this will end,” Bell said this week. “The concern is that we can see ongoing, smoldering transmission that can be introduced into other communities. The measles virus can find susceptible people wherever.”

While the number of new cases announced continues to be low, state health officials warn that public exposures have occurred recently at multiple locations in Spartanburg County. The exposure locations include Mabry Middle School in Inman, where 81% of students are up-to-date on vaccines and exposures have occurred previously. Other sites: Tabernacle of Salvation Slavic Church, 150 Outlet Rd. in Spartanburg, on Feb. 15 from 10 a.m. to 1 p.m.; Westgate Baptist Church, 1990 Old Reidville Rd. in Spartanburg, on Feb. 11 from 6:30 to 10 p.m .; Spartanburg Community College - Giles Campus, 107 Community College Dr. in Spartanburg, on Feb. 17 from 9:30 a.m. to 7:30 p.m.; Costco, 211 W. Blackstock Rd., Spartanburg, on Feb. 17 from 12 to 3 p.m.

February 24, 2026 – Just 6 new cases

Total outbreak cases: 979. New cases: 6.

Just six new cases of measles are announced by state health officials, plus 91 others who are in quarantine for exposures; one person is in isolation because of illness. The latest end date for those in quarantine is March 15. The newest cases have resulted in outbreak investigators identifying public exposures at Willow Creek Gathers Homeschool Co-op, where 17 individuals are in quarantine, the state health department said. Although South Carolina requires immediate reporting of cases of measles or suspected measles to the health department, the state doesn’t specifically require reporting about whether these cases were hospitalized or had complications. Over the course of the outbreak, the health department says it has learned about 21 people, children and adults, who have been hospitalized.

Since the outbreak began, the South Carolina Department of Public Health has used its mobile clinic to offer free measles-mumps-rubella vaccines in the Spartanburg County area.

February 27, 2026 – Hopes for earlier end to outbreak

Total outbreak cases: 985. New cases: 6.

Since Tuesday, state health officials say they have identified six new measles cases. There are 61 people in quarantine because of exposures; two people are in isolation for illness. The latest end date for people currently in quarantine and who may develop the disease is March 20. “We’re encouraged with the downward trend, particularly in the last two weeks,” Bell, the state epidemiologist, said this week. It’s possible that the outbreak may even end earlier than projected, she said. But the risk of another surge remains because of low vaccination coverage. The department said that based on the recent cases, investigators have identified public exposures that have recently occurred at Sugar Ridge Elementary, where 78% of students are up-to-date on vaccines. Fewer than five individuals from the school are in quarantine, officials said. This is the third round of quarantines for the school, health department records show. Another public exposure incident occurred at Costco - Spartanburg at 211 W. Blackstock Rd. on Feb. 22 from 2 to 6 p.m. It’s the third known measles exposure incident at the store, with the others occurring on Feb. 17 and Nov. 18, according to health department reports. State health officials said their mobile health unit will hold another measles vaccination clinic next week.

March 3, 2026 - Increased vaccination is helping slow outbreak, state says

Total outbreak cases: 990. New cases: 5.

The number of new cases reported to the state health department remains low: Just five new cases since Friday, health officials announced. There are 52 people in quarantine because of exposures and four in isolation because of illness. The latest end date for those in quarantine is March 27. The state health department also said there was a public measles exposure incident at Westgate Baptist Church, 1990 Old Reidville Rd. in Spartanburg, on Feb. 22 from 10:45 a.m. to 4 p.m. This church also had a measles exposure incident on Feb. 11. “We saw another strong increase in measles vaccination uptake during the month of February, which is encouraging,” Bell said at a media briefing this week. “Compared to February of 2025, there was a 133% increase in measles vaccination in Spartanburg County, with around 900 additional doses given,” she said. Statewide, there was a 70% increase in measles vaccination, with an additional 7,000 doses given. “This increase in vaccination is one of the reasons why this outbreak is slowing,” Bell said. “But given the surge in cases we saw following the Christmas holidays, we remain concerned that another surge could occur following spring break, when many people can be traveling and participating in more social activities.”

March 6, 2026 – Just one new case as outbreak cost reaches $1.6 million

Total outbreak cases: 991. New cases: 1.

Just one new measles case is announced by state health officials in their Friday update. There are 52 people in quarantine because of exposures and three in isolation because of illness. The latest end date for those in quarantine is March 27. Meanwhile, state health officials told Healthbeat this week that the public health response to the outbreak has cost taxpayers $1.6 million so far. Most of that has been personnel costs, including for contact tracing and other activities to combat the outbreak, the department said.

Of the 991 outbreak cases, most have been children and teens: 260 are younger than 5; 637 are ages 5-17; 86 are age 18 or older; and the age is unknown for eight cases. Almost all who have been infected have been unvaccinated or only partially vaccinated: 925 were unvaccinated; 19 had only one one dose of the recommended two-dose MMR vaccine; 26 were fully vaccinated with two doses of MMR; and the vaccination status was unknown for 21 cases.

March 10, 2026 – Slow trickle of cases continues

Total outbreak cases: 993. New cases: 2.

State health officials announce just two new measles cases have been identified since Friday; 42 people are in quarantine because of exposures; 2 are in isolation because of illness. The latest end date for those keeping watch for signs of illness while in quarantine is April 2. “We’re very encouraged by the decline in cases, but we won’t be able to declare this outbreak over until we’re certain that measles transmission has ended,” Bell said this week. The department doesn’t want to have measles cases surge during the upcoming spring break period. Bell said the department has asked all schools in the Upstate region to identify a point of contact who will be available when schools are closed over spring break to provide student contact information if it’s needed for measles exposure investigations. Healthbeat previously revealed how outbreak investigations were hampered and quarantines were delayed during school winter break because health officials couldn’t quickly get contact information from several schools.

March 13, 2026 – Three new cases

Total outbreak cases: 996. New cases: 3.

State officials announce three new measles cases, and that the number of people in quarantine because of exposures is down to 30. Four people are in isolation because of illness. The latest quarantine end date is April 2. Of the outbreak’s 996 cases, 993 have been in Spartanburg County and 36 have been in neighboring Greenville County. A handful of additional cases have been in three other nearby counties in South Carolina’s Upstate region: eight in Anderson County, six in Pickens County, and fewer than five in Cherokee County. Two additional counties in other parts of the state also have a small number of cases: Lancaster County, in the state’s Midlands region, and Sumter County in the Pee Dee region each have fewer than five cases, according to state data.

March 17, 2026 – ‘We are not letting our guard down’

Total outbreak cases: 997. New cases: 1.

State officials announce one new measles case and say there are only eight people in quarantine for exposures and none in isolation because of illness. The latest end date for those in quarantine is April 2. “We are not letting our guard down. It is too early to say that we will not see any more cases,” Bell said this week. She said it’s important that health care providers remain vigilant and continue to suspect measles when they see illnesses with a fever and rash. “That gives us the opportunity to immediately place people in isolation, to place their contacts in quarantine, if necessary,” she said. “If we let our guard down too early, then we just put ourselves in the position of allowing more disease to spread if we are not paying careful attention.” Before South Carolina can declare the outbreak over, there must be two incubation cycles – or 42 days – with no new cases, Bell said. In the meantime, spring break for many schools in the Spartanburg area is scheduled for early April, and state officials remain concerned that travel and socializing during the school break period could result in more measles cases.

March 20, 2026 – No new measles cases since Tuesday

Total outbreak cases: 997. New cases: 0.

State health officials, in their Friday update, announced no new measles cases had been identified since Tuesday. The last time there were zero new cases in one of their twice-weekly outbreak updates was more than four months ago on Nov. 4. There are two people in quarantine because of exposures. Their last date in quarantine is March 28.

March 24, 2026 – Again, no new measles cases

Total outbreak cases: 997. New cases: 0.

For the second update in a row, state health officials in their Tuesday update said no new measles cases had been identified. Two people remain in quarantine because of exposures, with a latest quarantine end date of March 28. Nobody is in isolation because of illness. It will take 42 consecutive days with no new cases – two incubation cycles of the virus – to determine that the outbreak’s transmission chain has been broken, the health department said. If the no cases trend continues, the last day of the outbreak will be April 26.

March 27, 2026 – No new cases, only one person in quarantine

Total outbreak cases: 997. New cases: 0.

South Carolina health officials announce they continue to detect no new measles cases. Just one person remains in quarantine because they lack immunity and were exposed – and that person is almost out of danger. Their quarantine ends March 28. One question lingers: Are there still some measles cases that aren’t being detected and reported? A report from outbreak modelers at the Centers for Disease Control and Prevention, completed earlier this month, said it was likely measles cases in the outbreak were going unreported, Healthbeat reported.

While Bell told Healthbeat she remains concerned about unrecognized cases, if they exist, the department doesn’t think there are a lot of them. “Our surveillance systems indicate this trend reflects a true decrease and not people avoiding health care,” she said. Before the outbreak can be declared over, a period of 42 days – two incubation cycles for the virus – must pass without any more measles cases. If that happens, the last day of the outbreak would be April 26.

March 31, 2026 – No new cases and nobody in quarantine

Total outbreak cases: 997. New cases: 0.

With no new cases reported again and also nobody in quarantine, the countdown to the end of the outbreak continues. The outbreak can’t be declared over until two incubation cycles of 21 days each have passed without any new cases. If that happens, the last day of the outbreak would be April 26, state health officials have said.

April 3, 2026 – Still no new cases

Total outbreak cases: 997. New cases: 0.

The countdown to an April 26 last day of the outbreak remains underway as state health officials again announce no new cases.

April 7, 2026 – Still no new cases as DPH scales back public updates

Total outbreak cases: 997. New cases: 0.

The countdown to an April 26 last day of the outbreak continues as state health officials again announce no new cases. Unless a new measles case is identified, the South Carolina Department of Public Health said it will reduce the frequency of its Wednesday media briefings to every other week. While Tuesday outbreak data updates will continue, Friday updates will be discontinued, the department said. “If a new case is reported, DPH will immediately notify the media and resume briefings and updates as appropriate,” the department said.

April 27, 2026 – DPH declares the outbreak over, risks remain

Total outbreak cases: 997.

After 42 days passed without any new outbreak cases, the South Carolina Department of Public Health declared the outbreak to be over.

“Though we reached nearly 1,000 cases, we are grateful that, by and large, it remained confined to one county and did not spread statewide, as was always our concern and fear,” Dr. Brannon Traxler, the department’s deputy director and chief medical officer, said at a news conference.

Traxler said there are three main reasons state health officials think the outbreak has ended: the large number of people infected, widespread community cooperation with quarantine and isolation, and increased vaccination against measles in recent months.

While this record-breaking outbreak is over, Traxler said conditions remain for another measles outbreak in the future, brought into the state through travel.

“If we don’t continue to see increases in vaccination, I’m worried that we could see another large – maybe not this large, but hopefully not – but another large outbreak in a community where it gets introduced from someone who had traveled.”

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

South Carolina’s measles outbreak is over: 7 things to know about largest U.S. outbreak in decades

2026-04-27T23:49:47+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Officials at the South Carolina Department of Public Health declared their record-breaking measles outbreak to be over on Monday after no new cases emerged during the past 42 days.

Here are seven things to know about the largest U.S. measles outbreak in more than 35 years:

Most people who got infected weren’t vaccinated

Of the 997 measles cases documented in the outbreak, 932 patients were unvaccinated, 19 had an unknown vaccination status, and 20 were only partially vaccinated with only one dose of the two-dose MMR (measles-mumps-rubella) vaccine, according to the department’s data.

Just 26 people were fully vaccinated with two doses of MMR vaccine. Two doses of the vaccine is about 97% effective in providing protection against measles infections; one dose is about 93% effective, according to the Centers for Disease Control and Prevention.

Infections, increased vaccination credited in stopping outbreak

The 997 people sickened with measles developed immunity to the disease, Traxler said. “Though that carried with it, of course, the risk of severe illness, a weakened immune system and the potential for devastating complications even years from now,” she said.

Another important factor in stopping the spread of the virus, she said, was that the “vast majority” of people who were infected or exposed followed public health instructions to stay home and avoid infecting others.

Lastly, thousands of people got vaccinated. In Spartanburg County, she said, an additional 3,788 doses of MMR vaccine were administered during the six months of the outbreak compared with the previous year.

“In particular, January and February were record months for MMR vaccination in the state,” she said.

Risks for future measles outbreaks continue in South Carolina

This outbreak may be over, but outbreak risks remain in Spartanburg County and across the state. Traxler noted that pockets of people who are not protected against measles remain in many communities.

“We’re going to continue to see sporadic cases that are going to be travel-associated most likely,” Traxler said, noting the goal is to keep one of these travel cases from sparking a larger outbreak.

State’s $2.1 million cost is only part of the outbreak’s bill

The department estimates that the outbreak response cost the state of South Carolina $2.1 million. But that was just the costs the department could calculate for staff time, vaccination costs, and other direct expenses.

It doesn’t include all of the costs to the health care system, schools, businesses, and beyond, she said. “What were the economic impacts to the state of parents who had to miss work?” she asked. It’s not part of that number.

Outbreak began with 5 cases, centered in Spartanburg County

The outbreak was first identified in early October, with just five cases. For weeks the virus seemed to spread slowly – then the holiday season began.

On the Tuesday before Thanksgiving, the state had logged 55 measles cases. By Dec. 12, there were 126 cases – and more than 300 people in quarantine, Healthbeat’s timeline of the outbreak shows.

By mid January – after the December holidays and multiple public exposures at schools and churches – the outbreak surged, with more than 100 new measles cases being identified every few days. By Jan. 20, the department had documented 646 cases. Cases slowed during February and March.

The last time the state announced a new case in the outbreak was on March 17, the day the case total reached 997.

Before the measles outbreak could be declared over, there needed to be two incubation cycles – or 42 days – without any new cases.

Winter break school closures delayed investigations, quarantines

During the critical December holiday period – before the outbreak surged – South Carolina health officials were hampered in their efforts to control measles exposures because of winter break school closures, Healthbeat reported earlier this year.

Internal department records, obtained by Healthbeat, revealed how outbreak investigators were delayed in their efforts to quickly quarantine schoolchildren exposed to measles right before the two-week winter break period began. Because schools were closed, outbreak investigators couldn’t reach anyone at multiple Spartanburg schools to get contact information for classmates, staff, and others who had been exposed to infected people.

To prevent similar communications gaps during the recent spring break period, the department contacted schools across the state’s 11-county Upstate region to identify a person who would be available to provide attendance and contact information during the spring break closures of schools and administrative offices.

Department’s response, lessons learned to be evaluated

“The outbreak is over, but our work to understand and prevent measles and future outbreaks is not,” Traxler said. “A thorough after-action review and analysis is being started. We believe our outbreak response team did a tremendous job under really unprecedented conditions. But there are always things that we can learn from and improve on in our future with future responses, and we are committed to doing so.”

One of the things the department did well, she said, was urging members of the health care community to be pro-active in immediately reporting any suspected measles case – even before any test results come back. That early heads-up, she said, allowed the department to immediately start educating the patient about the need to isolate and begin earlier contact tracing.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

NY health update: Declining MMR vaccinations, high Black maternal death rates, fish safety, and spring health alerts

2026-04-24T15:55:34+00:00

Before I jump into this week’s newsletter, I have to give a shoutout to my mom, who just ran the Boston Marathon. Watching her train so hard, get up at the crack of dawn, and then run 26.2 miles with 30,000 other runners was incredible. I’m so proud of her.

And congratulations to everyone else who left it all on the course last weekend. The videos of runners helping other runners over the finish line, people giving everything they had, and the volunteers, medics, and coordinators making sure everyone stayed safe and cared for — wow. Man, I love runners.

Okay, back to this week’s New York Dose. I’m covering new data on childhood MMR vaccination, what New York is doing to reduce Black maternal mortality, an environmental win for people fishing the Lower Hudson, and a few spring health updates, including what I’m doing to get ready for warm weather.

NYC childhood MMR coverage is down

New York has long had some of the highest vaccination rates in the country. But even here, cracks in that strong foundation are starting to show. In New York City, new data suggest routine childhood vaccination is being delayed. In March, the city reported that about one in three 2-year-olds had not received all doses of the seven recommended vaccines, prompting officials to launch a new campaign in response.

This is the kind of shift that can seem small on paper, but it’s exactly how vulnerability builds quietly over time.

One of the clearest warning signs is measles, mumps, rubella coverage. In 2024, 93% of New York City children ages 24 to 35 months had received at least one MMR dose by their second birthday. In 2025, that dropped to 89%.

Percent of New York City children ages 24-35 months who received at least one measles, mumps, rubella vaccine by their second birthday.

That matters, especially right now. As of this month, New York state has confirmed eight measles cases this year. Nationally, we’ve seen how quickly measles can spread in communities with lower vaccination rates (YLE national has covered that here). And in 2019, New York City experienced a major outbreak, with 649 cases in a largely unvaccinated community in Williamsburg.

Even small percentage-point drops matter. In a city as large as New York, they translate to thousands more children vulnerable to measles if the virus is introduced.

This is one of those issues that can feel abstract until it isn’t. Delayed vaccination leaves young children vulnerable during the exact years when some vaccine-preventable diseases can hit hardest. Measles is extraordinarily contagious, and community protection depends on keeping coverage high.

Black mothers in New York state die from pregnancy-related causes at 4x the rate of white mothers

Black Maternal Health Week (April 11–17) just wrapped up across the state, and unfortunately the numbers underlying it are striking. The week exists in part to address some of the most persistent and devastating disparities in American medicine: Black women are substantially more likely to die from pregnancy than mothers of other races. State data estimate that Black women died of pregnancy-associated causes about four times more often than white women in New York. In New York City, it’s about five times higher.

That gap is shocking, and frankly, unacceptable. But New York is taking steps to reduce Black maternal mortality by putting several policies in place to help.

Here are some programs in New York aimed at reducing maternal deaths:

Postpartum coverage now lasts a full year. New York Medicaid and Child Health Plus extended postpartum coverage from 60 days to 12 months, helping more families stay connected to care during a period when serious complications can still happen.
Doula care is covered by Medicaid. New York Medicaid covers doula services during pregnancy and up to 12 months postpartum, including prenatal visits, labor and delivery support, and postpartum care. Eligible New Yorkers can find participating doulas in the Medicaid program here.
New York became the first state in the country to offer paid prenatal leave. Since Jan. 1, 2025, New York has required private-sector employers to provide pregnant workers with 20 additional hours of paid prenatal leave for pregnancy-related medical care. This is the first law of its kind in the country, and it is separate from other leave options.

The paid prenatal leave policy is especially important. It gives workers paid time off for things like OB visits, testing, monitoring, and other pregnancy-related appointments. And that matters, because barriers to prenatal care are often not about willingness, but can be about whether someone can afford to miss work. It may mean choosing between a clinic visit and food for dinner, a co-pay and prenatal vitamins, an ultrasound, and keeping the air conditioning on. Policies that reduce the financial cost of getting care are one of the clearest ways to reduce barriers to care.

What you can do to access benefits:

If you’re pregnant or recently postpartum and on Medicaid, confirm that your coverage extends for a full year after pregnancy.
If you want labor or postpartum support, check whether you’re eligible for a state-covered doula through New York’s Medicaid doula directory.
And if you work in the private sector, ask your HR department about your paid prenatal leave rights.

For the first time in 50 years, you can eat striped bass you catch from the lower Hudson River

New York state recently updated its fish consumption advice and says you can now eat some fish from the Lower Hudson River for the first time in 50 years. The updated advisory reflects decades of cleanup on the Hudson to lower polychlorinated biphenyls (PCBs — a toxic synthetic chemical) contamination enough to meet health guidelines.

The biggest update is for striped bass: Pregnant women and children under 15 can now eat one meal per month, and the general population can eat up to four meals per month from the Lower Hudson. But some fish, including carp and small-mouth bass, are still off-limits because of PCBs, so it’s still important to check the specific guidance before eating what’s caught.

For example, there are new advisories on forever chemicals known as PFOS, which apply to Lake Ontario, Lake Erie, Lake George, Lake Champlain’s Cumberland Bay, Seneca Lake, and others. So, if you fish or your family fishes, check the local updated guidance before eating your catch.

New York fish advisory regions.

This change is a good reminder that public health wins can be slow, and often unglamorous (no offense to the fish). But the fact that we have cleaner water, better environmental regulation, and long-term monitoring for these chemicals — and can see our progress firsthand — is worth celebrating.

Pollen and tick updates

Some quick notes on spring health.

Tree pollen is ramping up, with some parts of the state now experiencing high levels. For those with asthma or more intense allergies, it’s a good idea to speak with a health care practitioner about controlling symptoms before pollen makes it worse.

Reducing pollen exposure comes down to a couple key behaviors:

Avoid pollen outside. Check local pollen counts (like on pollen.com) and limit outdoor activity during early morning and on high-wind, dry days. The best time to go outside is after it rains, which helps clear pollen from the air.
Avoid pollen inside. Remove shoes before entering your home, wipe down pets, change after being outside, shower especially before bed to rinse off pollen, keep windows and doors closed, and run a HEPA filter.

For a deeper dive, check out my recent post on pollen.

We’re also in the thick of tick season. From now until about October, ticks will be active across New York, including in New York City. If you’re heading to parks, wooded areas, or anywhere with brush and tall grass, use repellent, and do tick checks on yourself, kids, and pets.

Emergency department visits for tick bites in the Northeast so far this year (green) compared to last year.

Last quick segment. I know the weather has been all over the place, from gorgeous 88-degree afternoons, back to the icy rain we have this week, but I wanted to get a couple things on your radar as we get closer to more warm days.

First, the program that provides free air conditioners is now accepting applications across New York state. This is important because extreme heat is New York’s most deadly weather.

To see if you qualify to get a free air conditioner through the Essential Plan Cooling Program, check out the qualifying conditions and application here.

Second, now is a good time to check the expiration date of your sunscreen. The active ingredients that block UV rays in sunscreen degrade over time, reducing effectiveness, increasing sunburn risk, and potentially causing skin irritation or rashes. It’s a good idea to make sure what you have on hand isn’t expired, and replace it if needed.

Bottom line

You’re all caught up on New York public health news. Have a great weekend, and I’ll see you next week!

Love,

Your NY Epi

Where measles is spreading in the U.S.: Outbreaks fuel infections in states coast to coast

2026-04-09T21:27:09+00:00

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Measles infections continue to spread across the United States, largely fueled by outbreaks – large and small – in multiple states

Since January, there have been more than 1,670 confirmed cases of measles nationwide, with most states reporting at least one case to the Centers for Disease Control and Prevention.

States with 10 or more confirmed cases of measles since January include: Arizona, California, Colorado, Florida, Minnesota, New Mexico, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Utah, Virginia, and Washington state, according to federal, state, and local data.

But health officials in multiple states have told Healthbeat they are concerned measles cases are going unreported because there are people who aren’t seeking diagnosis and treatment. They also are worried that recent spring break travel may contribute to more people falling ill with measles in the next few weeks. It can take two to three weeks for symptoms to appear after a person is infected.

The good news: South Carolina, the site of the largest U.S. measles outbreak in decades with 997 cases, hasn’t had a reported measles infection in more than three weeks and will be declared over if that trend continues through April 26.

The bad news: Utah’s outbreak – now the largest, still-growing outbreak in the country – is approaching 600 known cases.

The CDC defines an outbreak as three or more related cases. Here’s what to know about six places where measles has been spreading:

Utah: The largest outbreak that is still growing

Utah’s large outbreak, like others, began with just a handful of cases that started being identified last June. A few were in Utah County, around Provo. Others were in a rural area in the southwest corner of the state – where the virus continued to gain traction, becoming the focus of the outbreak throughout last year.

By the end of 2025, 197 people had been diagnosed with measles largely in that one corner of the state. Then in recent months the outbreak surged statewide. Since January, another 386 people have been diagnosed, bringing the outbreak’s total to 583 reported cases as of this week. At least 47 people have been hospitalized.

Dr. Leisha Nolen, Utah’s state epidemiologist, said the number of cases known to public health officials is an undercount. “I can say confidently that we are missing cases,” she said.

But it’s difficult to say how many.

In some communities that are particularly distrustful of government and public health, as few as 1 in 10 cases may go unreported, she said. Cases in remote rural communities, with limited access to health care, may also have higher rates of underreporting, while more cases may get counted in cities with easier access to doctors and hospitals.

One thing is clear: Utah’s outbreak is continuing to grow. In the last three weeks, state health officials have learned of 121 new cases.

“In the beginning of our outbreak, we did have mostly communities along the southwest border with Arizona affected, and we were really trying to contain it in that area and prevent spread,” Nolen said. “But as you know, people move around.”

A state high school wrestling championship in mid February contributed to the spread of the disease, health officials said. The state’s TriCounty Health District in northeast Utah, with 59 reported cases, has been particularly hard hit in recent weeks following the event.

Kirk Benge, TriCounty Health director, said the region’s outbreak has been centered around the city of Vernal, which is known as “Dinosaurland” because of the area’s rich deposits of dinosaur fossils and nearby Dinosaur National Monument.

“We started with quite a large number of cases in a school,” Benge said. “Now we’re seeing the household spread that comes from all of those cases started in a school setting.”

There are encouraging signs the outbreak in the Vernal area may be slowing, he said.

“We saw week over week doubling there for a little while, and I think it plateaued here this last week, and it may be declining right now. So hopefully that trend continues,” Benge said.

He said that since the local outbreak began, large numbers of parents are seeking vaccines for their children and the number of vaccines administered is up 500% over the same period last year.

“I think we have a lot more just hesitant people who have been confused by mixed messages on social media,” Benge said. This kind of vaccine hesitancy is different than the staunch opposition to vaccination found in some other communities in the state, he said.

Still, many other parts of the TriCounty area remain vulnerable to measles outbreaks because of low vaccination rates – something the county’s board of health warned in a December 2024 open letter to the community that cited an increase from 4.8% to 11.9% of local parents seeking to exempt their children from school vaccines. “We want all residents to understand that individual decisions regarding vaccination impact us collectively,” the letter said.

To prevent outbreaks of measles, 95% of people in a community need to be vaccinated against the disease.

Arizona: Measles outbreak from 2025 continues to grow

A measles outbreak has been underway in Mohave County, along the Arizona-Utah border, since August 2025.

Last year the county had 214 cases. This year, at least 61 cases have been reported, state data show. Officials with the Mohave County Department of Public Health did not respond to an interview request.

Oregon: ‘Worrisome’ infections without obvious source

There have been just 13 measles cases reported across the state of Oregon as of April 3. While not technically an outbreak, Dr. Dean Sidelinger, the state’s epidemiologist, is concerned about hidden spread of the virus.

While the source of some of Oregon’s known measles cases can be traced to travel to another state with an outbreak, disease investigators haven’t found a source for most of the cases.

“That’s very worrisome to us in public health, because that indicates a level of spread in the community that we’re not detecting,” Sidelinger told Healthbeat.

The state’s wastewater testing has also been intermittently detecting measles in areas that don’t correlate with where cases are being reported, he said.

While Sidelinger said 9 out of 10 parents in Oregon have chosen to fully vaccinate their children, the state has localized communities where there are concentrations of unvaccinated people.

“Many of our communities, not just in Oregon, but across the country, who have lower vaccination rates, often have various reasons for that. But some are in more close knit, often faith-based communities that don’t typically seek health care, or maybe have a little bit more of a mistrust or distrust of government,” he said. “We worry that if it gets into one of these communities that it could spread fairly quickly.”

Florida: Cases continue in county with university outbreak

A measles outbreak linked to Ave Maria University in southwest Florida’s Collier County has grown to 106 confirmed and probable cases through April 4, the most recent data available on the state health department’s website. Statewide, there have been 144 measles cases reported since January, including a handful of cases in Broward, Pinellas and Hillsborough counties, the data show.

In recent weeks, spring break travel has resulted in a surge of travelers prompting concerns about the potential for further spread of the virus. The state health department and Ave Maria University didn’t respond to interview requests.

North Dakota: Two outbreaks since February

Since March 23 there have been six cases of measles reported in Ransom County, North Dakota, a largely agricultural area in the southeastern part of the state with a population of about 5,600 people. One person has been hospitalized, according to state data.

Officials at North Dakota Health and Human Services issued a press release on April 1 about the first Ransom County case, saying that the person “likely acquired the infection within the state” and that the case was not linked to a measles outbreak in Pembina County.

A spokesperson for the department said staff were out of the office and unavailable to answer questions about the current status of the outbreaks and efforts to control the spread of the disease.

The outbreak in Pembina County, which is in North Dakota’s northeast corner, involves 23 cases reported in February and March, according to the state’s online data. Four of these people were hospitalized.

A total of 32 cases have been reported across the state since January.

California: An outbreak sparked by travel to South Carolina

In recent months the Sacramento, California region has been experiencing a measles outbreak that was sparked by an unvaccinated toddler who had recently visited South Carolina’s outbreak area.

The toddler’s illness was reported to Sacramento County health officials in late February, then nearby Placer County identified three more measles cases in siblings from a different household who had been exposed to the toddler, according to the California Department of Public Health.

Additional cases have continued to be identified in both counties.

This week, Sacramento County announced that two additional measles cases have been reported. Both are unvaccinated children, raising the county’s number of confirmed cases to five.

“These five confirmed Sacramento County measles cases in recent weeks show the disease is circulating in Sacramento County,” the county health department said in an announcement about the cases. “The overall risk to the general public remains low but residents, especially those who aren’t vaccinated against measles or whose vaccination status is unknown, should be hyper-aware and take steps to protect themselves and others.”

In Placer County, where there have been eight confirmed measles cases, officials also are concerned that measles is spreading in the community. “Nearly all of the measles cases thus far have some association with homeschool enrichment programs in the region, either directly or through family members,” the county health department said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

Michigan measles outbreak shows high cost of stopping even a small number of infections from spreading

2026-04-03T22:40:20+00:00

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The small measles outbreak that health officials are combating in Michigan began last month with an unvaccinated young woman returning home from visiting Florida, a state where there have been more than 140 cases this year.

Her first symptoms around March 7 seemed like a cold. By the time the telltale measles rash appeared a few days later, she had exposed her family and scores of other people in public settings, according to health officials in Washtenaw County, near Detroit.

The Michigan outbreak is one of 17 new outbreaks nationwide reported to the Centers for Disease Control and Prevention since January. There have been 1,671 confirmed cases of measles reported this year across 32 states, according to CDC data.

Most of this year’s cases – 94% – have involved outbreaks. Some – like those in Texas and Florida – involve more than 100 infections. In a few, cases have surged into the hundreds, as is the case in the outbreak in Utah, which is still growing, and the outbreak in South Carolina, which appears to be ending.

Many of the outbreaks are small – just a few cases. But as public health officials in Washtenaw County, Michigan, are learning, the resources required to keep them that way can be enormous.

Staffing costs for managing a handful of measles cases: $45,000

“We’re still at seven cases,” Beth Ann Hamilton, communications coordinator for the Washtenaw County Health Department, told Healthbeat this week. “We’re definitely not out of the woods yet.”

Meanwhile, another measles case announced Thursday in neighboring Monroe County has state health officials concerned that measles may be silently spreading in the community. No definitive link has been established to the cases in Washtenaw County, but the timing and location of the new case are concerning, officials at the state health department said.

Because of this risk, the Michigan Department of Health and Human Services is recommending young children receive their first measles shot early – at 6 months to 11 months of age.

Yet even with just a handful of known measles cases, the containment workload is already taking its toll.

Spring break travel risks spread of measles across U.S.

At the Washtenaw County Health Department, measles control is taking priority over many other health department services as staff have been needed to help track down and counsel hundreds of exposed people, test them for immunity to measles when they don’t have vaccination records, and monitor those in quarantine.

“Seven cases may not seem like a lot, but it is, and it’s hundreds and hundreds of contacts that our staff have to follow up on and monitor,” Jimena Loveluck, the department’s health officer, told the Washtenaw County Board of Health on March 27.

“We’re not able to get other work done,” she said. “We just don’t have the capacity to respond and then continue all our regular level of services. The expense also is tremendous.”

Exposures have occurred at a popular mall in Ann Arbor, a community college, hospital, urgent care clinics, several stores, and a restaurant.

Investigating and managing the exposures of just the initial three or four cases cost $45,000 in staff time, Ruth Kraut, the department’s deputy health officer, told the board. Other health department staff noted that $100,000 in funding from the state to help with the outbreak had been largely spent.

@healthbeatnews
Is South Carolina’s record-breaking measles outbreak nearing its end? ⁠ ⁠ The state has gone more than two weeks without health officials learning of any new cases, but questions remain about how many measles infections have been going unreported. ⁠ ⁠ Healthbeat’s Alison Young breaks down what needs to happen before the outbreak can be declared over. ⁠ ⁠ 🔗 Check out our timeline of South Carolina's outbreak — and stay up-to-date with developments in outbreaks across the country — at Healthbeat.org. #measles #southcarolina #publichealth #outbreak
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“It’s been a huge effort,” Dr. Juan Luis Marquez, the department’s medical director, told the board. “We get lists of students or patients or whatnot. We don’t have much information to go by other than their name and date of birth. So that basically means our team of nurses and other folks calling everybody to verify their immunization status.”

Because two doses of measles-mumps-rubella vaccine is 97% effective at preventing the disease, public health officials are mostly trying to identify those who aren’t protected so they can be advised to quarantine at home and not spread the disease to others.

But people often don’t remember whether they’ve been vaccinated or don’t have access to their immunization records, Marquez said. So then they need to come to the health department clinic to have a blood test to check to see if they have measles immunity from past vaccination or infection.

The result is that the health department’s clinic is largely focused on measles and vaccine response, he said, and communicable disease efforts are being limited to measles and other high-risk cases.

Like forest fires, measles outbreaks are ‘sending out sparks’

A significant challenge for public health officials is that it’s difficult to know which small measles outbreaks can be quickly and easily contained, and which ones will spread to hundreds of people.

Dr. William Moss, a professor at the Johns Hopkins Bloomberg School of Public Health and director of the school’s International Vaccine Access Center, compared the measles landscape across the United States to a map of forest fires.

“You’ve got these bigger outbreaks, they’re kind of sending out sparks,” Moss said. “If that spark lands in a county or a community with high vaccine coverage, you don’t get much spread. And so you see one of these small outbreaks. But if it does land in a community with a large number of individuals who are under vaccinated or unvaccinated, then you get these larger outbreaks.”

It would be helpful to overlay measles cases onto maps with detailed vaccination coverage data, he said. But sources of vaccination data are limited and fragmented, and while school vaccination data can be helpful, it doesn’t include information about adults in the community.

“We and many other groups have been trying to develop ways to predict or forecast, as best we can, where the hotspots are. It’s just very difficult with measles,” Moss said.

Moss said that to know how easily measles will spread requires having detailed information about the coverage levels of vaccination and immunity within very localized communities where people socialize. But such data isn’t readily available, he said.

The places Moss and his team are watching closely are those where cases have been increasing the most in the past few weeks. That includes Hudspeth County, Texas, where the Johns Hopkins U.S. Measles Tracker has tallied 31 cases in recent weeks, and several counties in Utah, which is in the midst of a surge in its outbreak. Many of the cases in Hudspeth County, Texas involve a federal detention facility.

Since it began last year, Utah’s measles outbreak has sickened 559 people, 362 since January. South Carolina’s measles outbreak, the largest in the United States in decades, has had 997 known cases since October – more than 660 of them since January.

The good news: South Carolina health officials haven’t had a measles case reported to them in more than two weeks. If that trend continues for 42 consecutive days – which is two incubation cycles for the measles virus – that outbreak will be declared over after April 26.

As of early March, the South Carolina Department of Public Health told Healthbeat it had spent $1.6 million on its response to the outbreak.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

U.S. scientists sequence 1,000 genomes from measles, a disease long eliminated with vaccines

2026-04-02T19:08:46+00:00

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This week, the Centers for Disease Control and Prevention posted online its first large tranche of advanced genetic data from measles viruses spreading last year. Scientists with knowledge of the operation expect the agency to post heaps more in weeks to come, revealing whether the United States has lost its hard-won measles elimination status.

The CDC withheld the data for months as a team hit hard by mass layoffs and resignations sorted through the information. But now that scientists at the agency have posted their first batch of whole measles genomes — the genetic blueprint of the viruses — the rest should “start flowing more smoothly at a more rapid cadence,” said Kristian Andersen, an evolutionary virologist at the Scripps Research Institute who isn’t involved with the CDC’s effort but is following it.

The CDC did not answer queries from KFF Health News on its timeline for publishing measles data or analyses. However, once all the data is public, researchers can run quick initial analyses that will signal whether outbreaks across the United States last year resulted from the continuous spread of the disease between states, rather than separate introductions from abroad.

If there was continuous transmission for a year, that means the United States has lost its status as a country that has eliminated measles. That status, which the United States has held since 2000, reflects a country’s vaccination rates: Two doses of the measles-mumps-rubella vaccine prevent most infections and so stop outbreaks from growing.

More careful analyses take weeks.

“We should see a report in April,” Andersen said, “assuming no political interference.”

This is the first time that the United States has applied sophisticated genomic techniques to measles, which largely disappeared from the country a quarter-century ago because of broad vaccine uptake.

Declining vaccination rates, misinformation, and the Trump administration’s budget cuts and lagging response to outbreaks have fueled a resurgence of the disease. With at least 2,285 cases in 44 states, 2025 was the worst year for measles in more than three decades. This year is on track to surpass that, with 1,575 cases as of late March.

While welcoming the science, researchers say the government’s top priority should be to stop the virus from spreading.

“I think it’s incredibly important to do whole genome sequencing for outbreaks,” Andersen said, “but we shouldn’t need to do this for measles in the first place, because we have an extremely effective and safe vaccine.”

How the South Carolina measles outbreak grew from 5 to 997 cases

“That we’re even talking about this is nuts,” he added.

Health and Human Services Secretary Robert F. Kennedy Jr. and other government officials should sound an alarm about measles’ comeback and launch nationwide vaccine campaigns, said Rekha Lakshmanan, executive director of The Immunization Partnership, a nonprofit in Houston that advocates for vaccine access.

“I applaud the science,” she said, “but the more urgent need is to get measles under control as quickly as possible.”

Top officials have instead downplayed the seriousness of the disease, and false notions about vaccines have been granted new life in Kennedy’s CDC. This includes abrupt changes to vaccine information on CDC websites that medical associations say aren’t based on evidence and endanger lives.

Kennedy continues to promote unproven remedies that could mislead parents into believing that they can avoid vaccines without consequence. On the Joe Rogan Experience podcast in late February, Kennedy spoke at length about measures to improve America’s health but didn’t mention vaccines. He said preventive measures could entail “holistic medicine, or take vitamins, or take vitamin D, which is, as you know, it’s kind of miraculous.”

“The risk of measles remains low for most of the United States,” HHS spokesperson Emily Hilliard wrote. “CDC has made $8.5 million available to address measles response activities in seven jurisdictions experiencing outbreaks,” she wrote. “The CDC, HHS principles, and the secretary have been vocal that the MMR vaccine is the best way to protect yourself against measles.”

Genomic data hold clues to outbreak spread

In December, the CDC enlisted the help of one of the country’s leading centers for virus sequencing, the Broad Institute in Cambridge, Massachusetts. Major outbreaks in Texas, Utah, and South Carolina had been fueled by the same type of measles virus, labeled D8-9171. But since that type also circulates in Canada and Mexico, researchers need more data to discern whether it spread among states or entered the United States multiple times.

Whole genome sequencing provides that information because viruses evolve over time. The measles virus acquires a mutation every two to four transmissions between people, said Bronwyn MacInnis, director of pathogen surveillance at the Broad.

“There is enough signal in this data to tease apart questions at hand,” MacInnis said, “the main one being sustained transmission within this country.”

MacInnis’ team worked overtime to sequence the entire genomes of inactivated measles viruses that had been collected from states in 2025 and 2026.

“We’ve done about 1,000 samples and delivered the genome data back to the CDC,” sending it on a rolling basis since December, MacInnis said. “This is the CDC’s data to publish.”

The CDC didn’t post a single one of those genomes until late March, when eight appeared on a public database hosted by the National Center for Biotechnology Information. By Wednesday, an additional 154 had gone online.

“It should be on NCBI within a couple of weeks of being produced,” Andersen said, “and certainly not take longer than a month when you have an active outbreak.”

Dora Nabatanzi, a molecular biologist at the Broad Institute in Cambridge, Massachusetts, prepares chemicals needed to sequence the genomes of measles viruses.

Genomic data hold clues about how outbreaks start and spread. It allows researchers to develop tests, treatments, and vaccines — and detect variants that might evade them.

Such data was critical in the Covid pandemic. Chinese and Australian scientists posted the first SARS-CoV-2 genome online on Jan. 10, 2020, within a week of sequencing it. “It definitely shouldn’t take the CDC months,” said Eddie Holmes, the Australian virologist who helped publish the first coronavirus sequence.

One reason for the delay is that the CDC’s measles lab has been sorely understaffed amid mass layoffs and other turmoil at the agency over the past year, a CDC scientist told KFF Health News. Another reason, the researcher added, is a learning curve: The CDC and health departments haven’t needed to sequence hundreds of whole measles genomes before now. (KFF Health News agreed not to identify the scientist, who feared retaliation.)

In contrast with the CDC, the Utah Public Health Lab has shared measles genomes rapidly. Most of some 970 measles genomes posted online since Jan. 1, 2025, were sequenced by the state, hailing from Utah, Arizona, South Carolina, and other states willing to share them.

“We’ve only got a handful of samples from Texas that were collected kind of in the middle of their outbreak,” said Kelly Oakeson, a genomics researcher at the Utah Department of Health and Human Services. The genomes of the Texas and Utah measles viruses are similar but distinct, Oakeson said, meaning that intermediate versions of the virus are missing.

If the genetic code of viruses collected late in the Texas outbreak are a closer match to those from Utah’s, that will suggest that spread was continuous and the country has lost its measles-free status. The hundreds of genome sequences still sitting at the CDC probably hold the answer.

Evaluation of U.S. measles status delayed till November

The CDC expected to finish its analysis before April, said Daniel Salas, executive manager of the immunization program at the Pan American Health Organization, which works with the World Health Organization. That’s when PAHO was slated to evaluate the United States’ measles status.

He said PAHO delayed its evaluation until the organization’s annual meeting in November, partly because the CDC needed more time to do the genomic analysis and partly because the measles status of Mexico, Bolivia, and other countries is also under review, and holding staggered meetings for each country is inefficient.

The United States is the only country using whole genome sequencing to answer the elimination question, Salas said. Typically, countries classify measles viruses according to a tiny snippet of genes, then assume that large outbreaks caused by the same type are linked. Whole genomes provide a more accurate view.

CDC outbreak models warn about underreporting in S.C. measles outbreak

“If the U.S. can fill in the blanks with genomic data, that’s a sort of breakthrough,” Salas said. “That doesn’t mean other countries are going to be able to pull off this kind of analysis,” he added. “It takes a lot of specialized knowledge and resources.”

Equipment to sequence and analyze genomes costs upward of $100,000, and the cost to process each sample, including paying the researchers involved, typically ranges from $100 to $500 per sequence.

“I’m pro-science, but we shouldn’t have to do this,” said Theresa McCarthy Flynn, president of the North Carolina Pediatrics Society. “We don’t have to have a measles epidemic.”

Flynn said she regularly fields questions from parents concerned by misinformation spread by Kennedy and anti-vaccine groups, including the one he founded before joining the Trump administration. Parents have also pointed to changes in the CDC’s recommendations and to its websites that are at odds with the scientific consensus.

Before Kennedy took the helm, a CDC website said “Vaccines do not cause autism” in prominent type, and listed several large studies in premier scientific journals that refuted a link between vaccines and developmental disorders.

Last year, the website shifted to saying, “Studies supporting a link have been ignored by health authorities.” The high-quality studies were replaced with a report from a single investigator who has ties to anti-vaccine groups.

In an email to KFF Health News, Hilliard echoed the altered website’s claims about vaccines, disregarding extensive studies on the topic.

Flynn, of the pediatrics association, said, “The CDC itself is spreading misinformation about vaccines. I cannot overstate the seriousness of this.”

Although the acting director of the CDC, Jay Bhattacharya, says vaccines are the best way to prevent measles, he too has undermined vaccine policy. He said the controversial January decision to reduce the number of vaccines recommended to children was based on “gold standard science.” Hilliard wrote that the updated schedule was “aligning U.S. guidance with international norms.”

In fact, the new schedule makes the United States an outlier among peer nations.

A federal court temporarily invalidated the change last month in a lawsuit brought by the American Academy of Pediatrics and other groups.

Bhattacharya hasn’t held briefings with the public or the press on the surge of measles this year or activated the CDC’s emergency capabilities.

“Normally, we’d have a big push to get vaccination rates up in areas where it’s low. We’d do a big social media push, put out ads on getting vaccinated,” said another CDC scientist whom KFF Health News agreed not to identify, because of fears of retaliation. “People at the CDC want to do this, but political leadership at the agency has not allowed the CDC to do it.”

Further, the Trump administration’s cuts and delays to public health funds have made it hard for local health officials to protect communities. Philip Huang, director at Dallas County Health and Human Services in Texas, said the department lost over $4 million when the administration clawed back about $11 billion from health departments early last year as a measles outbreak surged in the state.

“We lost 27 staff and had to cancel over 20 of our community vaccination efforts, including to schools identified as having low vaccination rates,” he said. “There are simultaneous attacks on immunizations that are making our jobs harder.”

This story has been updated to include comments from Department of Health and Human Services spokesperson Emily Hilliard.

Amy Maxmen is a Healthbeat national reporter through a partnership with KFF Health News.

No new measles cases in South Carolina for a week, but CDC outbreak models warn about underreporting

2026-03-27T09:00:00+00:00

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For the first time since South Carolina’s record-breaking measles outbreak began last fall, the state has gone a full week without health officials learning of any new cases.

It’s an encouraging sign that the outbreak – which has 997 documented cases – may be nearing its end. However a report from outbreak modelers at the Centers for Disease Control and Prevention, completed earlier this month, raises questions about how many measles infections have been going unreported.

“There are likely some undocumented cases of measles in the affected region, raising the risk of spread to other populations in the region or nearby regions,” according to the March 3 risk assessment from the CDC’s Center for Forecasting and Outbreak Analytics.

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Is South Carolina’s record-breaking measles outbreak nearing its end? ⁠ ⁠ The state has gone more than two weeks without health officials learning of any new cases, but questions remain about how many measles infections have been going unreported. ⁠ ⁠ Healthbeat’s Alison Young breaks down what needs to happen before the outbreak can be declared over. ⁠ ⁠ 🔗 Check out our timeline of South Carolina's outbreak — and stay up-to-date with developments in outbreaks across the country — at Healthbeat.org. #measles #southcarolina #publichealth #outbreak
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The assessment says the extent of this underreporting is among several key uncertainties in predicting the future of the largest U.S. measles outbreak in decades.

Before the outbreak can be declared over, there must be a period of 42 days with no new cases – an important sign that chains of transmission of the virus have been broken. The last day of the outbreak would be April 26 if no more cases are reported, Dr. Linda Bell, South Carolina’s state epidemiologist, said Wednesday.

“We remain concerned about the possibility of unrecognized measles transmission, and we remain vigilant in monitoring any potential cases and spread,” Bell said.

State health officials worry spring break travel will spread measles as infections rise across the U.S.

Bell noted that the CDC’s modeling report was completed three weeks ago.

“Since that time, our measles case reports have continued to decline, our surveillance systems indicate this trend reflects a true decrease and not people avoiding health care,” Bell told Healthbeat.

Tests of wastewater in the outbreak area are not detecting measles, nor is there any sign from people going to emergency departments for measles-like symptoms, she said.

CDC officials did not grant interviews, and the agency’s written statements did not answer Healthbeat’s questions about information in the agency’s measles outbreak forecast report for South Carolina.

Scott Thorpe, executive director of the Southern Alliance for Public Health Leadership, said he thinks the state health department is using the best data it has available in its announcements last Friday and again Tuesday that no new measles cases had been reported.

“I think it’s very unlikely we’re at zero,” Thorpe said. “One of the really challenging, frustrating things about measles is that there absolutely can be cases we don’t catch, mild cases in particular.”

The last time South Carolina’s health department reported zero measles cases was on Tuesday, Nov. 4, when the outbreak had just 34 cases. But by Friday, Nov. 7, a case was reported, department records show. State health officials provide case number updates only on Tuesdays and Fridays.

Thorpe said he continues to be concerned about the upcoming spring break travel period increasing measles cases in the area. Many schools in Spartanburg County, where the outbreak is centered, are scheduled to be off for spring break during April 6-10.

It’s a concern Bell has previously expressed as well. South Carolina’s outbreak surged after the winter holiday break period.

‘Inconsistent’ or ‘sub-optimal’ compliance with isolation, quarantine

Outbreak modeling teams at the CDC have produced three “outbreak scenario” assessments for the South Carolina measles outbreak, the first on Jan. 2, plus two updates on Jan. 20 and March 3.

“Throughout the outbreak, our assessment consistently indicated that a larger outbreak, lasting at least six months, with some spread beyond the affected community, is the most likely outcome,” the agency’s outbreak modelers said in a March 6 web post that detailed their assessments.

The South Carolina outbreak was first identified in early October with five known cases.

As of early March, the CDC modelers said positive signs for the outbreak were that the rate of new cases was declining and that there were zero or minimal cases “outside of the affected community in the affected region” and that exposure settings affecting the “general population” had become limited or infrequent. Another positive sign: The number of households, schools, churches, and health care facilities with ongoing measles transmission was limited – a significant improvement from mid- to late January when the outbreak surged.

But in addition to concerns about the likelihood of some underreporting of measles cases, the CDC modelers also wrote that compliance with stay-at-home recommendations by infected and exposed people was “sub-optimal or inconsistent,” and that there had only been low to moderate immunization with the measles-mumps-rubella (MMR) vaccine among unvaccinated people in the area.

“Currently, there is no evidence that unvaccinated residents of the affected region are receiving MMR vaccine in high enough numbers to substantially reduce transmission,” the CDC report said.

How the South Carolina measles outbreak grew from 5 to 997 cases

However, Bell, who is leading South Carolina’s outbreak response, credits increased measles vaccination in recent months as a key reason the number of new measles cases being identified has slowed to a trickle throughout March and to zero reported in the past week. She said that in addition to people who got vaccinated, it is important to also consider that the nearly 1,000 people sickened with measles in the outbreak also acquired protective immunity to the virus through their infections. “That is a very risky way to get immunity,” she said.

“I should also add that our disease containment strategies, our investigation of cases while they’re infectious, and making sure that people remain in isolation, and making sure that people have guidance about being in quarantine, also contributes to preventing ongoing transmission in communities,” Bell said.

CDC forecasts note ‘close-knit’ low-vaccination community

The CDC modelers noted that Spartanburg County, where the outbreak has been concentrated, “is home to a large, close-knit community of about 15,000 people with low vaccination coverage,” and that in schools countywide, just 88.9% of students are vaccinated against measles, compared to a statewide average of 93.7%.

To stop measles from spreading within communities, 95% of the population needs to be vaccinated.

Neither the CDC nor South Carolina’s state health department would identify the “close-knit” community referenced in the CDC outbreak modeling assessments. However state health officials have previously acknowledged outbreak cases and multiple exposure incidents at Slavic-language churches whose members speak Ukrainian and Russian, as well as schools serving students from those communities.

Vaccine hesitancy among Ukrainian and Russian-speaking communities in the United States has been fueled in part by historic distrust of the former Soviet government and its health system, health officials in other states have found.

The CDC’s outbreak assessment updated on March 3 says that the “size of close-knit communities with low vaccination coverage” in the outbreak area, as well as their level of connection to other similar communities across South Carolina is a key uncertainty in predicting the outbreak’s future path.

The assessment notes that much is unknown about the extent of measles vaccination coverage in the region, “particularly among close-knit, under-vaccinated communities.” Use of school vaccination data can be used to help estimate community-wide immunization rates, the report said, but rates vary widely in the region.

Some of South Carolina’s earliest known outbreak cases and exposures involved Global Academy of South Carolina, a public charter school in Spartanburg whose founders are Ukrainian immigrants. Only 21% of Global Academy’s students were up-to-date on their school vaccinations, according to state data.

The Way of Truth Church in Inman, S.C., was identified as the location of a measles exposure incident in early November.

One church, Way of Truth Church in Inman, S.C., was identified as the location of an outbreak exposure incident in early November that resulted in at least 30 measles infections during the weeks that followed, according to state outbreak updates. Over the Christmas holiday period, multiple Slavic churches were associated with measles cases and exposure incidents, according to state outbreak updates. School and church officials have declined or not responded to past interview requests.

‘Intrusion into your life’ when families seek care for measles

Another key uncertainty impacting the future of the outbreak, according to the CDC outbreak modelers, is how quickly people who are experiencing measles symptoms or who have been exposed get tested and seek health care.

The report says “avoidance of testing or health care could give the impression that transmission is slowing when that is not the case.”

The CDC outbreak modelers are not alone in their concern about underreporting of measles cases in the South Carolina outbreak.

Dr. Robin LaCroix, a pediatric infectious disease specialist with Prisma Health, one of the major health systems treating measles cases in South Carolina’s Upstate outbreak area, said earlier this month that underreporting is a “big concern.” LaCroix noted the potential “intrusion” of public health investigations after health care providers notify health officials, as required, about measles cases.

“I think that we have captured only a fraction of the people who have become infected with measles because if you were not ill enough to seek medical care, you are never captured in the numbers that are reported, “ LaCroix told the Why Should I Trust You podcast.

“When you began to see what happened when you sought medical care – you had a call from the DPH, who wanted to know everywhere you had been for the four days before you became ill, or your child became ill, and there was a lot of intrusion into your life and activities related to that,” said LaCroix.

In addition, she said, an infected child’s school also would get reported to public health and other unvaccinated children who were exposed would be sent home for 21 days of quarantine.

“There were big community consequences around coming forward that my child has measles, and so then you open yourself up for again some ostracization within the community, that you caused us to have to send all of our children home. So I do think that there is an underreporting,” LaCroix said.

Prisma Health spokesperson Tammie Epps said LaCroix was unavailable for an interview with Healthbeat.

While Bell said she remains concerned that there may be some unrecognized measles cases, if they are out there and aren’t seeking medical care, she doesn’t think there are currently many because there are no signs of them in wastewater testing and other surveillance systems.

“We don’t see indications there are large numbers of unrecognized measles cases because people are self-isolating,” she said.

“No surveillance system captures 100% of cases,” Bell said, “but with a highly infectious disease like measles, if ongoing transmission were occurring from many unreported cases, it is more likely to be detected by at least one of these means in addition to provider reporting.”

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Spring break 2026: Travel season risks spread of measles across U.S., state officials tell Healthbeat

2026-03-19T09:00:00+00:00

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The spring break travel season is underway, with tens of thousands of people every day clogging U.S. airports in their quest for sun, surf, theme parks, big city excitement, and other getaways.

It’s a scene that worries public health officials amid another bad year for measles across the country – and the potential for increased spread of the highly contagious disease during this busy travel period.

“It feels like whack-a-mole right now,” said Scott Thorpe, executive director of the Southern Alliance for Public Health Leadership. “Just as the numbers are dying down in South Carolina, you see this big jump in cases in Utah. Then you see cases starting to pop up in other places across the South.”

State health department officials in multiple states – including California, Utah, Colorado, Georgia, and South Carolina – told Healthbeat they are concerned about spring break travel and the potential for measles to spread within and between states.

Driving those concerns: Spring break is happening with the United States on a trajectory to exceed last year’s record-breaking number of measles infections – the worst since 1992.

This year the Centers for Disease Control and Prevention has already logged 1,362 confirmed cases of measles across the country through mid-March, mostly among unvaccinated children and teens. In less than three months, that’s more than half of the 2,284 measles cases confirmed during all of last year.

Since January, there have been at least 14 new measles outbreaks identified across the country, including in Florida, California, Washington state, Texas, and Colorado. These are in addition to ongoing outbreaks that began last year in South Carolina, Utah, and Arizona. Across the country, 30 states have reported at least one measles case this year, CDC data show.

Measles, which is one of the most contagious viruses for humans, is transmitted through the air when an infected person breathes or coughs. The virus can linger in a room for up to two hours.

The disease is preventable with vaccination. Two doses of the measles-mumps-rubella shot are 97% effective in preventing measles; one dose is 93% effective.

Most of those being infected with measles aren’t immunized. Nationwide, about 92% were unvaccinated or had an unknown vaccination status, according to CDC data.

“As vaccination rates have just broadly declined across all these communities, it’s just incredibly hard to stop. And that’s just going to get worse,” Thorpe said. “Short of something crazy happening, we’re absolutely going to blow through what our numbers were for last year.”

The contribution of spring break exposures to these national measles case counts won’t be known for several weeks.

After a susceptible person is exposed to the virus, it can take one to three weeks for them to start falling ill with initial symptoms that may seem like a cold or the flu. By the time the hallmark measles rash appears, they will have been infectious for four days – potentially spreading the virus to even more people.

“Everybody’s on high alert,” said Pat Endsley, president-elect of the National Association of School Nurses.

Top spring break destination Florida is No. 3 for measles

Dr. Rana Alissa, president of the Florida chapter of the American Academy of Pediatrics, told Healthbeat she’s very concerned about the potential for spring break travel to spread measles infections – especially in her home state, which already has measles cases in several communities, plus a large outbreak linked to a university.

Florida – with 116 confirmed measles cases since January – ranks No. 3 in the nation for 2026, behind South Carolina and Utah, which continue to battle outbreaks that began last year, according to the latest CDC data.

“Everyone wants to come to Florida,” Alissa said. “It’s always crowded. Orlando is going to be crazy, Daytona Beach, Clearwater, Miami.”

With these crowds comes an increased risk that some of the people are carrying measles. “It is very scary,” said Alissa, who is advising unvaccinated infants and children, as well as people with weakened immune systems, to avoid crowded areas because of the risk of measles.

Besides a fever and rash, measles can cause serious and sometimes life-threatening complications, including pneumonia and dangerous swelling of the brain, as well as “immune amnesia,” which increases a person’s susceptibility to other diseases in the future. Pregnant women and their babies are also at increased risk of complications from measles.

In addition to being a top state for measles this year, Florida is a perennial spring break hot spot. Cities throughout the state continue to be among the nation’s top spring break destinations, according to 2026 booking data from AAA and Booking.com.

At Tampa International Airport, the spring break travel surge is underway, with about 75,000 to 80,000 passengers a day expected through April 13. The biggest travel day, the airport predicts, will be this coming Sunday, when 90,000 travelers are expected to pass through the airport.

In Orlando, airport officials expect this week to bring some of their highest passenger volumes of the spring break period, with nearly 212,000 passengers arriving and departing last Sunday, plus another 205,000 passengers on Monday.

Florida health department won’t discuss large measles outbreak

Officials with the Florida Department of Health did not answer questions from Healthbeat since March 6 about the risks posed by spring break travel to and from the state, and what kinds of measles prevention and control activities the department is performing.

The department’s top official, Florida Surgeon General Joseph Ladapo, last fall announced plans to end all school-age vaccine requirements in the state, a move that has faced resistance in the legislature. In 2024, during a measles outbreak at a South Florida elementary school, Ladapo sent a letter to parents allowing them to keep sending their unvaccinated children to class, despite their risk of infection.

Most of Florida’s measles cases this year are part of a large outbreak linked to Ave Maria University in southwest Florida’s Collier County, about 35 miles northeast of Naples. At least 98 confirmed and suspected measles cases have been diagnosed in the county through March 7, according to state health department data. Five of those cases were reported during the first week of March, the data indicate.

Despite repeated requests, officials at the Catholic university did not respond to Healthbeat’s questions, including about the current status of the outbreak and any actions being taken to address the potential health impact of the school’s Easter break, scheduled for April 2-6.

Florida’s health department also wouldn’t discuss the university’s outbreak or answer Healthbeat’s questions about other locations in the state where ongoing spread of measles may be occurring, and how many people statewide are in quarantine because of measles exposures. While such information – which doesn’t involve identifying specific patients – is routinely made public in other states, the Florida health department’s media relations team said it was unable to discuss ongoing epidemiological investigations because of state confidentiality statutes.

The department’s data show at least 12 other Florida counties have reported confirmed or probable measles cases since January. They include the Tampa-St. Petersburg area, where six cases have been diagnosed in Pinellas County, and two more in Hillsborough County. In the Jacksonville area, Duval County has reported six cases; in the Pensacola area, Escambia County has identified five cases; and in South Florida, two cases have been diagnosed in Broward County and one in Miami-Dade County .

Concerns about measles extend beyond spring break hot spots

In response to interview requests and questions about rising U.S. measles cases and spring break travel sent earlier this month to the CDC, a spokesperson for the U.S. Department of Health and Human Services emphasized the risk of measles being imported from other countries.

“The risk of measles remains low for most of the United States due to high population-level immunity from MMR vaccination,” press secretary Emily Hilliard said in an email Tuesday night to Healthbeat. “That said, anyone who is not protected against measles is at risk if exposed. Since measles is common in many countries, unvaccinated travelers can bring measles to the United States at any time, and it can spread to other people who are not protected against measles.”

Hilliard said the CDC is supplying technical support and funding to states dealing with outbreaks and that vaccination is the best protection, “especially if you plan to travel internationally or to a place with a measles outbreak.”

While international travel can play a role in U.S. measles cases, according to CDC data, only nine of the 1,362 confirmed U.S. measles cases since January involved international visitors; last year just 25 of the 2,284 confirmed cases were international visitors. In both years, most of the measles cases across the country have involved outbreaks where the virus has spread from person to person within U.S. communities with low vaccination rates, such as those that have occurred in South Carolina, Texas, Arizona, New Mexico and other states.

As a growing number of states are already dealing with measles cases this year, officials at several state health departments expressed concerns about the risks posed by spring break travel.

This year California has had three outbreaks of measles – the first outbreaks in the state since 2020. Some of these California cases are linked to an unvaccinated toddler who had recently traveled to a measles outbreak area in South Carolina.

As of Monday, California has had 29 confirmed cases of measles; two have been hospitalized, according to the California Department of Public Health.

“International or domestic travel during spring break carries a risk of transmitting measles to Californians,” the department said in an email. “CDPH continues to closely monitor measles and to work with medical and public health partners to limit its spread during and after the spring break travel season.”

Georgia Department of Public Health spokesperson Nancy Nydam Shirek said that while people who are not immunized against measles are at high risk any time they are exposed to the virus, “that risk increases if they visit crowded tourist destinations, travel through airports, or go to areas with ongoing measles outbreaks.”

Two doses of the measles-mumps-rubella shot are 97% effective in preventing measles; one dose is 93% effective.

Two cases of measles have been reported this year in Georgia. One involved a baby too young to be routinely vaccinated who became infected during international travel. State health officials said they don’t know how the other case, a resident of Bryan County near Savannah, became infected and they cannot rule out unrecognized spread of the virus within the state, Healthbeat reported earlier this month.

In Utah, the spring break travel surge comes at a precarious time in the state’s measles outbreak, which began last year and has resulted in 443 reported infections as of Tuesday.

“What is concerning to me is we are seeing spread of this disease through our entire state,” Dr. Leisha Nolen, Utah’s state epidemiologist, said at a media briefing earlier this month. “For a while it was really limited to the southern part of the state, but it is now expanding, and we are having people diagnosed in every part of our state. And these are not just mild infections.”

Measles infections in Utah have resulted in more than 120 people going to emergency rooms, 31 needing to be admitted overnight, and three needing treatment in an intensive care unit, she said.

While the disease has spread in a variety of settings, Utah officials said cases involving school activities are noteworthy.

“We have definitely seen people get infected with measles from wrestling events, from dance-drill teams and from basketball. So we really encourage people to protect their children,” she said. “The measles vaccine is the best thing to protect your child. It is how we can stop this infection.”

In Colorado, where as of Monday 11 cases of measles have been identified along with multiple locations where infectious people potentially exposed others, state health officials said they are working to raise public awareness through media campaigns and provider webinars. The department also is doing direct outreach to families whose children are overdue for their MMR vaccines. In 2025 and 2026, this outreach resulted in 48% of the contacted families getting their children immunized, the department said.

South Carolina shows how holiday breaks can fuel outbreaks

“Measles is spread very easily to anyone who is susceptible,” said Dr. Linda Bell, state epidemiologist in South Carolina, where officials worry spring break travel could reignite an outbreak that has sickened nearly 1,000 people since last fall.

The outbreak has slowed to a trickle in recent weeks. After months of tracking cases, quarantining exposed people, and urging vaccination, the state health department announced Tuesday just one new measles case, bringing the total to four cases identified in the past week.

“The risk of spread is increased by the number of people exposed,” Bell said, “so things like air travel and people visiting tourist attractions during holiday breaks are a concern.”

It’s a risk South Carolina officials watched play out in mid-January, when measles cases surged to hundreds of cases a week after the winter holiday break period where gatherings with families and friends fueled the spread of the disease – not only within South Carolina, but to other states. The department’s measles control efforts were further hampered because outbreak investigators couldn’t get contact information from schools during winter break closures, delaying the quarantine of exposed students, an issue the department is trying to fix for spring break.

As infected South Carolina residents traveled the country during the winter break period, internal health department records show they exposed others to measles at travel convenience stores in Georgia and Florida, at a hotel and a youth conference in Kentucky, and at a hospital and a hotel in Florida, Healthbeat revealed last month.

Many schools in Spartanburg County, the epicenter of South Carolina’s outbreak, are scheduled to close for spring break the week of April 6-10.

State officials remain concerned there could be another surge in cases.

“It is far too early for us to let our guard down,” Bell said Wednesday. “We will see what happens with spring break.”

The problem is there are still many more unvaccinated people in South Carolina and across the country for the virus to infect.

To stop measles from spreading within local communities, 95% of the population needs to be vaccinated. But in most states, statewide vaccination rates among kindergartners have fallen below that “herd immunity” level, according to CDC data. And even where vaccination rates may seem high on a statewide or countywide level, pockets of unvaccinated children and adults within localized communities can still fuel outbreaks, experts said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

Doctors warn of a deadly complication from measles outbreaks

2026-03-13T15:57:15+00:00

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The first sign came when Deepanwita Dasgupta was 5 and started stumbling more while playing at her home in Bangalore in southern India. The girl was always up to something, so her parents figured extra bumps and bruises were just symptoms of an active childhood. Maybe, they thought, it was ill-fitting shoes.

Relatives described the unicorn-loving child as smart, affectionate, and occasionally rascally. Before she learned the alphabet, she had figured out how to find her favorite show, “Blippi,” on a phone. She was known to sneak butter from the fridge to enjoy a few finger licks.

But then her limbs started jerking. A spinal tap revealed measles in her cerebrospinal fluid. The virus she probably had as an infant had secretly made its way to her brain. Now 8 years old, Deepanwita is paralyzed, unable to talk.

Measles causes complications — ranging from diarrhea to death — in 3 in 10 infected people, according to the Infectious Diseases Society of America. Some are immediate, while others take weeks or months to appear. The one Deepanwita is experiencing, subacute sclerosing panencephalitis, or SSPE, typically takes years to rear its head.

“People think, ‘Oh, you know, if we get measles, then we’ll be fine, because I know my neighbor had it and they’re fine,’” said Yasmin Khakoo, who leads the national Child Neurology Society but spoke to KFF Health News in her capacity as a New York City doctor with expertise in neurologic conditions.

South Carolina wants to avoid a spring break measles outbreak surge, enlists school help during closures

Measles, though, can be dangerous: A 7-year-old in South Carolina will have to relearn how to walk after enduring one of the more immediate complications, brain swelling. And every so often, the virus plants a ticking time bomb in the nervous system. A person can recover from measles and continue life as usual, no longer contagious and without any identifiable symptoms — sometimes for a decade or more — before problems appear. While some patients end up severely disabled for a while, Khakoo said, the condition is almost always fatal.

Before the advent of widespread and effective vaccines, the complication occurred enough in the United States that in the 1960s a doctor created a national registry of SSPE patients. Researchers now estimate about 1 in 10,000 people who get measles will develop SSPE, but the risk is significantly higher for those who contract measles before age 5. Populous nations where the virus is endemic, including India, see cases routinely.

Now, doctors and researchers fear that as vaccination rates drop and measles spreads in the United States, cases of this debilitating complication will also rise here. Since the start of 2025, the Centers for Disease Control and Prevention has recorded over 3,500 measles cases — more than in the entire preceding decade — mostly people who were unvaccinated. Many were children. Last year, Connecticut doctors diagnosed a 6-year-old with SSPE, and in California, a school-age child who’d had measles as an infant died of it.

“We are likely to see SSPE cases going forward, especially if we don’t get this under control,” said Adam Ratner, a member of the American Academy of Pediatrics’ Committee on Infectious Diseases and author of the book "Booster Shots."

Concern about SSPE was great enough that in January, the Child Neurology Society published a video to educate U.S. clinicians about the condition, and doctors who have seen such cases are warning their peers.

“We don’t have a way of knowing who’s going to get it, and we don’t have a way of very effectively treating it,” said Aaron Nelson, a professor of neurology with the New York University Grossman School of Medicine. “The one best thing that we can do, ideally, is to prevent children from having to go through it in the first place.”

The recommended two-dose measles vaccine slashes an exposed person’s risk of getting the contagious virus from 90% to 3% — and thus reduces the chance of SSPE. The vaccines carry small risks of febrile seizure and a bleeding condition, but measles itself has a higher risk of causing both.

Researchers find some missed SSPE cases

A 2017 study of California children who developed SSPE after a measles outbreak there years ago determined that 1 case is diagnosed for about every 1,400 known cases of measles in children under age 5, and 1 for every 600 infected babies.

The researchers also found that, over the years, doctors had missed some cases among patients who had died with undiagnosed neurologic illness.

The possibility that future cases could go undiagnosed spurred Nava Yeganeh and her colleagues to publish a news release in September when a Los Angeles County child died of SSPE.

Deepanwita Dasgupta and her mother, Anindita Dasgupta, celebrate the child’s fifth birthday in 2022.

“We’ve had very few cases of measles in the last 25 years in this country,” said Yeganeh, who is the medical director with the Vaccine Preventable Disease Control Program at the Los Angeles County public health department and has had two patients with SSPE. “Unfortunately, that’s changing, and so we wanted to make sure that everyone was aware of this long-term complication.”

The California child who died had gotten measles as an infant, Yeganeh said, before the child could receive the vaccine. Measles is highly contagious, so at least 95% of the population must be immune to it to protect vulnerable people — including babies too young to vaccinate and people who are immunocompromised — from infection.

“This is an example of someone who did everything right, wanted to protect their child against this infection, and unfortunately ended up losing their child because we didn’t have herd immunity for them,” Yeganeh said.

Shortly after Yeganeh’s group published the news release in California, Nelson was working to get the word out, too.

He had recently seen a 5-year-old whose family had traveled to the United States for medical care after the child started stumbling, jerking, hallucinating about bugs and animals, and having seizures. The child had contracted measles as an infant and had been too young to be vaccinated. Nelson diagnosed the child with SSPE.

“Imagine that: Having a child who is healthy and happy, moving to talking less and less, eventually not able to walk,” Nelson said. “It’s a very sad thing.”

He thought he would encounter the condition only in medical school textbooks, as a relic of the past. Instead, in October he found himself presenting the case at the Child Neurology Society’s national conference and participating in the society’s video about the condition. “I’ve now seen something I shouldn’t have ideally seen ever in my career,” he said.

Warning signs come from India

Globally, the number of measles outbreaks has increased in recent years, and physicians in places including the U.K. and Italy have recently seen clusters of SSPE.

The high human cost of measles’ spread is especially evident in India. While total cases aren’t tracked, about 200 families caring for people with SSPE, including Deepanwita’s, are in a single chat group in the Bangalore area.

In New Delhi, Sheffali Gulati studies SSPE and sees about 10 new patients a year with the condition, what she calls the “delayed echo” of measles outbreaks. The youngest she has seen was 3 years old.

“The ages are coming down, and a death or a vegetative state can develop as soon as in six months to five years of onset,” said Gulati, who leads the pediatric neurology program at the All India Institute of Medical Sciences and until recently led India’s Association of Child Neurology.

Gulati hasn’t found any treatments that reverse SSPE’s course, only some that slow its progress. She’s found herself counseling parents: It’s catastrophic, it’s not their fault, and they can do nothing but accept it.

Deepanwita’s relatives try to find joy where they can. They think they noticed the girl smiling when her favorite cousin called recently. Anindita Dasgupta, her mother, said Deepanwita moves her hands and feet on her own and sometimes turns her head, especially when her father enters the room. The girl communicates with her parents through her eyes and a few sounds.

But it’s far from where she was in 2022: At a cousin’s birthday, a few months before noticeable symptoms started, Deepanwita started the birthday song and sang the loudest.

At her own 8th-birthday gathering last year, Deepanwita, wearing a pink eyelet dress and a nasal tube, could only blink and move her eyes as she sat propped up before two cakes that she would not be able to eat. She can no longer swallow, so her mom dabbed a bit of icing on her tongue.

‘The problem could be solved with vaccination’

Roberto Cattaneo, a molecular biologist at the Mayo Clinic in Rochester, Minnesota, has been studying SSPE for years. He recently used postmortem brain tissue to map how the measles virus can spread from the frontal cortex to colonize the entire brain. Still, he said it’s a “black box” what exactly measles is doing in those dormant years between the initial infection and when the symptoms of neurologic damage crop up.

It’s possible the virus replicates in the brain that whole time, undetected, killing off neurons. But with so many neurons in the human brain — 10 times as many as people living on the planet — the brain may find a way to adjust, Cattaneo said, until finally it can’t anymore.

He’s applying for funding to continue research on the disease and possible treatments, though ultimately, he wishes he didn’t have to. The tools to obliterate the condition already exist.

“The problem could be solved with vaccination,” Cattaneo said. The United States should have no cases of SSPE, he said. “It’s just painful.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

South Carolina wants to avoid a spring break measles outbreak surge, enlists school help during closures

2026-03-12T21:28:16+00:00

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Amid concerns that spring break could reignite South Carolina’s measles outbreak, state health officials are trying to avoid a repeat of the communication gaps that delayed measles exposure investigations when schools were closed for winter break.

Healthbeat revealed last month that the South Carolina Department of Public Health was hamstrung in late December in its efforts to quickly warn and quarantine students and staff who had been exposed to measles. The problem: Schools were closed over winter break and they had nobody available to provide contact information to outbreak investigators.

The result was that people who were unaware they were infectious continued to interact with others in the community during the busy winter holiday season. In the weeks that followed, cases of measles surged dramatically and the South Carolina outbreak became one of the largest in decades.

“We are concerned that we may see another surge in cases,” Dr. Linda Bell, South Carolina’s state epidemiologist said. “So we have actually been in contact with schools to work with them more closely, to make sure that we have points of contact.”

Bell said Thursday that the department has sent letters to schools in South Carolina’s 11-county Upstate region asking them to identify a person who will be available during the spring break vacation period – when schools and administrative offices are closed – who can provide school attendance and contact information if it is needed for measles exposure investigations.

Here's how the S.C. measles outbreak grew after the holidays

“We’ve been receiving steady responses from the schools for those points of contact,” she said.

The health department said late Thursday that the letters, which requested contact information by March 10, were sent to all public school superintendents in the Upstate region. Only 11 of the 23 superintendents had supplied contacts as of Thursday. “DPH has previously established contacts at private and charter schools that have been impacted by the outbreak,” the department said.

Of the 993 measles cases recorded since the outbreak was identified in October, 936 have been in Spartanburg County and most of the others in nearby Upstate counties, according to state data. Almost all of those who have been infected were unvaccinated and most have been school-age children and teens.

In recent weeks, the number of new measles cases being reported to the department has slowed to a trickle. On Monday, the health department said just two new cases had been identified since Friday.

In Spartanburg County, spring break is scheduled for April 6-10 for many schools, but dates vary throughout the state.

“We’re very encouraged by the decline in cases, but we won’t be able to declare this outbreak over until we’re certain that measles transmission has ended,” Bell said. School holiday break periods pose an increased risk for the spread of measles because they often involve people traveling and socializing more.

The winter holiday break was a time of significant spreading of measles in the Spartanburg area.

Between early October – when the outbreak began – and Dec. 22, when Spartanburg County schools closed for winter break, there had been a total of 144 measles cases during the nearly three-month period. Then, in just the three weeks after schools reopened in January, there were more than 500 new cases of measles, state data show.

When Healthbeat asked South Carolina’s health department last month why it hadn’t reached out to schools to have contacts in place before winter break, the department said: “DPH cannot direct school employees to come to work to assist with outbreak investigations.”

Bell on Thursday said the new outreach to schools is an example of the department incorporating lessons learned into its outbreak response. “DPH has made the ability to communicate with school officials who have access to the information needed for case investigation a priority ahead of the upcoming spring break,” she said.

Measles is highly contagious and spreads through the air when an infected person breathes, coughs, or sneezes. The virus can linger in a room for up to two hours after an infectious person has left. Because a person is infectious for four days before the telltale measles rash appears, and initial symptoms may seem like a cold, many people spread the disease before they know they have it.

While two doses of the measles-mumps-rubella vaccine is 97% effective in preventing measles, those who are unvaccinated are at high risk of infection if they are exposed.

Christian school refused to share student information

Based on internal health department records, Healthbeat reported last month that during winter break there were delays quarantining people who had been exposed to measles – just prior to the holiday recess – at three public schools and one private Christian school.

In most cases, the schools were closed and didn’t have anyone available to provide information.

But when outbreak investigators reached Westgate Christian School in Spartanburg, the principal refused to provide information required to ensure those at risk of spreading the disease knew of the need to stay in quarantine, according to a health department warning letter to the school that Healthbeat recently obtained under South Carolina’s public records law.

According to the Jan. 9 letter, Westgate Christian School Principal Gail Grab responded to requests for information about exposed students by sending an email on Dec. 30 that said in part: “We will not provide personal details and immunization status information for the students in our school.”

Then when Grab sent outbreak investigators a list of exposed students on Dec. 31, the only names on it were the siblings of the person who had measles.

The department’s “final warning” letter on Jan. 9 gave the school until 1 p.m. the next day to provide the required information about all students who were had contact with the person with measles or the department would issue a public health order, under which the school could face fines of $1,000 per day for each exposed student’s name left off the list.

“Your continued failure to comply with this lawful demand has significantly impeded DPH’s ability to conduct mandatory case investigation, contact tracing, and quarantine monitoring,” the letter said. “This lack of cooperation places quarantined students, school staff, and the families of your students at increased and unnecessary risk of measles exposure, a highly contagious and serious disease.”

The school did comply before the deadline, Bell said.

Grab did not respond to requests for an interview on Wednesday. Pastor James Wooten, Westgate Christian’s president, replied Wednesday to emailed questions about the letter by saying he was traveling. He previously told Healthbeat that the school thought it had provided all necessary information on Dec. 31. He did not previously disclose that the school’s principal had sent an email refusing to provide required information.

Plans unclear at schools with past delayed measles investigations

Officials at the other three schools where state investigations of measles exposure incidents were delayed during winter break did not answer Healthbeat’s questions Wednesday and Thursday about any changes they have made for the upcoming spring break period.

Mark Robertson, principal at Global Academy of South Carolina, a public charter school where state records show only 21% of students are up-to-date with school immunizations, said he had no comment.

A vaccination rate of 95% is needed in communities to stop the spread of measles.

South Carolina has spent $1.6 million to combat its huge measles outbreak – and it’s not over yet

Cynthia Robinson, a spokesperson for Spartanburg County School District 6, did not respond to emails and calls on Wednesday and Thursday. Delays investigating measles cases over winter break occurred at the district’s Jesse S. Bobo Elementary School, where state data show 94% of students are up-to-date on vaccines.

Other schools that had delayed measles exposure investigations over winter break were in Spartanburg County School District 2: Sugar Ridge Elementary, where state data show 78% of students are up-to-date on vaccines, and Boiling Springs Elementary, where 80% of students are up-to-date on vaccines, also had delays investigating measles exposures during winter break, Healthbeat previously reported.

Adrian Acosta, a District 2 spokesperson, did not answer Healthbeat’s questions about what the district will do differently during spring break to avoid the winter break problems providing health officials with measles contact tracing information.

Acosta first sent a statement saying a district nurse supervisor is available 24/7. Then when asked if this person will be available during the spring break vacation period, Acosta emailed another statement saying school administrators are “always on the job.” Acosta added: “If an administrator knows they will be out of touch or unreachable, then it is expected that they have a communication plan in place.”

But Acosta did not respond to questions about what the district will do differently during spring break to prevent a recurrence of the delays.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Source of Georgia measles case remains a mystery as people who were exposed continue quarantine

2026-03-05T19:25:28+00:00

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How and where an unvaccinated Georgia resident recently became infected with measles remains unknown and multiple unvaccinated people continue to be in quarantine because they are at risk of developing the disease, according to the state’s health department.

It is unknown whether the person – a resident of Bryan County, near Savannah – became infected in Georgia through undetected measles spreading within the state, or if the infection occurred during recent travel to Washington, D.C., the Georgia Department of Public Health said Thursday in response to questions from Healthbeat.

“We cannot definitively determine whether the individual was infected in Georgia or during travel, but there is no record of exposure to a known case of measles,” said department spokesperson Nancy Nydam Shirek.

The District of Columbia has reported no confirmed cases of measles through Feb. 26, according to the Centers for Disease Control and Prevention. While the D.C. health department has issued alerts about infectious visitors potentially exposing others to measles at events in the nation’s capital, the Georgia person didn’t attend any of those kinds of gatherings, Nydam Shirek said.

Here's how the South Carolina measles outbreak grew

Nationwide, the United States is on track to have another record year of measles cases. During 2025, there were 2,281 confirmed measles cases across the country, according to the CDC. In just the first two months of this year, the CDC has confirmed 1,136 measles cases.

While infectious, state health investigators determined that the Bryan County resident exposed “several dozen” other people in Georgia to the highly contagious measles virus. Most were protected against the disease with up-to-date vaccinations. However, “fewer than 20” were not vaccinated against measles and are in quarantine or under active monitoring, Nydam Shirek said.

While it usually takes about seven to 14 days after exposure for an infected person to start showing symptoms of measles, it can take as long as 21 days. The incubation period for those exposed to the Bryan County person ends on March 15, Nydam Shirek said.

“To date, there are no reported cases of secondary measles infection,” she said.

The department has not announced any locations of public places where the infected person exposed others to the virus. According to media reports, officials at Bryan County Schools last month notified parents that the infectious person was at Bryan County Middle High School on Feb. 13. The district’s spokesperson, Melissa Roberts, did not respond to Healthbeat’s questions on Wednesday and Thursday.

Nydam Shirek said the state health department does not issue public notifications about school exposure incidents. “When there is a school exposure, the communication comes from the school, not DPH,” she said. In other states, such as South Carolina, which is experiencing a major outbreak, the health department also alerts the public about school exposures.

There were no other public locations, such as restaurants or stores, where exposures occurred, Nydam Shirek said, and all people who were exposed have been notified.

So far this year, Georgia has identified one other measles case. It involved a baby who was too young to be routinely vaccinated against measles who became infected during international travel, state health officials said in January.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

South Carolina has spent $1.6 million to combat its huge measles outbreak – and it’s not over yet

2026-03-04T23:49:23+00:00

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South Carolina has spent an estimated $1.6 million so far on public health efforts to combat its huge measles outbreak, according to information the state’s health department provided to Healthbeat on Wednesday.

The outbreak, which began with just five known cases in October, surged in January following the winter holidays, and has slowed in recent weeks. The total number of people infected in the outbreak, which is centered around Spartanburg County, reached 990 this week.

Most of the estimated $1.6 million spent so far on the outbreak response has been for personnel, the South Carolina Department of Public Health said in response to Healthbeat’s questions.

As the outbreak grew, the number of staff assigned to work full-time on the outbreak grew to as many as 90 people, said Dr. Linda Bell, the state epidemiologist.

Most of these staff, Bell said, have been involved in doing investigations of individual measles cases and tracing their contacts to help identify and quarantine those at risk of infection and further spread of the disease.

S.C. measles cases surged after holiday school closures delayed outbreak investigations

Funding for some of the outbreak’s public health costs has come from the Centers for Disease Control and Prevention, through an immunizations cooperative agreement, which helps with outbreak response activities, the South Carolina DPH said. Additional funding has come from a H5N1 Public Health Crisis Response Cooperative Agreement, which funds influenza and other public health emergency preparedness and response, the department said, as well as some other state and federal funds.

Although the number of new measles cases being detected each week has dropped significantly, the outbreak continues. The department said that final costs will be calculated once the outbreak is over.

But the threat the outbreak could surge again remains – especially with the potential for the virus to spread during the upcoming spring break travel period, Bell said.

“We remain concerned and must be mindful of the fact that we can see cases increase again from the low number that we’re seeing now,” she said. In recent weeks, the outbreak has slowed to about 10 new cases a week amid increases in measles vaccination in the Spartanburg County area and across the state.

The increased travel during school spring break raises the potential for the kind of increased spread of measles that South Carolina experienced over schools’ winter break period. “In the two consecutive weeks following the Christmas holidays, we had over 200 cases reported in each of those weeks,” Bell said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

Huge S.C. measles outbreak slows, fueling cautious optimism it may end earlier than predicted

2026-02-25T21:56:44+00:00

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South Carolina’s huge measles outbreak has slowed significantly in recent weeks, raising hopes among health officials that the disease’s spread might end sooner than expected, the state’s epidemiologist said Wednesday.

Since Feb. 17, the South Carolina Department of Public Health has documented 17 new measles cases. That’s far fewer than the 100 or more new cases being identified every few days during mid-January, when the outbreak spiked following the winter holidays.

“We’re encouraged with the downward trend, particularly in the last two weeks,” said Dr. Linda Bell, who has been leading the state’s response since the outbreak was identified in October with an initial five cases.

Since then, 979 people – mostly school-age children – have been sickened with measles. All but 52 of the cases have been in Spartanburg County; about 95% have been among people who were not vaccinated.

“No one should underestimate the hard work and long hours that front-line, often entry level epidemiologists have put into this response, and [who] are largely responsible for this downward trend that is actually occurring a bit earlier than previously projected,” Bell said.

Earlier in the outbreak, Bell said that modeling had suggested the outbreak might last for as long as six months.

“The case counts per week now are really down to the level that we were seeing at the beginning of December,” she said. “We are now 22 weeks into this and we hope, with that continued downward trend, in parallel to the hope that vaccination coverage will increase, will help us end this sooner than was originally projected.”

Bell said the department has asked the Centers for Disease Control and Prevention to assist the department in the coming weeks to do studies to help learn from the outbreak, including studies that examine chains of transmission and the costs associated with the public health response to the outbreak, as well as health care costs.

Officials remain concerned, however, that the outbreak has the potential to spike yet again. “This is not over yet. It’s not nearly over yet,” Bell said. “It is these pockets of under-vaccinated people who remain susceptible. That ongoing susceptibility in our population may continue to fuel ongoing spread.”

To stop measles outbreaks from spreading in localized communities, at least 95% of people need to be vaccinated. But in Spartanburg County, state health officials have said measles vaccination rates for school children across the county are just 90% – and they are even lower within some individual schools and communities.

“Many of the schools in Spartanburg County have some of the lowest vaccination coverage rates in the state,” Bell said. “So all of those are contributing to the reason that the outbreak has been focused in Spartanburg County, because of higher risk there, because of lower coverage.”

This is also a likely contributing factor for why measles cases identified recently in a few other South Carolina counties haven’t spread widely in those locations, Bell said. Of the 979 cases in the South Carolina outbreak, 927 involve people in Spartanburg County.

“Even if we are only seeing a dozen or so cases per week, the risk we can surge remains,” Bell said.

Bell noted that schools will be going on spring break in the coming weeks, bringing with it the risk of people who have been exposed to measles becoming infectious and spreading the disease to others at tourist attractions and while traveling. “This is a great concern,” she said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Hospitals fighting measles confront a challenge: Few doctors have seen it before

2026-02-24T15:10:14+00:00

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ASHEVILLE, N.C. — At around 2 a.m., 7-year-old twin brothers arrived at Mission Hospital in Asheville. Both had a fever, a cough, a rash, pink eye, and cold symptoms.

The boys sat in one waiting room and then another. Two hours and 20 minutes passed before the two were isolated, according to Centers for Medicare & Medicaid Services records obtained by KFF Health News. Then two more hours ticked by.

As the sun rose, an emergency room doctor called the state epidemiologist and described the symptoms. The public health official told him to keep the kids in the hospital and quarantine them. Shortly after that call, the patients were diagnosed.

It was measles.

Hospital staff gave the father instructions on how to quarantine the family and sent them home.

The virus exposed at least 26 other people in the hospital that January day, federal investigators determined. Health inspectors for CMS investigated the measles infections and other failures in care and concluded that the twins’ symptoms should have triggered an isolation procedure for which Mission Hospital staffers had trained seven months earlier. CMS designated Mission in “Immediate Jeopardy” for the exposures and other unrelated issues, one of the most severe sanctions a hospital can face, threatening to pull federal funding unless it remedied the problems.

A spokesperson for Mission said its staff was trained to manage airborne sickness and is following federal rules.

As U.S. hospitals face an increasing risk of encountering measles, and pressure to immediately spot it, health care workers face an unusual barrier: Many don’t know what it looks like.

How the South Carolina measles outbreak grew from 5 to 973 cases

“There’s a word, ‘morbilliform’ — it means measles-like, and there are lots of viruses that can cause a rash that looks like a measles rash in children,” said Theresa Flynn, a pediatrician in Raleigh and the president of the North Carolina Pediatric Society. In 30 years in health care, she’s never seen a measles case, she said.

North Carolina has reported more than 20 cases since mid-December, and more than 3,000 people nationwide have been infected since the beginning of 2025.

Children in areas with low immunization rates have been especially susceptible to outbreaks, triggering public health campaigns to promote the measles vaccine. CMS Administrator Mehmet Oz encouraged vaccination in a CNN interview on Feb. 8.

With two doses of the measles, mumps, and rubella vaccine, a person has a 3% chance of getting the virus after exposure. If exposed, an unvaccinated person has a 90% chance of being infected, according to the CDC. It can take a week or two before someone infected with measles shows symptoms.

But for the past year, the Trump administration has sown doubt about vaccine effectiveness. Health and Human Services Secretary Robert F. Kennedy Jr. was a longtime anti-vaccine activist before taking office, and under his leadership the Centers for Disease Control and Prevention has reduced the number of shots recommended to children.

After measles erupted in West Texas last year, Kennedy publicly recommended unconventional and unproven treatments for the virus, including steroids, antibiotics, and cod liver oil.

Infectious disease experts and doctors said federal policies have left health care workers to lean on their own experience or guidance from their state public health systems to fight a disease that many are preparing to see for the first time and that initially may behave like the common cold.

“As measles becomes more common, all of us are leveling up in our ability to recognize and immediately respond to suspected measles,” Flynn said.

Staff trained to look for three C’s: cough, coryza, conjunctivitis

Officially, the United States has maintained “measles elimination status” since 2000, meaning the United States has avoided significant spread of the virus. After outbreaks in Texas, Arizona, Utah, and now South Carolina, the nation is on track to lose that designation before the year is out. Its own adopted regulations tie elimination status to a lack of a continuous viral spread persisting for 12 months.

One county in South Carolina, an hour’s drive from Asheville, has had more than 900 cases in the current outbreak — more than Texas reported in all of 2025.

Symptoms of measles, a virus that attacks the lungs and airways, can include fever, cough, a blotchy rash, and red, watery eyes. Researchers consider measles among the most contagious diseases, and the virus may remain active for up to two hours after an infected person leaves a room.

It can be lethal, with 1 to 3 deaths per 1,000 cases in children.

In 2025, two children in Texas and one adult in New Mexico died of measles.

Along with tracking data, the CDC provides detailed summaries on its website for diagnosing measles. State public health agencies and some counties have developed dashboards tracing the disease as it surfaces in such places as hospitals, schools, grocery stores, and airports. Large hospital systems developed staff training protocols last year and shared them with area clinics.

Look for the three C’s, that guidance said: cough, coryza (cold symptoms), and conjunctivitis (pink eye). According to CMS inspection records, HCA Healthcare, which owns Mission Hospital, trained Mission staff on the three C’s early last year. On top of failing to isolate the twin patients right away, Mission staff didn’t have a designated area for patients with respiratory symptoms, federal inspectors found.

S.C. measles cases surged after holiday school closures delayed outbreak investigations

The CDC advises health workers to immediately place patients with measles or suspicious symptoms in a special isolation room, where airflow is controlled inward. The Mission patients were separated from other patients only by plastic partitions, according to the CMS records.

Mission spokesperson Nancy Lindell said the hospital was equipped and staffed to manage airborne illnesses like measles.

“Our hospital has been working with state and federal health officials on proactive preparedness, and we are following guidance provided by the CDC,” Lindell said.

(Dogwood Health Trust, a private foundation established as part of HCA’s purchase of Mission Health, helps fund KFF Health News coverage.)

Most U.S. clinics and hospitals have never experienced measles cases, said Patsy Stinchfield, a former president of the National Foundation for Infectious Diseases and a nurse practitioner. She called CMS’ Immediate Jeopardy penalty for Mission “extreme,” given the virus can be so difficult to identify.

“In the middle of winter right now, measles looks like every other viral respiratory infection that kids come in with,” Stinchfield said.

The CDC has been less communicative in the past year with clinics about their response to outbreaks, said health workers and infectious disease experts. This disconnect began soon after Trump took office, according to a KFF Health News investigation finding that health officials in West Texas were unable to talk with CDC scientists as measles surged last February and March.

“We certainly do not feel the support or guidance from the CDC right now,” said Brigette Fogleman, a pediatrician at Asheville Children’s Medical Center, where staff members have come up with their own method of staving off the virus: screening patients over the phone and in their cars before a visit.

In response to questions about how the CDC is supporting health care organizations during the measles resurgence, spokesperson Andrew Nixon said that “state and local health departments have the lead in investigating measles cases and outbreaks” and that the CDC provides support “as requested.” He pointed to numerous guides and simulation tools the agency has developed as the virus has spread.

Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University, acknowledged that diagnosing measles is a major challenge, emphasizing that coordination among public health agencies is critical in overcoming that challenge.

Stinchfield attributed the spread of measles to CDC leaders’ lack of communication to clinics and to the public — no ads on buses, no social media campaigns, no sense of urgency. “When you are at the highest level of measles cases in 30 years, we should be seeing lots more from our federal government,” Stinchfield said. “And I think it’s harming kids and causing an inordinate amount of work and expense that really doesn’t belong in health care right now.”

State prepares for more measles cases

In North Carolina’s Buncombe County, home to Asheville and Mission Hospital, health officials had counted seven measles cases by mid-February and anticipated many more, according to state epidemiologist Zack Moore. It’s unclear how many of those are connected to the Mission exposure.

“We are preparing for a future in which we follow a trajectory like South Carolina,” Moore said, “where we see sort of a gradual accumulation of cases, and then all of a sudden it reaches kind of a tipping point, and we see a more explosive growth in the outbreak and spread across the state.”

Maternity unit, BMW plant among groups exposed in South Carolina measles outbreak, records reveal

Fogleman, who is also a pediatrician, and Buncombe health department director Jennifer Mullendore spoke during a recent Facebook livestream hosted by the county, urging families to get their children vaccinated, debunking vaccine misinformation, and updating parents on local case numbers.

Days before, a local private school had quarantined about 100 students after an exposure. Only 41% of students there were immunized, according to state data.

At Fogleman’s clinic, parents are asked to wait in their vehicles with their children, and staffers come out to screen them there. Some parents resist vaccination and note recently weakened federal recommendations around measles vaccines for children under 4, she said.

Kennedy handpicked the committee members who made those recommendations, with several members having spread medical misinformation in the past.

One parent recently told a nurse, “It’s only measles. It doesn’t kill anybody,” Fogleman said.

That’s not true, her team must explain.

As the clinic holds families in the parking lot, trying to figure out whether symptoms point to the dangerous virus, it’s difficult to get the message across, Fogleman said, especially when the nation’s top disease agency hasn’t conducted a widespread information campaign about the risks from measles — or the vaccine’s ability to almost entirely prevent it.

“We can’t change the past,” Fogleman said. “All we can do is try to educate and move forward.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

S.C. measles cases surged after holiday school closures delayed outbreak investigations

2026-02-17T10:00:00+00:00

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South Carolina’s state health department faced a significant problem in the critical weeks before the state’s measles outbreak surged in January.

As schoolchildren continued to fall ill with measles in late December, outbreak investigators needed help from schools to get contact information for the classmates, staff, and others who had been exposed. They needed to be warned quickly so they wouldn’t spread the virus to others if they were infected.

But schools were closed for their two-week winter break. Nobody was available at most schools to provide the information health officials needed, according to South Carolina’s state epidemiologist and records obtained by Healthbeat.

This communication gap between the South Carolina Department of Public Health and schools in Spartanburg County – the outbreak’s epicenter – resulted in delays quarantining people who were at risk of unknowingly spreading the highly contagious disease. An infected person is contagious beginning four days before the tell-tale measles rash appears.

At the same time, the state health department was grappling with its own holiday staffing challenges, according to the internal DPH outbreak reports that Healthbeat obtained under South Carolina’s public records law.

While the number of measles cases grew in December, the number of DPH staff assigned to combat the outbreak dropped. The internal DPH reports repeatedly note concerns about holiday staffing, workloads, burnout, the availability of backup staffing, and “limited support due to workforce reduction in April 2025.”

Only after New Year’s Eve did outbreak staffing begin to increase significantly, records show.

Dr. Linda Bell, the state epidemiologist who is leading South Carolina’s outbreak response, said that despite challenges, public health staff “worked diligently throughout the holidays.”

“DPH made many efforts to reach impacted schools over the holidays with limited success because the schools were closed,” Bell said in written responses to Healthbeat’s questions.

By early January, the South Carolina measles outbreak surged to become one of the largest in the United States in decades.

“It’s impossible to know exactly what impact school closures and the resulting delays had on the spike in cases,” Bell told Healthbeat.

However, the delays hampered one of the department’s key strategies for slowing the virus’ spread: Rapid identification and home quarantine of exposed children and adults who were at risk of developing and further spreading the disease because they aren’t vaccinated.

This occurred during a time of increased socializing over the holidays, she noted.

It usually takes a week to 12 days, and sometimes as long as three weeks, for people infected with measles to start showing symptoms. The virus spreads through the air when a contagious person breathes, sneezes, or coughs.

Before Spartanburg County schools closed for winter break on Dec. 22, the state health department had logged 144 measles cases since the outbreak began in early October, state data show. In the three weeks after schools reopened during the week of Jan. 5, outbreak investigators were chasing after more than 500 new cases of measles.

The outbreak continues to grow, reaching 950 confirmed cases in South Carolina as of last week, a tally that doesn’t include cases sparked in other states.

School officials with Spartanburg County’s District 2 and District 6, whose elementary schools were among those with delayed exposure investigations during winter break, have declined repeated requests from Healthbeat for interviews or information about their procedures for providing time-sensitive public health information during extended school break closures.

Both districts have had multiple measles exposure incidents in their schools since the outbreak began last fall, requiring dozens of students to be excluded from class due to quarantines.

What happened in South Carolina is a cautionary tale for health departments and schools across the United States – especially as measles makes a resurgence amid declining vaccination rates. So far this year, at least 24 states have reported measles cases to the Centers for Disease Control and Prevention.

In the coming weeks, schools across the country will be closing again for spring break.

“I just want to emphasize how normal Spartanburg is,” said Scott Thorpe, executive director of the nonprofit Southern Alliance for Public Health Leadership, noting that the pockets of low vaccination rates that have fueled the South Carolina measles outbreak are also common in other communities. “I hope that everybody is really preparing for this, because I don’t think it’s going anywhere anytime soon.”

With some communities having multiple school districts plus numerous private schools, Thorpe said that strengthening lines of communication between public health and schools takes time. “To try to figure out how to interact successfully in all these circumstances, in a crisis situation, is really hard,” he said.

School nurses, staff often not paid to work over breaks

Pat Endsley, president-elect of the National Association of School Nurses, said school breaks can pose a special challenge for health departments doing infectious disease contact tracing because school nurses and other staff often aren’t being paid to work during those periods – and they may even be traveling out of town.

With every state operating differently, Endsley said she’s not aware of any national best practice for addressing school contact tracing for measles during extended school break periods. A lot of the best practices were written specifically to address the emergence of the Covid-19 pandemic, she said.

“The gold standard would be to have some kind of person who is at the school, who’s not going anywhere, who could have access to information,” said Endsley, who served as a school nurse in Maine for 23 years and now teaches full time.

“Maybe that’s something that would come out of South Carolina, or Texas, or these other places with measles,” she said. “Based on this information, we could develop some exemplars of communication.”

How the South Carolina measles outbreak grew from 5 to over 900 cases

In at least some communities, health departments have found ways to ensure measles exposure investigations aren’t thwarted by school breaks.

Health officials battling another large measles outbreak along the Utah-Arizona border said they had no difficulties reaching impacted schools over the recent winter break.

“Our epidemiologists report that contact tracing and other issues involving students ran uninterrupted over the winter holidays, mainly due to frequent communication with an established point of contact with our largest school district,” said David Heaton, a spokesperson for the Southwest Utah Public Health Department. The school contact was available to help over the holidays, Heaton said.

Dani Lagana, a spokesperson for the Mohave County Department of Public Health in Arizona, said the department’s measles response activities are not dependent on school calendars.

“Effective contact tracing in school-associated cases relies on established communication protocols and coordination between public health and education partners,” Lagana said by email. “Health departments routinely plan for coverage during holidays and breaks to ensure appropriate notification and follow-up when needed.”

It’s unclear why – before winter break closures began – similar arrangements weren’t put in place between the South Carolina DPH and schools in Spartanburg County.

“DPH cannot direct school employees to come to work to assist with outbreak investigations,” the South Carolina department said in an emailed statement to Healthbeat.

The department said it has contact lists for school administrators, but these administrators may not have access to the detailed information outbreak investigators need when schools are closed.

“Comparisons of response activities from one jurisdiction to the next should be made with caution,” the state health department said. “Each jurisdiction has unique circumstances including differences between centralized vs. autonomous county public health agencies.”

Winter break delays in investigations of measles exposures occurred at Boiling Springs Elementary, where 80% of students are up-to-date on vaccines.

In South Carolina, public health activities are centralized and provided by state DPH employees at offices across the state. Arizona and Utah, have multiple local health departments covering a single county or multi-county region, in addition to state health departments.

Healthbeat asked each of Spartanburg County’s seven public school districts whether they had any policies or procedures that would specifically enable rapid sharing of student contact information during holiday breaks with public health officials who are trying to control infectious disease outbreaks. None of the districts provided answers to these questions.

Schools play an important role in helping public health investigators quickly determine which students, teachers, staff, and visitors may have been exposed to the infected individual. Not only does measles spread through the air, the virus can linger in a room for two hours after the contagious person has left.

School staff can provide health investigators detailed information about the movements of an infected student – and who was around them while they were contagious – by going through class schedules and rosters of those participating in extracurricular activities and riding on school buses. They also know which students lack immunity to measles because school records show which ones have exemptions from vaccine requirements for medical or religious reasons.

Rapid notification of at-risk individuals is critical, health officials say, so they know to quarantine at home and watch for early signs of measles that might otherwise be mistaken for a cold or the flu. In the four days before measles’ hallmark rash appears – and the person is already contagious – their earliest symptoms are typically a fever, cough, runny nose, and red, watery eyes.

“I definitely can see the issue that DPH had during winter break with schools closed two to three weeks, and no way to do that school notification, contact trace, get information from nurses,” said Dawn MacAdams, president of the South Carolina Association of School Nurses. “But then you run into: nurses don’t get paid during that time.”

MacAdams said that during Covid, school nurses faced overwhelming workloads and long hours helping with contact tracing without being paid for the extra work. “Nurses were working Christmas Eve, Christmas Day, New Year’s because the numbers were exploding and the guidance was changing,” she said.

MacAdams said she’s not sure what the solution is for ensuring timely contact tracing of school-associated measles exposures when schools are closed.

“That’s a really good question to think about with DPH on what are the things we can do,” she said. “Most spring breaks are somewhere the first or second week of April this year. So we’re going to be in another desert of the availability of school personnel to provide information.”

Records show quarantine delays at five Spartanburg schools

Internal South Carolina DPH reports show there were delays during winter break notifying and quarantining people who had been exposed to measles at three public schools, one public charter school, and one private Christian school.

For the exposure incidents at these schools, the department’s internal daily outbreak summary reports during winter break repeatedly listed that health officials were reaching out to the facilities or that the status of quarantine actions were still “TBD” – or to be determined.

It’s unclear how many exposed students and staff weren’t contacted quickly because these schools were closed. “Parsing out all those we were working to reach, whether students or others, during that time when cases were surging is not possible,” Bell said.

Measles investigation and quarantine delays occurred at Global Academy of South Carolina, a public charter school where only 21% of students are up-to-date on required school vaccines.

One of the schools where winter break investigation and quarantine delays occurred is Global Academy of South Carolina, a public charter school where only 21% of students are up-to-date on required school vaccines, including the measles, mumps and rubella shot. To prevent measles outbreaks, 95% coverage is needed.

It took Global Academy until Jan. 9 to provide outbreak investigators with a requested “line list” detailing the names and contact information for exposed students and staff, the DPH documents obtained by Healthbeat show. The school’s winter break was Dec. 22-Jan. 2.

“Global Academy finally provided a line list yesterday, and we are going through it,” a DPH official said in a Jan. 10 email updating the South Carolina governor’s office on the outbreak response.

The school’s principal, Mark Robertson, did not answer Healthbeat’s questions and told a reporter to contact DPH.

Global Academy was one of the first two schools to have confirmed measles cases when the outbreak began in early October. The school has had repeated rounds of students being quarantined and excluded from class.

Other schools that had delayed winter break investigations of measles exposure incidents included large public elementary schools in Spartanburg County School Districts 2 and 6, the records show. Throughout the outbreak, the district’s schools have had exposure incidents requiring students to quarantine, state records show.

In District 2, winter break delays occurred in investigations of exposures at Sugar Ridge Elementary, where state data show 78% of students are up-to-date on school vaccines, and at Boiling Springs Elementary, where 80% of students are up-to-date on vaccines.

In District 6, the delays also occurred at Jesse S. Bobo Elementary School, where state data show 94% of students are up-to-date on school vaccines.

Officials with both districts have declined repeated requests from Healthbeat since Jan. 9 for interviews or answers to specific questions about the outbreak’s impact on student health, as well as the circumstances surrounding the exposure investigation delays over the winter break.

Health officials’ efforts to get complete exposure contact information from one school were so protracted coming out of the winter break that they were preparing to issue a formal public health order to force compliance. The school says it promptly provided information.

Maternity unit, BMW plant among groups exposed in South Carolina measles outbreak, records reveal

In January, the state health department issued a “final notice letter” to Westgate Christian School in Spartanburg because of the school’s continued “noncompliance,” Healthbeat reported earlier this month. The school was closed for its Christmas break from the afternoon of Dec. 19 through Jan. 2.

Outbreak investigators had been asking for contact information for exposed students and staff since Dec. 29, Bell said. A list that the school provided on New Year’s Eve was deemed “insufficient.”

When Westgate Christian’s break was over and the requested information still hadn’t been provided, Bell said the department issued a “final notice” to the school on Jan. 9. The letter warned that if the information wasn’t received by 1 p.m. on Jan. 10, the department “would issue a Public Health Order pursuant to S.C. Code § 44-1-140 compelling compliance.”

The issue was resolved the next day when the school provided the requested information, Bell said.

Pastor James Wooten, Westgate Christian’s president, said that until the school’s administrator received the “final notice” email – at 5 p.m. on Friday, Jan. 9 – she thought the health department had been provided everything it needed on Dec. 31.

“Other than a thank you acknowledging receipt, she received no further correspondence or request for information until the final notice warning,” Wooten told Healthbeat last week. School officials wonder why, if outbreak investigators needed more information, “they didn’t simply reply to the email and request it,” Wooten said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

S.C. hospital system with maternity unit measles exposure to require masks

2026-02-04T23:51:32+00:00

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South Carolina’s measles outbreak is prompting Prisma Health, one the state’s major health care systems, to begin requiring masks for anyone entering its hospitals’ labor and delivery units and other birthing areas, as well as its emergency departments.

Prisma Health’s announcement on Wednesday came two days after Healthbeat revealed measles exposure incidents in the labor and delivery unit at Prisma Health Greer Memorial Hospital and in the emergency department of Prisma Health Greenville Memorial Hospital, as well as at some of the system’s other urgent care and private practice offices.

At a press conference, Prisma physicians said the new masking requirements are an additional safety measure being taken in response to the growing outbreak, which has had a spike in new cases since the holidays. As of Tuesday, state health officials had confirmed 876 measles cases, mostly in and near Spartanburg County.

Maternity unit, BMW plant among groups exposed in South Carolina measles outbreak, records reveal

“There is no incident that has prompted this,” said Dr. Kendreia Dickens-Carr, a Prisma Health OB-GYN. “This is a public health concern, and the measures that we are taking is to prevent any more [cases].”

Dickens-Carr said obstetric floors at Prisma Health hospitals across South Carolina, just like the emergency departments, will enforce masking on entry for all patients and those accompanying them until they have been evaluated to determine if they have an infectious disease.

In labor and delivery and other birthing areas, any patient or care partner who has a fever, rash, or respiratory symptoms will be asked to keep wearing their mask, the Prisma press release said.

Internal state health department records obtained by Healthbeat under South Carolina’s public records law list several public exposure incidents during December and January across Prisma Health facilities, from hospitals to urgent care centers and pediatrics practices. Similar measles exposure incidents have also occurred in facilities operated by the region’s other major health provider, the Spartanburg Regional Healthcare System, the records show.

The exposure at the labor and delivery unit at Prisma Health Greer Memorial Hospital, which is located between Spartanburg and Greenville, is of particular concern, experts say, because of the increased risks measles poses to unvaccinated mothers and their babies.

Prisma Health has not answered Healthbeat’s questions since last week about how and when the exposure occurred at the labor and delivery unit and whether anyone became infected. The Prisma Health representatives at Wednesday’s press conference again declined to answer these questions.

The risks of pregnant women being exposed to measles was among issues highlighted Wednesday by South Carolina state epidemiologist Dr. Linda Bell in her weekly call with reporters about the current state of the outbreak.

How the South Carolina measles outbreak grew from 5 to 876 cases

Bell said the South Carolina Department of Public Health has learned of 19 people, including children and adults, who have required hospitalization for complications of measles since the outbreak started last fall. These complications have included measles encephalitis in children – a dangerous swelling of the brain that can have long-term consequences.

“Additionally, several pregnant women were exposed to and required administration of immune globulin to protect against the high risk of complications for measles to pregnant women and their newborns that they could infect,” Bell said.

Immune globulin is a type of protective antibody treatment. Bell declined to provide additional details or say whether the exposures occurred in health care settings.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

Maternity unit, BMW plant among groups exposed in South Carolina measles outbreak, records reveal

2026-02-02T10:00:00+00:00

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In South Carolina’s surging measles outbreak, infectious people have exposed others to the virus in the labor and delivery unit of a hospital – where babies are at high risk of infection, as well as in the workplaces of some of the region’s major employers, including manufacturing plants for BMW and Michelin.

Internal records obtained by Healthbeat from the South Carolina Department of Public Health’s outbreak response reveal more about the scope of the outbreak’s impact within the state and across the country than has been previously made public.

The documents, obtained under South Carolina’s public records law, also show the state’s outbreak has resulted in measles exposure incidents in public locations in several other states. They include infectious people from South Carolina who attended a large youth conference in Kentucky, went to a hospital in Florida, and visited busy travel convenience stores in Georgia and Texas.

How the South Carolina measles outbreak grew from 5 to 847 cases

Within South Carolina, the department’s internal outbreak reports, as well as emails updating the state’s governor’s office, reveal numerous measles exposure events inside health care facilities. Many have involved urgent care clinics. Others have occurred when infectious people exposed others to the virus at hospitals and pediatrics practices.

The reports note the challenges state health department officials have faced trying to stop one of the largest measles outbreaks in decades, including making sure those in quarantine understand they need to stay at home and away from others, and dealing with some schools that have been slow to cooperate with outbreak investigations. The records reveal the department issued a final notice last month to a private Christian school, warning that it was about to face enforcement action for failing to fully share information about exposed students.

After initially growing slowly since the outbreak was identified on Oct. 2 with just five cases, the number of measles cases exploded in January, nearing 850 confirmed infections by the end of the month. For now, the outbreak is mostly in and near Spartanburg County, in the northwest part of South Carolina, where it’s being fueled by clusters of unvaccinated children and adults.

South Carolina travelers expose people in other states

While health officials in Washington state, North Carolina, and California have announced recent measles cases in their states that are linked to the South Carolina outbreak, the documents obtained by Healthbeat list additional states and locations where infectious people who are part of the outbreak have traveled.

According to the South Carolina DPH’s internal briefing reports for its director, there were exposure incidents during December and January involving contagious South Carolina residents who traveled to Kentucky, where exposures occurred at a “Large NYE Youth Conference” and also at a Hyatt Place hotel; in Georgia at a Love’s travel center; in Texas at a Buc-ee’s travel center; and in Florida at an Embassy Suites hotel.

In addition, there was a potential public exposure at a hospital in Florida, according to a Dec. 29 email from the South Carolina health department to the South Carolina’s governor’s office. The email did not include the hospital’s name or location.

The other reports released to Healthbeat provide little information about the circumstances of the public exposure sites or whether anyone became infected. In most cases, the reports only list the names of sites of public exposures that have occurred in the previous 21 days – which is the maximum period of time it can take for a person to develop symptoms after being exposed to measles.

The South Carolina DPH told Healthbeat its staff was not able to quickly provide more details about the locations listed in the records. Officials with Hyatt, Love’s, Buc-ee’s, and Embassy Suites’ operator Hilton did not answer Healthbeat’s questions about the exposure incidents listed in the reports.

A spokesperson for the Texas Department of State Health Services said it had not been notified of a measles exposure incident at a Buc-ee’s there during this time period. Officials at the Florida Department of Health did not respond to questions from Healthbeat seeking more information about the hospital and Embassy Suites exposures there.

It’s also unclear exactly where or when the “Large NYE Youth Conference” occurred in Kentucky. The South Carolina DPH said it doesn’t have specific details of the event. Officials at the Kentucky Department for Public Health did not answer Healthbeat’s questions about the conference or the separate exposure incident at a Hyatt Place hotel, which appears to have resulted in the infection of a Kentucky resident.

Last month, the local health department in Lexington-Fayette County, Kentucky, issued a measles alert saying an “unvaccinated, out-of-state traveler” stayed at the Hyatt Place in Hamburg, Kentucky, from Dec. 31 through Jan. 2, and also visited a Panera in Hamburg on Jan. 1. No mention was made of the South Carolina outbreak.

An unvaccinated Kentucky resident who was exposed to this “out-of-state traveler” later tested positive for the disease, the Kentucky DPH announced on Jan. 15. A department spokesperson did not answer Healthbeat’s questions about whether the Hamburg exposures and measles infection are linked to the South Carolina outbreak.

Exposures include hospitals, a maternity unit, urgent care centers

Within South Carolina, the state health department’s internal outbreak reports reveal more measles exposure locations than just the schools and stores, restaurants, businesses, and others that have been publicly shared in the information released to the public.

South Carolina state epidemiologist Dr. Linda Bell, in emailed comments to Healthbeat, said the state only notifies the public of the locations of measles exposure incidents when the department knows the specific date and time the exposure occurred, and when it cannot notify all those who have been directly exposed to the infectious person.

In recent weeks, Bell has spoken at media briefings about health care facilities – without naming names – as a place where measles exposures and infections have been occurring.

“We have seen transmission associated with exposures in health care settings,” Bell said during a Jan. 28 briefing. She said the department continues to encourage health care facilities to put masks on people who arrive with symptoms of respiratory illness, which can be early symptoms of measles, and isolate them from waiting areas where other people might be exposed.

Bell said health facilities also should make sure their workers – including administrative and intake staff – are vaccinated. “We are having to track a number of workers across disciplines and health care settings who have been exposed,” Bell said.

As U.S. is poised to lose measles-free status, RFK Jr.’s new CDC deputy downplays its significance

State health officials and members of the medical community have been urging that anyone who may have measles call before visiting health facilities, so that arrangements can be made to safely provide assessment and care – such as through a remote telemedicine appointment, an after-hours office visit, or admission to a special hospital isolation unit.

The newly released documents detail the names of hospitals, urgent care clinics, and some practice locations where infectious people have exposed others to measles.

Two of the major health systems serving the South Carolina Upstate region at the center of the outbreak – Spartanburg Regional Healthcare System and Prisma Health – have had multiple incidents where infectious people went into their facilities and exposed others to measles in the December through January period, the state health department’s records show.

One of the listed exposure incidents occurred in the labor and delivery unit at Prisma Health Greer Memorial Hospital, which is located between Spartanburg and Greenville. A spokesperson for Prisma would not answer questions about the incident or whether any infections were associated with it.

Measles is especially dangerous to babies, who are too young to be vaccinated, according to the Centers for Disease Control and Prevention. The virus spreads through the air and infectious particles can remain in a room for two hours after the infected person has left the area.

“Exposure to measles in a labor and delivery unit is highly concerning because measles is extremely contagious and poses serious risks to both pregnant people and those who may not be fully protected against measles,” said Dr. Michael Warren, chief medical and health officer for the March of Dimes, who previously served as the associate administrator of the federal Health Resources and Services Administration’s maternal and child health bureau.

While not commenting on the specific incident in South Carolina, Warren told Healthbeat that the ability of the measles virus to linger in the air for hours increases the likelihood of exposures occurring in that kind of a health care setting. The Birthplace at Greer Memorial Hospital has 10 labor, delivery, recovery and postpartum and recovery rooms, according to a promotional video on its website.

“Labor and delivery units care for multiple patients, with pregnant and postpartum women, newborns, and health care workers in close proximity, so even a single measles exposure can lead to rapid spread if not identified and managed quickly,” Warren said. He added that because newborns and pregnant people can’t receive the measles vaccine, those who are exposed may need special treatment with immunoglobulin, a substance that helps fight infections.

In addition to the exposure incident at Greer Memorial Hospital, other Prisma Health facilities that are listed in the records as sites of public measles exposures include: Greenville Memorial Hospital and its emergency department; Prisma Health Pediatrics in Greer; Prisma Health Urgent Care locations in Boiling Springs and Greenville; and Prisma Pediatrics - Spartanburg.

A South Carolina Department of Public Health nurse holds a box containing vaccine for a mobile clinic in Spartanburg County. Two doses of the vaccine is 97% effective at protecting against infection with measles, according to the Centers for Disease Control and Prevention.

Prisma Health did not answer questions about whether it is aware of any measles infections occurring in association with exposure incidents in its facilities. In a brief emailed statement, a spokesperson for the system noted that measles is highly contagious and that people can spread the virus before they are diagnosed.

“Prisma Health has taken extensive proactive measures during the measles outbreak to protect patients, visitors, and team members, including visitor restrictions, enhanced masking policies, additional precautions, and broad patient and community education,” the statement said.

Spartanburg Regional Healthcare System also wouldn’t answer questions about the specific exposure incidents inside its facilities and whether any have resulted in infections. Among the system’s facilities noted in the records for exposures: Spartanburg Regional Medical Center, Spartanburg Regional ER, and Pelham Medical Center.

In an emailed statement, the system said it has taken several actions to address the risks of measles exposure in its facilities. They include signs posted at Medical Group of the Carolinas practices to inform patients about the signs and symptoms of measles and instructing them to stay in their vehicles, call the practice’s phone number, and wear a mask. Masks are being required in all of the system’s emergency rooms and immediate care centers. “Associates and providers also are taking airborne precautions – such as wearing masks – when evaluating patients who might have measles,” the system said.

Measles enters BMW, Michelin manufacturing plants

Beyond health care facilities, the documents also show exposures at some major employers in the Spartanburg area that have not been included in the information the state health department has released publicly.

The most prominent of the employers listed in the records are BMW and Michelin.

BMW Manufacturing employs more than 12,000 people at BMW Group Plant Spartanburg, which assembles BMW sports activity vehicles and coupes on what the company describes as its 10 million-square-foot campus. Michelin has had a major tire manufacturing presence in the Spartanburg area for decades.

The state health department flagged the exposures at the BMW and Michelin plants to the state’s governor’s office in a Jan. 12 email with outbreak updates.

In a statement to Healthbeat, BMW said: “The Plant Spartanburg workforce has been informed about the measles cases at the plant. We are following guidance from the South Carolina Department of Public Health and are in regular communication with our teams regarding recommended health protocols.”

The BMW statement said it is providing measles vaccinations onsite and that the company is sharing updates and resources with employees. “We will continue to monitor the situation closely and encourage anyone who is unvaccinated or uncertain about their vaccination status to contact their health care provider promptly,” the company said.

A spokesperson for Michelin declined to answer questions about its exposure and what actions the company is taking in response.

Outbreak investigators face challenges at some schools

Since the South Carolina outbreak began in October, hundreds of students in the Spartanburg area have needed to quarantine at home – and stay out of classes – because they have been exposed to someone who was contagious with measles.

While many schools have helped the state health department’s outbreak investigators identify which students have been exposed and need to be quarantined because they are not fully vaccinated or lack immunity from prior infection, the records obtained by Healthbeat show that others have been slow to provide information.

As measles exploded, officials in Texas looked to CDC scientists. Under Trump, no one answered.

In one case, the health department got to the point of threatening enforcement action.

Last month, the South Carolina DPH issued a final warning to Westgate Christian School in Spartanburg that it was about to be served with a public health order and face possible penalties because of its failure to comply with an outbreak investigation, according to the records and additional information Bell provided in response to Healthbeat’s questions.

“Being able to identify and notify staff and students who may have been exposed and are at risk for measles is very important to our efforts to limit the spread of measles to the greatest degree possible,” Bell said. “In order to do so, we require lists from the school of those who may be at risk. Schools that don’t provide the full information needed to contact those at risk within 48 hours are considered noncompliant.”

According to Bell, on Dec. 29 the state health department provided a formal, written request to Westgate seeking contact information for students identified as close contacts of a person with measles. The list that the school provided on Dec. 31 was “insufficient,” Bell said.

Bell said the department issued a final notice to the school on Jan. 9, warning that if the requested information wasn’t received by 1 p.m. on Jan. 10, the department “would issue a Public Health Order pursuant to S.C. Code § 44-1-140 compelling compliance.” Under its authority to collect information to address threats to public health, she said the department can take enforcement actions including fines and other legal actions when organizations fail to comply.

Bell said the school provided the required information on Jan. 10, resolving the issue.

Pastor James Wooten, who is listed as the school’s president, told Healthbeat that the school drew the warning because of “some confusion.” The school is a ministry of Westgate Baptist Church. Wooten said that the final notice was unexpected and that the school thought it had provided the health department with the requested information.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Flu rates remain high in Georgia but show signs of easing after holidays

2026-01-23T18:58:32+00:00

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Flu rates are still high in Georgia this month but appear to be dropping slightly as people resume regular schedules after the winter holidays.

That’s in line with national trends that show a drop in flu positivity rates from prior weeks, according to the latest data from the U.S. Centers for Disease Control and Prevention.

The percentage of flu tests that came back positive at selected labs in the metro Atlanta area dropped from a high of 40% for the week ending Dec. 20 to about 18% for the week ending Jan. 10, according to data from the Georgia Department of Public Health.

The CDC predicts a moderately severe flu season for adults 18-64 and those over age 65. However, it predicts a “high-severity” season for children 17 and under.

Why flu season will likely be worse this year and how to prepare

That doesn’t mean the threat is over. Six people died in Georgia in the week ending Jan. 10, bringing the death toll from the flu since the season started in October to 69. That includes two deaths of children between the ages of 5 and 17. The flu season usually runs through March.

Vaccination remains the best way to protect against the flu, said Dr. M.G. Finn, a professor of biochemistry at Georgia Tech and an expert in viruses and immunology.

Finn said there is a gap between this year’s vaccine and the variant of flu that is circulating widely, in part because scientists design the vaccine well in advance of the flu season. Still, the vaccine reduces the risk of hospitalization by about 40%, he said, making it a valuable tool for protecting health.

“You want to bias the odds in your favor of not getting seriously ill if you happen to come across somebody who has the flu, and you want to minimize the chances of you passing it along to people around you,” Finn said. “It’s completely and utterly safe, so there is no risk whatsoever for taking it.”

Other respiratory viruses also continue to circulate. The positivity rate for RSV at selected clinical laboratories was 10.6% for PCR tests, about the same rate it’s been since late November, according to DPH data

However, the CDC has identified low rates of Covid in wastewater for the week ending Jan. 10, with very low rates of Georgians visiting emergency rooms for Covid and lower rates of Covid-related hospitalizations than at the same time last year.

Meanwhile, Georgia reported its first measles case of the year, on Jan. 12, in a child who was too young to be vaccinated and who had a history of international travel. The case was reported in the Coastal Health District, which covers eight counties around Savannah.

The CDC and the American Academy of Pediatrics recommend that children get the first dose of the measles, mumps, rubella vaccine at ages 12 to 15 months and the second dose between 4 and 6 years of age.

That case was acquired during international travel, according to DPH, meaning it is not likely linked to the large outbreak in neighboring South Carolina.

There have been 700 cases reported since the outbreak in the region around Spartanburg began in October.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

As U.S. is poised to lose measles-free status, RFK Jr.’s new CDC deputy downplays its significance

2026-01-22T01:38:12+00:00

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After a year of ongoing measles outbreaks that have sickened more than 2,400 people, the United States is poised to lose its status as a measles-free country. However, the newly appointed principal deputy director at the Centers for Disease Control and Prevention, Ralph Abraham, said he was unbothered by the prospect at a briefing for journalists this week.

“It’s just the cost of doing business with our borders being somewhat porous for global and international travel,” Abraham said. “We have these communities that choose to be unvaccinated. That’s their personal freedom.”

Infections from other countries, however, accounted for only about 10% of measles cases detected since Jan. 20, 2025, the official start of the deadly measles outbreak in West Texas, which spread to other states and Mexico. The rest were acquired domestically. This marks a change since the United States eliminated measles in 2000. Measles occasionally popped up in the United States from people infected abroad, but the cases rarely sparked outbreaks, because of extremely high rates of vaccination. Two doses of the measles, mumps, and rubella vaccine strongly prevent infection and halt the virus’ spread.

To maintain its measles elimination status, the United States must prove that the virus has not circulated continuously in the nation for a year, between Jan. 20, 2025, and Jan. 20, 2026. To answer the question, scientists are examining whether the major outbreaks in South Carolina, Utah, Arizona, and Texas were linked.

Health officials confirmed that the main measles virus strain in each of these outbreaks is D8-9171. But because this strain also occurs in Canada and Mexico, CDC scientists are now analyzing the entire genomes of measles viruses — about 16,000 genetic letters long — to see whether those in the United States are more closely related to one another than to those in different countries.

The CDC expects to complete its studies within a couple of months and make the data public. Then the Pan American Health Organization, which oversees the Americas in partnership with the World Health Organization, will decide whether the United States will lose its measles elimination status. And that would mean that costly, potentially deadly, and preventable measles outbreaks could become common again.

“When you hear somebody like Abraham say ‘the cost of doing business,’ how can you be more callous,” pediatrician and vaccine specialist Paul Offit said in an online discussion hosted by the health blog Inside Medicine on Tuesday. “Three people died of measles last year in this country,” Offit added. “We eliminated this virus in the year 2000 — eliminated it. Eliminated circulation of the most contagious human infection. That was something to be proud of.”

Abraham said vaccination remains the most effective way to prevent measles but that parents must have the freedom to decide whether to vaccinate their children. Several states have loosened school vaccine requirements since 2020, and vaccine rates have dropped. A record rate of kindergartners, representing about 138,000 children, obtained vaccine exemptions for the 2024-25 school year.

Information on vaccines has been muddied by Health and Human Services Secretary Robert F. Kennedy Jr., who previously founded an anti-vaccine organization. He has undermined vaccines throughout his tenure. On national television, he has repeated scientifically debunked rumors that vaccines may cause autism, brain swelling, and death.

Jennifer Nuzzo, director of the Pandemic Center at Brown University, disparaged the Trump administration’s focus on finding genetic technicalities that may spare the country’s measles-free status. “This is the wrong thing to pay attention to. Our attention has to be on stopping the outbreaks,” she said.

While scientists race to study spread of measles in U.S., Kennedy unravels hard-won gains

“If we keep our status, it should be because we have stopped the spread of measles,” she said. “It’s like they’re trying to be graded on a curve.”

The Trump administration impeded the CDC’s ability to assist West Texas during the first critical weeks of its outbreak and slowed the release of federal emergency funds, according to KFF Health News investigations. However, the agency stepped up its activity last year, providing local health departments with measles vaccines, communication materials, and testing. Abraham said HHS would give South Carolina $1.5 million to respond to its outbreak, which began nearly four months ago and had reached 646 cases as of Tuesday.

If the CDC’s genomic analyses show that last year’s outbreaks resulted from separate introductions from abroad, political appointees will probably credit Kennedy for saving the country’s status, said Demetre Daskalakis, a former director of the CDC’s national immunization center, who resigned in protest of Kennedy’s actions in August.

And if studies suggest the outbreaks are linked, Daskalakis predicted, the administration will cast doubt on the findings and downplay the reversal of the country’s status: “They’ll say, who cares.”

Indeed, at the briefing, Abraham told a reporter from Stat that a reversal in the nation’s status would not be significant: “Losing elimination status does not mean that the measles would be widespread.”

Data show otherwise. Case counts last year were the highest since 1991, before the government enacted vaccine policies to ensure that all children could be protected with measles immunization.

Lauren Sausser contributed reporting. Amy Maxmen is a national reporter for Healthbeat through a partnership with KFF Health News.

Amid funding threats, nearby measles, and vaccine changes, Georgia’s public health board hasn’t met in months

2026-01-09T21:41:34+00:00

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As the federal government makes major changes to food and vaccine policy, uncertainty swirls in Washington over public health funding to states, and neighboring South Carolina is battling a surging measles outbreak, the board of the Georgia Department of Public Health has decided it doesn’t need to meet this month.

“As there is no official business pending for the Georgia Board of Public Health, no meeting is scheduled at this time,” state Department of Public Health spokesperson Nancy Nydam Shirek told Healthbeat on Friday.

The nine-member board last met in September. It unexpectedly cancelled a November meeting “due to unforeseen scheduling issues,” according to a note on its website.

The date of the next meeting “is to be determined,” Nydam Shirek said.

“This is an agency with a budget pushing more than $800 million,” said Richard Griffiths, former president of the Georgia First Amendment Foundation and an open government advocate.

“There’s no reason for them to meet at all? That seems farfetched. For the board to not meet is effectively saying that everything is perfect, and we know that’s not the case, because Georgia ranks the eighth worst in the country for infant mortality.”

Georgia lawmakers return as federal health funding uncertainty looms

When the board does meet, it typically hears from public health Commissioner Dr. Kathleen Toomey and State Epidemiologist Dr. Cherie Drenzek about disease trends in the state. Public health employees also give updates on topics ranging from newborn screening to food service inspections.

The meetings, held via Zoom, provide board members a chance to ask questions about how programs are working. For example, at the September meeting, Dr. James Curran, the board’s chair, criticized new vaccine policies introduced by U.S. Health and Human Services Secretary Robert F. Kennedy Jr.

Toomey said at that meeting the agency would consider following other guidelines, such as those from the American Academy of Pediatrics, if the federal government changed its recommendations around routine childhood vaccines.

The federal government did change its recommendations this week.

The board met just four times each in 2024 and 2025. It also met just twice during the first two years of the Covid pandemic, but resumed meeting more regularly in 2023. Georgia’s open meetings law requires state agencies to meet “in accordance with a regular schedule.”

In response to questions from Healthbeat about why it does not meet more frequently, Nydam Shirek said, “The Georgia Department of Public Health regularly issues news releases and posts on social media on topics of interest and public health matters of concern. DPH also maintains a website that provides information about all DPH programs.”

Since the September meeting, flu rates have spiked in Georgia, and health department workers put in hundreds of working hours to contain a measles outbreak at Georgia State University.

Now a measles outbreak in South Carolina has surged to 310 cases since October 2025, and Georgians are worried about spread. In the 2023-24 school year, 88.4% of Georgia students had received two doses of the measles vaccine, which is below the 95% needed for herd immunity, according to data from the Centers for Disease Control and Prevention.

“Wouldn’t the board be wanting to know what the Department of Public Health has prepared in case that outbreak crossed into Georgia?” Griffiths said.

And the federal budget, which contributes more than half of Georgia’s public health budget, is bogged down in Washington. Looming cuts to Medicaid and Affordable Care Act health insurance plans could impact 492,000 Georgians by 2034, according to a Georgia Health Initiative analysis.

“It is unfortunate that the board isn’t meeting regularly, especially at a time when public health faces such profound funding and messaging challenges from HHS,” family medicine doctor and GSU professor of public health Harry Heiman told Healthbeat.

“Ensuring transparency and presenting the critical role of public health agencies is more important than ever,” Heiman said, adding that board meetings serve as an opportunity to talk about the good work DPH does, too, “like our effective response and containment of measles outbreaks,” as well as share its plans to address poor health outcomes and health inequities.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

South Carolina measles outbreak grows in wake of holiday season

2026-01-06T21:39:20+00:00

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The ongoing measles outbreak in South Carolina – one of the nation’s largest in recent months – continues to grow in the wake of the holiday season, with 26 new infections reported Tuesday.

This surge in new cases raises to 211 the total number of people infected in the outbreak, which began last fall and is centered in Spartanburg County, along the state’s northwestern border.

Nearly all of those infected have been children and teens, and nearly all have been unvaccinated, according to the South Carolina Department of Public Health. Four people, including children and adults, have been hospitalized for complications of the disease.

“The sharp increase in cases and the number of people currently in quarantine does not indicate the outbreak is waning,” said Dr. Linda Bell, the state epidemiologist who is leading the department’s measles response.

“The primary challenge to controlling measles spread is the lower than needed vaccination coverage to achieve herd immunity in the community,” she said.

Statewide, the percentage of students who are fully vaccinated with two doses of measles vaccine has fallen below the 95% needed to protect against outbreaks. At some individual schools, vaccination rates can be significantly lower.

South Carolina’s outbreak is among 49 U.S. outbreaks reported during 2025, according to the Centers for Disease Control and Prevention. Nationwide, these outbreaks were responsible for most of the 2,065 confirmed measles cases nationwide last year, according to CDC data that was most recently updated on Dec. 31.

While scientists race to study spread of measles in U.S., Kennedy unravels hard-won gains

It’s the first time in more than 30 years that the number of measles cases in the United States has exceeded 2,000. There were three deaths.

Arizona, which also is experiencing a recent outbreak of measles along the Arizona-Utah border, had identified 214 infections as of its update on Tuesday. In Utah, 156 people had been diagnosed with measles in that outbreak as of Dec. 30.

Texas, which announced the end to its significant measles outbreak in August, confirmed more than 760 cases, with 99 people hospitalized and two deaths of school-age children.

The United States was deemed to have eliminated measles in 2000. But the ongoing outbreaks that began last year have put the country at risk of losing its measles elimination status.

In South Carolina, state health officials on Tuesday said 144 people are in quarantine and seven more are in isolation. For those in quarantine, the latest end date is Jan. 28.

The outbreak shows no signs of being brought under control. The state health department said the newly identified cases potentially exposed others to measles in multiple public settings, including schools and churches.

It typically takes 7 to 12 days – but sometimes up to 21 days – after exposure for people to start showing initial symptoms, such as cough, runny nose, red eyes, and a fever, which are later followed by a rash. That means those who were exposed and became infected in late December will start showing symptoms now and in the coming days.

“This disease finds pockets of unvaccinated folks and just runs through those pockets like wildfire,” said Dr. Robert Oliverio, chief medical officer for ambulatory care and population health for Roper St. Francis Healthcare in Charleston. “It tends to hit hard. These couple of school systems in the Upstate now are really getting decimated.”

While the outbreak has so far been centered around Spartanburg County on the northern edge of the state, he said he wouldn’t be surprised to see cases in other parts of the state. “I can’t imagine that we’ll get through this season, particularly with schools getting back in and kids traveling around.”

A person who has measles is contagious starting four days before the disease’s hallmark rash appears and continues to be able to spread the virus through four days after symptoms appear. South Carolina health officials have emphasized that this means people can spread the disease before they know they are infected.

“It is very important for those with mild illness or who are in quarantine to stay home to protect others,” the state health department said Tuesday. “We encourage employers to support workers in following DPH recommendations to stay out of work while ill or in quarantine. which also protects businesses, other workers, and clients.”

Among the places where new public exposures to measles have occurred: Sugar Ridge Elementary and Boiling Springs Elementary on Dec. 18 and 19, prior to the schools’ winter break. Nine students of these schools are in quarantine, state health officials said.

Between Dec. 19 and Dec. 25, exposures occurred at four churches: Tabernacle of Salvation Church, Slavic Pentecostal Church of Spartanburg, Unitarian Universalist Church of Spartanburg, and Ark of Salvation Church.

Over the weekend, South Carolina health officials issued another public alert that a person infected with measles – who was unaware they were infectious – had made Christmas Eve visits in Greenville, S.C., to a Best Buy store and a downtown gastropub called the Nose Dive. Then on Dec. 27, the person attended a planetarium show at the Spartanburg Library.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

New York health update: Nuts recalled, measles nearby, medspa red flags, flu rising

2025-12-19T15:56:47+00:00

How beautiful was New York this weekend with the snow?! I hope you all enjoyed it, stayed warm, and didn’t have any slips (I had to catch myself a couple times on ice.)

As we head into the holidays and many of us travel to be with loved ones, there’s some health news to keep in mind. This week, I’m covering a recall of mixed nuts, measles in Connecticut, health violations at medspas, and circulating respiratory viruses before YLE slows down for a holiday break. As always, drop us any comments on what you’re interested in hearing more about.

Let’s jump in.

Salmonella and Wegmans mixed nuts recall

Time for a pantry check: Wegmans grocery store is recalling two mixed nuts products for potential Salmonella contamination, sold in New York and eight other states and Washington, D.C. Products were sold between Nov. 3 and Dec. 1. No illnesses have been reported so far.

Products recalled:

Wegmans Deluxe Unsalted Mixed Nuts 34-oz. tub, Family Pack
- UPC 077890421314
- Lot 58041
- Best by Jul. 28, 2026
Wegmans Deluxe Unsalted Mixed Nuts 11.5-oz. bag
- UPC 077890421352
- Lot 58171
- Best by Aug. 10, 2026

Recalled mixed nuts from Wegmans.

Routine testing by the supplier found one lot of raw pistachios to be positive for salmonella. The company then initiated a recall after determining these pistachios had been further used in the production of the Deluxe Mixed Nuts products.

What to do:

Don’t eat them. Return for a refund or discard them.
If you ate them and get fever, diarrhea, vomiting, or belly pain, most people can recover at home. But call your clinician sooner if you’re pregnant, over age 65, immunocompromised, or if your symptoms are severe/dehydrating.

Medspas are everywhere. Here’s how to check if yours is legit

Medical spas (or “medspas”) — those day spa-like clinics offering beauty services — are popping up everywhere. While they might feel like day spas, offering services like manicures or facials, many of their other procedures — Botox, fillers, IV drips, etc. — require providers to have a medical license. So before you visit one for a holiday season facial or a new treatment, it’s a good idea to make sure you know what you’re getting into.

A recent investigation into 15 New York City medpas (all of which had been flagged by consumers or agency staff as potentially problematic) found several health and safety violations, many of which could put customers and employees at risk.

Percentage of medspas receiving violations by type.

If you plan to visit a medspa, there are a couple of steps you can take to make sure standards are being met:

If you are getting something that qualifies as a medical procedure (a rule of thumb is anything that breaks the skin or goes inside your body), check that your provider has a valid license. You can verify it through New York’s official database. Medical procedures must be performed by a licensed medical professional — like an MD, DO, PA, or RN — and in a licensed medical setting. It’s the law. All 15 of the investigated medspas were offering medical procedures without proper licensing.
Check the business’s license. An “Appearance Enhancement Business” license covers cosmetology-type services (like facials, manicures, and hair salon services), but it does not cover injectables or other more invasive medical services, such as Botox, IV drips, or liposuction.
Look for medical “green flags”:

A real medical intake (history, meds, allergies), informed consent, and a plan for complications.
Clear labeling and unopened product (especially for injectables).
Clean room setup (hand hygiene, sharps container, sterile supplies).

Over half of the investigated medspas had serious sanitation and hygiene issues; some offered foreign or unregulated medications, and others used expired or potentially fraudulent products.

Report concerns. To file a complaint against a medical practitioner in New York, you can contact the New York State Department of Health’s Office of Professional Medical Conduct for doctors/PAs or the New York State Education Department’s Office of Professional Discipline for other professionals (licensed or unlicensed).

Measles in Connecticut (and what it means for New York)

Connecticut just confirmed its first measles case in more than four years in an unvaccinated child under 10 in Fairfield County. The child had recently traveled internationally with family. Contact tracing by the health department is underway, and people who may have been exposed are being notified. The health department said unvaccinated or under-vaccinated (with fewer than two doses of MMR) children and adults, including those with vaccination exemptions, will need to be out of school for 21 days.

Measles is one of the most contagious viruses — it can linger in the air for up to two hours after an infected person leaves a room, and 9 out of 10 unvaccinated people exposed will get infected. It also isn’t “just a rash” and can cause severe illness: In children under 5 years old, 1 in 5 cases are hospitalized. In severe cases, measles can cause pneumonia and brain swelling.

What to do (in Connecticut, New York, and anywhere else):

Check MMR status for everyone in your household. Two doses are about 97% effective at preventing measles.
If you think you or your child were exposed and develop symptoms, call your doctor/urgent care. Make sure to call before showing up in person so that proper precautions can be taken to avoid exposing others.
Watch for symptoms: fever/cough/runny nose/red eyes, then rash that often starts at the hairline and moves downward.

It’s not too late to get vaccinated, especially if you will be traveling internationally or to any U.S. region with a measles outbreak.

The recommendation is:

Being fully vaccinated with the MMR vaccine at least two weeks before departure.
If the trip is less than two weeks away and the traveler is not immunized, getting one dose of MMR is advised.

As always, consult with your medical provider to discuss what’s right for you and your family.

Infectious disease ‘weather report’

Flu: Increasing sharply. The most recent data show that cases and hospitalizations in the state have increased by 29% and 75%, respectively. Emergency department visits and hospitalizations for the flu in New York City are also rising, with the largest increases among kids under 18.

Hospitalizations for respiratory viruses in New York.

RSV: Also increasing across the state, mostly in kids under age 4. Statewide, hospitalizations increased by 18%.

Covid: Slowly increasing in New York.

As we head into the holidays, when many of us will be traveling to see loved ones, flu is top of mind. To reduce the spread of illness, consider masking in indoor crowded spaces — I’ve been wearing mine on the train, in the airport, and at grocery stores — and reducing contact with others if you’re feeling sick.

Bottom line

You’re all caught up on New York public health news! I hope the holidays bring you peace, joy, rest, and all the cookies.

Love,

Your NY Epi

There’s more to the measles comeback than misinformation

2025-12-18T12:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s Global Checkup in your inbox a day early.

Hello from Sydney, Australia.

I arrived on Sunday to spend the holidays with my in-laws. It has been an odd and heavy start. We landed just hours after the attack at Bondi Beach, a short distance from where we are staying. At the same time, this is Australia at Christmas, with its familiar rituals. Shrimp, shorts, and sunburns.

This week, I am finally catching up on a disease I have largely avoided covering: measles. I have tended to see its resurgence in the West as a misinformation problem with American roots. But as we’ll see, that framing falls short.

My name is William Herkewitz, and I’m a journalist (usually) based in Nairobi, Kenya. This is the Global Health Checkup, where I highlight five of the week’s most important stories on outbreaks, medicine, science, and survival from around the world.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

Blaming misinformation isn’t enough to explain measles’ return

Follow measles across the West and you find an uncomfortable trail of resurgence. For example: Europe is seeing record cases, and Canada just officially lost its measles elimination status. For developed countries, this rise is most often blamed on vaccine misinformation. Basically, that widespread distrust and conspiracy-minded thinking (supercharged by a Covid-era backlash) is increasingly hollowing out vulnerable, unvaccinated pockets of people for the virus to spread between.

Disease breakdown: Measles is one of the most contagious viruses on Earth. It spreads through the air when an infected person coughs or breathes. It causes fever, cough, a distinctive rash, and can lead to death, especially in young children. Two doses of the 50-year-old measles vaccine is 97% effective and remains the only viable way to stop the spread of the disease.

In the United States, it is especially easy to believe this explanation right now. As Healthbeat reports, America’s chief public health official and renowned anti-vaxxer Robert F. Kennedy Jr. is actively undermining “the ability of public health officials to prevent and contain outbreaks” of the virus. But is that the full story?

Australia is the strongest test of this explanation (and, conveniently, I’m here). That’s because it’s a country with one of the world’s most robust public health and vaccination systems, free childhood vaccines, and historically high coverage. And measles cases are rising here, as well, Medscape reports.

I reached out to Julie Leask, a professor of public health at the University of Sydney and one of Australia’s leading experts on what people think, feel, and do about vaccination. I asked if vaccine misinformation is simply eroding confidence in the same way here, too.

Leask surprised me. In Australia, she said, while “the clickbaity idea that [measles resurgence] is all about vaccine refusal” absolutely dominates local headlines, the data do not fully support that explanation. She pointed to Australia’s National Vaccination Insights Project, a vaccination surveillance system that tracks the real-world reasons children miss doses. “Vaccine refusal is absolutely a problem,” she told me, “but it’s not the only problem.”

Leask notes that two other forces are doing at least as much work to recirculate the disease in Australia. One is rising measles cases in developing countries like Vietnam, Thailand, and Indonesia, where people may travel and return with an infection. The other is a mix of everyday practical barriers that Leask calls “social determinants of vaccination.” These range from hard-to-reach clinics and staff shortages to families who missed routine shots during the pandemic and never fully caught up, which have left pockets of children without vaccines or only partially vaccinated. Together, she said, those factors can pose as much risk as anti-vaccine sentiment alone.

The larger lesson, she argued, is that across the developed world, measles control depends as much on keeping vaccination easy, accessible, and routine as it does on countering misinformation.

Is misinformation rising, and should we be wary of it? Without question. But focusing on it alone misses where other real gaps are opening.

Kenya court pauses ‘America First’ health deal

Over the weekend, Kenya’s High Court halted the new U.S.-Kenya health aid deal that we discussed last week, Kenya’s The Standard reports. The agreement was meant to lock in $1.6 billion in American funding, and was the first test case of Washington’s new “America First” health aid model.

The issue? Data.

Tucked into the agreement was a provision committing Kenya to share population-wide health data with the United States and U.S. companies for up to 25 years, a scope and timeline that critics say were never clearly explained to the public or debated in parliament.

Last week I wrote that I “initially didn’t read this as a nefarious data grab,” but rather as a clumsy fix for the surveillance gap the United States created by exiting the World Health Organization. (But, as The Standard notes, the agreement “requires Kenya to share extensive medical data, including HIV/AIDS, tuberculosis, malaria, maternal and child health,” in addition to data purely on “disease surveillance,” which frankly makes my more charitable interpretation harder to sustain.)

Certainly, this ruling is an early embarrassment for the Trump administration’s flagship health agreement, though its practical impact on the deal will remain unclear for quite a while. The case isn’t even due in court until Feb. 12.

What’s the takeaway?

Well, it’s worth revisiting my conversation with John Kuehnle, who ran America’s health programs for the U.S. Agency for International Development in Kenya from 2020 to 2024. We discussed the data clause last week, well before the court intervened, and Kuehnle walked through potential rationales for why U.S. negotiators wanted the data in the deal at all.

A generous interpretation is that the information could “be mutually beneficial if it’s used to develop medicines and medical devices that are tailored to the needs for Kenyans and other Africans,” he said. But Kuehnle noted that this business case is thin at best. “What’s the point of making a drug tailored to a population that can only afford it if a donor buys it, when the donor funding runs out in five years?”

Even if the courts allow the data sharing to go through, Kuehnle cautioned that political consent is unlikely to outlast the money. “If no material gains come from Kenyans giving their data to the U.S. in the first five years, I would not be surprised if this fizzles after five years and the funding runs out,” he said. “I don’t see Kenyans continuing to share data for 20 years after the funding runs out simply because a politician in 2025 agreed to do so.”

An HIV surge in Papua New Guinea

Papua New Guinea is facing one of the fastest-growing HIV epidemics in the world*, The Guardian reports. New infections have roughly doubled since 2010, with nearly half occurring among children and young people. This has prompted the government to declare HIV a national crisis, as overstretched health services buckle after the loss of international funding.

Over a third of people living with HIV in Papua New Guinea don’t know they are infected, and mother-to-child transmission of the virus remains “one of the highest globally.” At the same time, prevention and outreach have weakened as international funding has fallen away. The Guardian story notes that hundreds of clinics run by the government and churches have cut back services or shut down entirely.

Luckily, Australia has moved to plug part of the funding gap, increasing its annual HIV funding to about $6.6 million. UNAIDS says this will keep its Papua New Guinea office operating for another two years. But this intervention only buys time. One source in the article says what when U.S. funding stopped this year, there was “no second plan given to us, and we were told to close down the clinic,” said a social worker in the capital, Port Moresby.

The takeaway: Even senior Papua New Guinean officials concede that there is no clear plan for the HIV outbreak if foreign funding doesn’t return. Foreign minister Justin Tkatchenko warned the country needs a “fallback position,” adding: “The long-term strategy is doing it ourselves. We can’t continually rely on other donor partners to help us.”

(*Worth noting: Papua New Guinea’s doubling of HIV cases is still dwarfed by the wild surges currently seen in the Philippines, Fiji, or Madagascar.)

Your lungs on airplane mode

Air travel has a dirty little secret … what passengers are breathing.

A new study in the journal Environmental International finds that airline passengers can be exposed to extremely high levels of ultrafine air pollution while flying, Oman’s The Arabian Stories reports. This is especially true during boarding, taxiing, and landing.

The findings are new here, but so too was the research approach. The researchers basically brought air-quality monitors onto real flights and measured what was in the cabin air at each stage of the trip, instead of relying on estimates or airport data.

The key point is that jet engine pollution can seep into cabin air before the plane reaches cruising altitude, when filtration systems work best. The particles the researchers measured are small enough to reach deep into the lungs and even enter the bloodstream, raising concerns for flight crews and airport workers who face this exposure repeatedly.

So the takeaway … is never fly again?

No, not exactly. While the pollution spikes were striking, the researchers also found that when you average exposure across an entire flight, overall ultrafine particle levels inside planes are actually lower than what people experience in many everyday settings, like sitting in heavy road traffic. The researchers say the risk is less about any single flight than about repeated exposure, and the findings point to specific moments on the ground where pollution is entering the cabin and could, in theory, be reduced.

Yes, we’re ending on poop

Let’s end this week’s edition with some optimistic news somewhere unexpected: the sewer.

Public health officials in the UK are expanding wastewater testing to spot outbreaks by analyzing what people flush away, the Financial Times reports. When people are infected, they shed viruses and bacteria in their waste, often days before symptoms appear. Sewers gather this, uh, trove of data, turning treatment plants into incidental health monitors for entire cities.

What I found striking in the Financial Times reporting isn’t the UK’s plan itself, but how fast wastewater surveillance is proliferating and diversifying worldwide.

The EU launched a Global Consortium for Wastewater and Environmental Surveillance for Public Health last year, while local projects are popping up elsewhere. In Houston, researchers detected measles virus in sewage 10 days before any cases were officially reported, a result that Anthony Maresso of Baylor College said “underscores the high sensitivity of the method.” In Nevada, scientists are using artificial intelligence to scan wastewater for flu, RSV, mpox, measles, gonorrhea, and drug-resistant fungi.

Gross? Absolutely. But incredibly cool? Oh yeah.

It’s a reminder that even as traditional disease surveillance faces challenges, new tools are emerging in unlikely places. And sure, wastewater is messy and unglamorous … but after the flush, the data are hard to spin!

Healthbeat will be on a holiday break for the next two weeks. I’ll see you next year.

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

While scientists race to study spread of measles in U.S., Kennedy unravels hard-won gains

2025-12-05T15:09:32+00:00

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The United States is poised to lose its measles-free status next year. If that happens, the country will enter an era in which outbreaks are common again.

More children would be hospitalized because of this preventable disease. Some would lose their hearing. Some would die. Measles is also expensive. A new study — not yet published in a scientific journal — estimates that the public health response to outbreaks with only a couple of cases costs about $244,000. When a patient requires hospital care, costs average $58,600 per case. The study’s estimates suggest that an outbreak the size of the one in West Texas earlier this year, with 762 cases and 99 hospitalizations, costs about $12.6 million.

America’s status hinges on whether the country’s main outbreaks this year stemmed from the big one in West Texas that officially began Jan. 20. If these outbreaks are linked, and go on through Jan. 20 of next year, the United States will no longer be among nations that have banished the disease.

“A lot of people worked very hard for a very long time to achieve elimination — years of figuring out how to make vaccines available, get good vaccine coverage, and have a rapid response to outbreaks to limit their spread,” said Paul Rota, a microbiologist who recently retired from a nearly 40-year career at the Centers for Disease Control and Prevention.

Instead of acting fast to prevent a measles comeback, Robert F. Kennedy Jr., a lawyer who founded an anti-vaccine organization before taking the helm at the Department of Health and Human Services, has undermined the ability of public health officials to prevent and contain outbreaks by eroding trust in vaccines. The measles vaccine is safe and effective: Only 4% of nearly 1,800 confirmed U.S. cases of measles this year have been in people who had received two doses.

Kennedy has fired experts on the vaccine advisory committee to the CDC and has said, without evidence, that vaccines may cause autism, brain swelling, and death. On Nov. 19, scientific information on a CDC webpage about vaccines and autism was replaced with false claims. Kennedy told The New York Times that he ordered the change.

“Do we want to go back into a pre-vaccine era where 500 kids die of measles each year?” asked Demetre Daskalakis, a former director of the CDC’s national immunization center, who resigned in protest of Kennedy’s actions in August. He and other scientists said the Trump administration appears to be occupied more with downplaying the resurgence of measles than with curbing the disease.

HHS spokesperson Andrew Nixon said in a statement that vaccination remains the most effective tool for preventing measles and that the “CDC and state and local health agencies continue to work together to assess transmission patterns and ensure an effective public health response.”

Scientists look for links between outbreaks

CDC scientists are indeed tracking measles, alongside researchers at health departments and universities. To learn whether outbreaks are linked, they’re looking at the genomes of measles viruses, which contain all their genetic information. Genomic analyses could help reveal the origin of outbreaks and their true size, and alert officials to undetected spread.

Scientists have conducted genomic analyses of HIV, the flu, and Covid for years, but it’s new for measles because the virus hasn’t been much of a problem in the United States for decades, said Samuel Scarpino, a public health specialist at Northeastern University in Boston. “It’s important to get a surveillance network into place so that we could scale up rapidly if and when we need it,” he said.

Fulton health team logs 200 extra hours tracing measles exposures tied to GSU student

“We are working with the CDC and other states to determine whether what we’re seeing is one large outbreak with continued spread from state to state,” said Kelly Oakeson, a genomics researcher at the Utah Department of Health and Human Services.

At first glance, the ongoing outbreak in Utah and Arizona, with 258 cases as of Monday, seems linked to the one in Texas because they’re caused by the same strain of measles, D8-9171. But this strain is also spreading throughout Canada and Mexico, which means the outbreaks could have been sparked separately from people infected abroad. If that happened, this technicality could spare the United States from losing its status, Rota said. Being measles-free means the virus isn’t circulating in a country continuously year-round.

Canada lost its measles-elimination status in November because authorities couldn’t prove that various outbreaks from the D8-9171 strain were unrelated, said Daniel Salas, executive manager of the comprehensive immunization program at the Pan American Health Organization. The group, which works with the World Health Organization, includes health officials from countries in North, South, and Central America, and the Caribbean. It makes a call on measles elimination based on reports from scientists in the countries it represents.

Early next year, PAHO will hear from U.S. scientists. If their analyses suggest that measles has spread continuously for a year within the United States, the organization’s director may revoke the country’s status as measles-free.

“We expect countries to be transparent about the information they have,” Salas said. “We will ask questions, like, ‘How did you determine your findings, and did you consider other angles?’”

In anticipation of PAHO’s assessment, Oakeson and other researchers are studying how closely the D8-9171 strains in Utah match others. Instead of looking at only a short snippet of genes that mark the strain, they’re analyzing the entire genome of the measles virus, about 16,000 genetic letters long. Genetic mutations occur naturally over time, and the accumulation of small changes can act like a clock, revealing how much time has ticked by between outbreaks. “This tells us the evolutionary history of samples,” Oakeson said.

For example, if one child directly infects another, the kids will have matching measles viruses. But measles viruses infecting people at the start of a large outbreak would be slightly different than those infecting people months later.

Although the Texas and Utah outbreaks are caused by the same strain, Oakeson said, “more fine-grained details are leading us to believe they aren’t super closely related.” To learn just how different they are from each other, scientists are comparing them with measles virus genomes from other states and countries.

Ideally scientists could pair genetic studies with shoe-leather investigations into how each outbreak started. However, many investigations have come up dry because the first people infected haven’t sought care or contacted health departments. As in West Texas, the outbreak in Utah and Arizona is concentrated in close-knit, undervaccinated communities that are leery of government authorities and mainstream medicine.

Researchers are also trying to learn how many measles cases have gone undetected. “Confirmed cases require testing, and in some communities, there’s a cost to going to the hospital to get tested: a tank of gas, finding a babysitter, missing work,” Andrew Pavia, an infectious disease doctor at the University of Utah, said. “If your kid has a measles rash but isn’t very sick, why would you bother?”

Subtle Surveillance: Researchers analyzing genomes

Pavia is part of a nationwide outbreak surveillance network led by the CDC. A straightforward way to figure out how large an outbreak is would be through surveys, but that’s complicated when communities don’t trust public health workers.

“In a collaborative setting, we could administer questionnaires asking if anyone in a household had a rash and other measles symptoms,” Pavia said, “but the same issues that make it difficult to get people to quarantine and vaccinate make this hard.”

Instead, Pavia and other researchers are analyzing genomes. A lot of variation suggests an outbreak spread for weeks or months before it was detected, infecting many more people than known.

As measles exploded, officials in Texas looked to CDC scientists. Under Trump, no one answered.

A less intrusive mode of surveillance is through wastewater. This year, the CDC and state health departments have launched efforts to test sewage from households and buildings for measles viruses that infected people shed. A study in Texas found that this could function as an early warning system, alerting public health authorities to an outbreak before people show up in hospitals.

The quiet research of CDC scientists stands in stark contrast to its dearth of public-facing actions. The CDC hasn’t held a single press briefing on measles since President Donald Trump took office, and its last publication on measles in the agency’s Morbidity and Mortality Weekly Report was in April.

Rather than act fast to limit the size of the Texas outbreak, the Trump administration impeded the CDC’s ability to communicate quickly with Texas officials and slowed the release of federal emergency funds, according to investigations by KFF Health News. Meanwhile Kennedy broadcast mixed messages on vaccines and touted unproven treatments.

Daskalakis said that as the outbreak in Texas worsened, his CDC team was met by silence when they asked to brief Kennedy and other HHS officials.

“Objectively they weren’t helping with the Texas outbreak, so if we lose elimination, maybe they’ll say, ‘Who cares,’” Daskalakis said.

Nixon, the HHS spokesperson, said Kennedy responded strongly to the Texas outbreak by directing the CDC to help provide measles vaccines and medications to communities, expediting measles testing, and advising doctors and health officials. The U.S. retains its elimination status because there’s no evidence of continuous transmission for 12 months, he added.

“Preliminary genomic analysis suggests the Utah and Arizona cases are not directly linked to Texas,” the CDC’s acting director, Deputy HHS Secretary Jim O’Neill, wrote on the social platform X.

Given Kennedy’s distortions of data on vitamin A, Tylenol, and autism, Daskalakis said the Trump administration may insist that outbreaks aren’t linked or that PAHO is wrong.

“It will be quite a stain on the Kennedy regime if he is the health secretary in the year we lose elimination status,” he said. “I think they will do everything they can to cast doubt on the scientific findings, even if it means throwing scientists under the bus.”

Amy Maxmen is a national reporter for Healthbeat through a partnership with KFF Health News.

Fulton epidemiologist calls measles containment a ‘public health win’ after weeks of tracing contacts

2025-10-14T20:58:52+00:00

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Public health workers spent about 200 extra work hours to track down 268 people who might’ve been exposed to measles in recent weeks in an outbreak that began with an unvaccinated Georgia State University student, Fulton County health officials said Tuesday.

The county health agency identified the first measles case Sept. 10 in the student, who had spent time on campus, at a Sweetgreen eatery at Ponce City Market, and local soccer practices and games, Director of Epidemiology Sasha Smith said during the Fulton Board of Health meeting.

“These measles investigations are lengthy, and they’re very resource intensive,” Smith said. “We have to do rigorous contact tracing.”

For the outbreak to be considered over, two incubation periods (42 days) must pass without additional cases. That would put the end of this outbreak over about Oct. 22. “We’re on the tail end of” it, Smith said.

Of 268 identified as “close contacts” of the first case, seven either had not been vaccinated or had an unknown vaccination status. Those seven entered home quarantine to avoid spreading the highly contagious respiratory virus, Smith said.

Of those seven, three contracted measles. Smith said some of those quarantined agreed to get the measles, mumps, rubella vaccine but would not specify how many.

Smith said the GSU student first infected had no history of international travel, and it’s uncertain where they contracted measles, which she called a “bit concerning.”

The Board of Health sent an environmental health team to Sweetgreen, where the student had spent hours over three days while contagious, and alerted the restaurant’s employees about the potential exposure.

Since many of the close contacts were exposed at GSU’s downtown Atlanta campus, it was easy to track down students’ vaccination records, Smith said. The university requires students to be vaccinated but allows exemptions for religious reasons. Students must sign an affidavit to obtain the exemption, a GSU spokesperson said.

Smith said containing the outbreak had been a “huge public health win” and credited the hard work of public health employees and the cooperation of other organizations, including other county health departments and the state Department of Public Health, and those who were asked to quarantine.

Georgia has reported a total of 10 measles cases this year. Nationally, 1,563 cases had been reported as of Oct. 8, according to the Centers for Disease Control and Prevention. Most of the cases are connected to a large outbreak in west Texas and New Mexico. Two Texas children and a New Mexico adult – all unvaccinated – have died.

Measles has been reported in Alabama, Florida, Tennessee, and South Carolina, where 16 cases have been reported and more than 150 unvaccinated children in Spartanburg County are quarantined due to the ongoing outbreak.

Meanwhile, Smith said Fulton is also hearing from parents and child care facilities about cases of hand, foot, and mouth disease.

It is highly contagious and causes a fever, mouth sores, and a skin rash, though it typically is not serious, according to the CDC.

Smith urged parents to keep their children at home until they have been free of fever for 24 hours without fever-reducing medicine and no longer have open blisters.

HIV update, West Nile season, tuberculosis cases

The agency is starting a do over of $2 million in grants awarded last month to 12 community organizations for work on HIV prevention and care, interim district health director Chris Rustin said.

The awards, funded by the CDC, had not been consistently evaluated, so the board canceled them on Thursday and will start the bidding process over.

Affected groups include AID Atlanta, SisterLove, the AIDS Healthcare Foundation, Empowerment Resource Center, and the Georgia Harm Reduction Council.

Meanwhile, Fulton is close to filling nine jobs in HIV prevention and sexual health after 17 of those workers were laid off in May. Fourteen of the jobs were restored. Nine employees are set to start on Thursday, as recruiting continues for the remaining vacancies.

A few other Fulton health updates:

West Nile virus: The season is almost over, said Brandon Leftwich, environmental health director. Fulton County had one case in a human this year, and there were a total of 15 human cases in Georgia this year as of Oct. 7, according to the CDC.
Tuberculosis: Fulton County health workers have identified an apartment complex where there are eight cases of tuberculosis. Many of the patients came from West Africa, and workers are screening 20 of their contacts for the disease, according to a board document.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

What’s new in NY health: measles in Oswego wastewater, chikungunya in Long Island

2025-10-03T13:32:38+00:00

Is it just me, or does it all of a sudden feel like fall in New York this week? And I am all for it 🍁 There’s a lot to cover this week, so let’s jump right in.

Infectious disease ‘weather report’

Covid-19: Declining, but still elevated.

RSV: No activity yet in New York.

Flu: No activity yet in New York.

During this lull is the perfect time to get vaccinated — before respiratory viruses pick up.

A new Centers for Disease Control and Prevention report underscores why. Last flu season was especially severe, with one of the highest numbers of pediatric flu deaths in recent years. Nationwide, 109 children developed influenza-associated encephalopathy, a dangerous brain swelling caused by flu infection. In New York alone, 26 children died. And pediatric flu deaths here have been increasing.

Now is the time to get vaccinated and reduce the risk of severe infection. Katelyn Jetelina at YLE National wrote an excellent fall vaccine primer to help you navigate decisions.

Measles detected in Oswego County wastewater

The New York State Health Department issued an alert after measles was detected in wastewater in Oswego County. (The Wastewater SCAN group is testing for measles in Oswego and Ithaca, and New York City is running their own measles testing program.) This means there is at least one case in the community, even though no infections have been identified yet. The alert is to remind health care providers to stay alert for signs and symptoms of measles in patients.

Because measles is so contagious, you need ~93-95% of the population to be vaccinated to prevent an outbreak. In Oswego County, 87.8% of kids under 2 are vaccinated, leaving some susceptible to infection. In response, the health department is monitoring for cases.

The actual risk of an outbreak depends on the community surrounding the person infected. If the person shedding the virus is in a community with high vaccination rates, the risk is low. But if they’re in a pocket with lower coverage, the chance of spread is higher.

For now, no cases have been identified. I’ll be keeping a close eye on this.

For the public, the guidance hasn’t changed: Vaccination is the best protection. For more details, here are common FAQs on the measles vaccine from YLE National.

Measles symptoms usually start like a cold or flu (fever, cough, runny nose, etc.). A rash typically appears a few days later. If you’re sick and think you may have measles, call ahead before going to a clinic, urgent care, or ER so infection-control precautions can be taken.

Chikungunya in Long Island and a death due to EEE

Last week, a woman in Long Island tested positive on a preliminary screen for chikungunya, a virus spread by certain species of mosquitoes. What makes this case unusual is that she had no recent travel history. (Occasionally, travelers will return to New York after acquiring chikungunya abroad.) The New York State Health Department is running additional tests to confirm. If confirmed positive, this would be the first locally acquired case in New York.

Chikungunya is very rare in the United States. The last locally transmitted cases occurred in 2015, with small outbreaks in Florida and Texas. Globally, it’s much more common, particularly in the Caribbean and South America, and a major outbreak is ongoing in China this year.

Symptoms include:

Fever
Severe joint pain or swelling
Headache
Muscle pain
Rash

Why now? Evidence shows that climate change is expanding and shifting the range of the mosquitoes that can carry chikungunya. More frequent human travel and global shipping also help mosquitoes spread, as they can hitch rides on planes, boats, and even in luggage. While we won’t ever know if climate change directly caused this single case, it likely played a role. Epidemiologist Colin Carlson broke down how climate change may be:

Allowing the mosquito to survive in New York
Creating warmer conditions that support viral replication within mosquitoes
Driving larger global outbreaks, increasing the chance of introduction here in New York

As we move into fall and temperatures drop, the risk of more local cases decreases. The overall chikungunya risk in New York remains very low, but we’re still in mosquito season, so it’s best to avoid bites. Wear repellent (Deet or picaridin) or long sleeves, especially at dawn and dusk when mosquitoes are most active, and dump standing water around your home.

Sadly, the case of Eastern Equine Encephalitis virus we covered last week has died. We are sending our love to his family and loved ones.

CTE was confirmed in man who shot and killed four in Midtown NYC office building

Public health goes beyond microbes. Understanding the drivers of violence, and especially gun violence, is incredibly important in the United States.

The man who shot and killed four people in a Midtown Manhattan office building in July was found to have chronic traumatic encephalopathy during an autopsy. CTE is a degenerative brain disease caused by repeated head trauma and is seen most often in athletes and military veterans. It’s linked to impulsivity, depression, memory loss, cognitive decline, and suicidal thoughts. It can only be definitively diagnosed after death.

In a letter, the gunman claimed he developed CTE from playing football. He said his attack was directed at the NFL headquarters and claimed they hid the effects of CTE.

Did CTE cause the shooting?

We won’t ever know whether CTE fully explains this violent act, or if it was just one piece of a more complex picture involving mental health. The truth is, the link between CTE and violence isn’t well understood. One big reason is selection bias. Most brains studied for CTE are from people who showed noticeable symptoms or were involved in high-profile acts of violence. That means we’re missing the full picture. Many people may live with CTE without ever being violent.

CTE isn’t just about concussions

Research shows it’s the cumulative number and intensity of head impacts, not just concussions, that increase risk. Even minor hits, repeated over time, can damage brain cells and blood vessels, leading to microscopic bleeding and toxic protein build-up in the brain.

Prevention starts early

Changing how kids practice football, like reducing full-contact drills or encouraging flag football, can dramatically reduce risk. The Concussion Legacy Foundation estimates that a high school offensive lineman averages 734 head impacts a season with an average strength of 26 g. Because most hits occur in practice, if the number of practice hits were cut in half, like by switching to flag football from some drills, it could cut the overall number of head impacts kids experience by about a third. The fewer and softer the hits, the safer the brain.

Because CTE is only diagnosed after death, it’s incredibly hard to study, and many research gaps remain. But given the possible links to violence and severe mental health issues, it’s an urgent public health priority.

If you or someone you love is struggling after repeated head trauma, resources and help are available: The CDC’s Heads Up Program and the Concussion Legacy Foundation HelpLine can provide resources to those at risk of or struggling with brain injury.

CDC wants to know how you feel after vaccination

V-safe is a vaccine safety monitoring system that lets you tell CDC how you feel after vaccination by completing check-ins. It was created to monitor the safety of Covid-19 vaccines and has expanded to include RSV vaccines. The data collected through V‑safe helps the CDC communicate timely, transparent information about the safety of vaccines. You can sign up here to complete short check-in surveys by text or email following your vaccine.

Bottom line

You’re all caught up on New York health news! Now is the time to get fall vaccines before things start picking up again. See you next week, and I hope you enjoy this changing season!

Love,

Your NY Epi

Measles spreads from Georgia State student to three others

2025-09-24T16:31:33+00:00

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Measles has spread from an unvaccinated Georgia State University student to three other people, bringing the total cases reported in Georgia this year to 10.

Three “close contacts” – two who were unvaccinated and one with an unknown vaccination status – got measles from the student, according to a press release from the state Department of Public Health. The three new patients are isolating at home.

Measles is highly contagious and can linger in the air for up to two hours after an infected person has been there. In a group of unprotected people, 9 in 10 of those exposed will be infected.

Earlier this month, the DPH reported that an unvaccinated person who had spent time on the Georgia State campus, at Inter Atlanta FC soccer practices and games, and at a Sweetgreen restaurant at Ponce City Market had measles.

The initial case prompted a large contact tracing effort by the Fulton County Board of Health and DPH that had identified 268 close contacts of the student as of Tuesday. Seven are enrolled in “active monitoring.”

The student had not traveled outside the United States.

Georgia State requires students to be vaccinated but allows exemptions for religious reasons. Students must sign an affidavit to obtain the exemption, a spokesperson told Healthbeat. The student did not live in GSU housing.

Georgia had six measles cases in 2024. This year, a January outbreak involved three unvaccinated children from the same Gwinnett County family after the initial patient had traveled to New York City. A second outbreak reported in May involved three unvaccinated members of the same family who contracted measles after at least one member traveled internationally.

Nationally, 1,514 cases have been reported as of Sept. 23 according to the Centers for Disease Control and Prevention. Most of the cases are connected to a large outbreak in west Texas and New Mexico. Two Texas children and a New Mexico adult – all unvaccinated – have died. Cases have been reported in South Carolina, Alabama, Florida, and South Carolina this year.

A school-age child in California recently died from a rare but fatal complication of measles, subacute sclerosing panencephalitis. The child contracted measles as an infant before they were eligible to receive the vaccine, the Los Angeles County Department of Public Health reported earlier this month.

Vaccination is the most effective way to prevent measles. Children typically get two doses of the vaccine as part of the measles, mumps, rubella regimen – the first between ages 12 and 15 months, and the second between ages 4 and 6 years.

About 95% of people need to be vaccinated to prevent widespread transmission of the virus, or achieve “herd immunity,” according to the CDC.

In Georgia vaccination rates have been on the decline.

Kindergarten vaccination data from the CDC show 86.8% of the state’s children were fully up-to-date on their MMR vaccinations last year.

Symptoms of measles include a high fever, cough, runny nose, red watery eyes, and a characteristic red rash.

People who suspect they or their child have measles are urged to call their health care providers before going to a hospital, clinic, or doctor’s office to avoid infecting staff and other patients.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Access to Covid shot and 2 childhood vaccines may change this week. Here’s what to know.

2025-09-17T11:00:00+00:00

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Americans may get some movement – but maybe not much clarity – this week on their future access to Covid vaccines and two childhood immunizations as a federal committee convenes in Atlanta to vote on recommendations.

The guidance that emerges from the Advisory Committee on Immunization Practices meeting on Thursday and Friday could influence how and when pharmacists and doctors give the vaccines and whether insurers will pay for them.

The committee has become a political battleground as Health and Human Services Secretary Robert F. Kennedy Jr. seeks to rework the country’s health infrastructure. Kennedy fired the previous expert members of ACIP and replaced them with his own picks, many of whom share his anti-vaccine views.

Public health experts are expecting mixed messages from the meeting. The committee may recommend some shots, with restrictions that could keep people confused as to who should get them.

“For those who are opposed to vaccination, making people feel uncertain about vaccines is kind of their stock in trade,” said Brian Abramson, an attorney who has published a textbook on vaccine law.

Here’s what to know about the meeting and how it could affect access to Covid shots, as well as hepatitis B and MMRV vaccines for children.

What is ACIP? Why does it matter?

ACIP’s recommendations guide how the CDC sets child and adult immunization schedules.

The panel’s recommendations create the standards most health care providers follow and are “considered the gold standard,” said Dr. Ashley Chinchilla, a professor at the University of Georgia College of Pharmacy.

For example, in Georgia and many other states, state law governing which vaccines pharmacists can administer relies on ACIP recommendations. That’s what caused the recent confusion around Covid shots.

While the Food and Drug Administration approved the vaccines for people over 65 and for adults with underlying health conditions last month, ACIP has not issued a recommendation for the updated Covid shots. That’s left patients and pharmacists in limbo, with many pharmacies requiring a prescription to get the shot, a departure from past practice.

“We’re in this holding pattern until there is an official recommendation,” Chinchilla said.

The recommendations also guide which vaccines insurers cover. While private insurers could decide to cover vaccines even if they are not recommended by ACIP, many government programs are bound by the ACIP recommendations, said Matt Motta, a professor at the Boston University School of Public Health.

That includes Vaccines for Children, a federal program that pays for vaccines for under- and uninsured children. About half of all U.S. children are eligible for the program, according to the CDC.

What is on the ACIP agenda?

There are three items on the ACIP agenda for this week: the MMRV vaccine, the hepatitis B vaccine, and the Covid vaccine.

MMRV

The first time on the agenda for Thursday is the measles, mumps, rubella, and varicella, or chickenpox, shot.

It combines the MMR vaccine with the varicella vaccine into one shot that was designed “to make it easier for families to give this vaccine to their children” by eliminating an extra shot, said Dr. Yvonne Maldonado, a former ACIP voting member and a professor of pediatric infectious disease at Stanford University.

There is a higher incidence of febrile seizures in young children who get the combination dose, Maldonado said, but families are advised of this risk and can decide whether to get the MMRV shot as one vaccine or separately.

“In many cases, it’s just easier to give the combination and saves the baby an extra shot,” she said.

ACIP could recommend that the MMR shot be given separately from the varicella shot, Maldonado said.

If that happens, “it’s not going to be a tremendous impact in terms of vaccination overall, as long as people continue to get MMR and V or MMRV together. But it does start to weaken the recommendations around vaccination,” Maldonado said. “It does make it harder for people to get vaccines, and it starts to make people question … what the schedule was.”

Hepatitis B

The committee is scheduled to discuss the hepatitis B vaccine on Thursday afternoon. Currently, the CDC recommends the vaccine for all infants and most adults.

The birth dose is on the agenda for the Thursday meeting, and ACIP could decide to recommend that infants get it later in life instead.

Dr. Tony Fiore, a retired CDC infectious disease expert, said it’s important for the United States to continue to provide the vaccine to infants because hepatitis B can cause serious medical conditions, like cirrhosis or liver cancer, and early death.

The blanket dose for all newborns has helped dramatically reduce cases of hepatitis B. The disease is highly contagious and can be transmitted in a variety of ways, including from mother to child.

“The vaccine is very safe,” Fiore said. He’s concerned removing the recommendation of the birth dose could lead to an increase in cases. While there are screening procedures to check pregnant women for the disease, Fiore said those are complex, and the birth dose ensures that babies born to mothers with the disease do not get it.

Covid

The committee is slated to spend Friday discussing the Covid vaccine.

Ideally, ACIP would recommend that the vaccine be recommended for everyone over 6 months, as in past years, Fiore said.

But several public health experts said it’s more likely that ACIP will follow the FDA’s decision last month to recommend the shots only for adults over 65 and adults with underlying health conditions.

That would be better than further narrowing the eligibility requirements, Motta said.

But it would mean that groups outside the ACIP recommendation may have to get a prescription to receive the shots off-label and that could jeopardize insurance coverage.

This chart shows the 2025-26 combined respiratory vaccine recommendations from various organizations.

What has changed at ACIP?

Kennedy’s remaking of ACIP has drawn criticism and lawsuits from professional medical societies, including the American Academy of Pediatrics and the Infectious Diseases Society of America.

“The committee is staffed [with] a very small number of very extreme people,” Motta said. “Yes, they have scientific credentials. Yes, many of them are medical doctors, but their opinions do not reflect where most of the scientific community is on those issues.”

The committee normally uses a rigorous scientific review process, working in close consultation with experts at the CDC. Representatives from a variety of professional organizations attend the meetings and advise the members, Maldonado said.

That hasn’t been happening this year, and it’s unclear whether the professional groups’ liaisons will participate in the meeting, Maldonado said.

“It feels like this new ACIP since the June meeting has been incredibly ideological,” she said. “That’s very concerning when it comes to understanding how we’re going to be able to utilize vaccines to protect public health.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

New measles case confirmed in Atlanta. Exposures span GSU, Ponce City Market, and soccer fields.

2025-09-12T20:03:04+00:00

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An unvaccinated Georgia State University student has been diagnosed with measles, the seventh case in Georgia this year, after spending time on campus, at Inter Atlanta FC soccer games and practices, and at a restaurant at Ponce City Market over a nine-day period.

The amount of time the patient spent in public while potentially infectious between Sept. 2 and 11 will require “an absolutely massive contact investigation,” said Scott Thorpe, executive director of the Southern Alliance for Public Health Leadership.

The student spent time while infectious in two buildings at GSU (the Aderhold Learning Building and Langdale Hall), at the Sweetgreen restaurant on North Avenue, and at Inter Atlanta FC soccer practices and games, according to a Georgia Department of Public Health press release issued Friday.

The student had not traveled outside the United States. In the past few decades, most cases of measles in the United States came from people who were exposed while traveling abroad. But over the past year, cases caused by domestic transmission have increased.

The student did not live in GSU housing, a university spokesperson said.

Measles is highly contagious and can linger in the air for up to two hours after an infected person has been there. In a group of unprotected people, 9 in 10 of those exposed will be infected.

“DPH is working with the Fulton County Board of Health, GSU, Inter Atlanta FC, and Sweetgreen to notify individuals who may have been exposed to the virus and are at an increased risk of developing measles,” the DPH press release said. The agency said it “urges health care providers to maintain heightened awareness for patients with measles.”

The Fulton County Board of Health will conduct screenings and contact tracing, a GSU spokesperson said.

“The university has informed those impacted that they will be contacted and [is] encouraging their cooperation and compliance,” the university spokesperson said.

The university requires students to be vaccinated but allows exemptions for religious reasons. Students must sign an affidavit to obtain the exemption, a spokesperson said.

Georgia had six measles cases in 2024. The case announced Friday is the seventh this year.

A January outbreak involved three unvaccinated children from the same Gwinnett County family after the initial patient had traveled to New York City. A second outbreak reported in May involved three unvaccinated members of the same family who contracted measles after at least one member traveled internationally.

Nationally, 1,454 cases have been reported as of Tuesday, according to the Centers for Disease Control and Prevention. Most of the cases are connected to a large outbreak in west Texas and New Mexico. Two Texas children and a New Mexico adult – all unvaccinated – have died. Cases have also been reported in South Carolina, Alabama, Florida, and South Carolina this year.

About 95% of people need to be vaccinated to prevent widespread transmission of the virus, or achieve “herd immunity,” according to the CDC. The United States eliminated widespread transmission of measles in 2000.

But that status could be at risk, said Dr. Jane Seward, former deputy director of the Division of Viral Diseases at the CDC.

“The danger now … is that these importations get in, and they get into a community that has lower vaccine coverage than you need to interrupt ongoing transmission,” Seward said.

In Georgia vaccination rates have been on the decline.

Kindergarten vaccination data from the CDC show 86.8% of the state’s children were fully up-to-date on their MMR vaccinations last year.

“We’re likely to see more and more cases like this across Atlanta and across Georgia as our vaccination rates continue to fall,” Thorpe said. “The risks – particularly for vulnerable populations like small children who aren’t yet vaccinated – are significant.”

Tony Fiore, a doctor and infectious disease expert who worked at the CDC, said the latest case will put a major strain on county and state health departments working to trace people who were potentially exposed.

Several groups could be at risk if they were exposed, Fiore said. That includes babies who were too young to be vaccinated, the 2%-5% of people who don’t develop immunity after normal vaccination, the unvaccinated, and those who lost or never had immunity.

“If we are lucky, none of those scenarios will be in play since we still have high vaccine coverage in the U.S., for now,” he said.

Symptoms of measles include a high fever, cough, runny nose, red watery eyes, and a characteristic red rash.

People who suspect they or their child have measles are urged to call their health care providers before going to a hospital, clinic, or doctor’s office to avoid infecting staff and other patients.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

As measles exploded, officials in Texas looked to CDC scientists. Under Trump, no one answered.

2025-08-25T09:00:00+00:00

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As measles surged in Texas early this year, the Trump administration’s actions sowed fear and confusion among CDC scientists that kept them from performing the agency’s most critical function — emergency response — when it mattered most, an investigation from KFF Health News shows.

The outbreak soon became the worst the United States has endured in over three decades.

In the month after Donald Trump took office, his administration interfered with Centers for Disease Control and Prevention communications, stalled the agency’s reports, censored its data, and abruptly laid off staff. In the chaos, CDC experts felt restrained from talking openly with local public health workers, according to interviews with seven CDC officials with direct knowledge of events, as well as local health department emails obtained by KFF Health News through public records requests.

“CDC hasn’t reached out to us locally,” Katherine Wells, the public health director in Lubbock, Texas, wrote in a Feb. 5 email exchange with a colleague two weeks after children with measles were hospitalized in Lubbock. “My staff feels like we are out here all alone,” she added.

A child would die before CDC scientists contacted Wells.

“All of us at CDC train for this moment, a massive outbreak,” one CDC researcher told KFF Health News, which agreed not to name CDC officials who fear retaliation for speaking with the press. “All this training and then we weren’t allowed to do anything.”

Delays have catastrophic consequences when measles spreads in undervaccinated communities, like many in West Texas. If a person with measles is in the same room with 10 unvaccinated people, nine will be infected, researchers estimate. If those nine go about their lives in public spaces, numbers multiply exponentially.

Georgia’s kindergarten vaccination rates decline as more parents claim exemptions

The outbreak that unfolded in West Texas illustrates the danger the country faces under the Trump administration as vaccination rates drop, misinformation flourishes, public health budgets are cut, and science agencies are subject to political manipulation.

While the Trump administration stifled CDC communications, health secretary Robert F. Kennedy Jr. fueled doubt in vaccines and exaggerated the ability of vitamins to ward off disease. Suffering followed: The Texas outbreak spread to New Mexico, Oklahoma, Kansas, Colorado, and Mexico’s Chihuahua state — at minimum. Together these linked outbreaks have sickened more than 4,500 people, killed at least 16, and levied exorbitant costs on hospitals, health departments, and those paying medical bills.

“This is absolutely outrageous,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University. “When you’re battling contagious diseases, time is everything.”

‘The CDC is “stressed” currently’

Wells was anxious the moment she learned that two unvaccinated children hospitalized in late January had the measles. Hospitals are legally required to report measles cases to health departments and the CDC, but Wells worried many children weren’t getting tested.

“I think this may be very large,” she wrote in a Feb. 3 email to the Texas Department of State Health Services. Wells relayed in another email what she’d learned from conversations around town: “According to one of the women I spoke with, 55 children were absent from one school on 1/24. The women reported that there were sick children with measles symptoms as early as November.”

In that email and others, Wells asked state health officials to put her in touch with CDC experts who could answer complicated questions on testing, how to care for infants exposed to measles, and more. What transpired was a plodding game of telephone.

One email asked whether clinics could decontaminate rooms where people with measles had just been if the clinics were too small to follow the CDC’s recommendation to keep those rooms empty for two hours.

“Would it be possible to arrange a consultation with the CDC?” Wells wrote on Feb. 5.

“It never hurts to ask the CDC,” said Scott Milton, a medical officer at the Texas health department. About 25 minutes later, he told Wells that an information specialist at the CDC had echoed the guidelines advising two hours.

“I asked him to escalate this question to someone more qualified,” Milton wrote. “Of course, we know the CDC is ‘stressed’ currently.”

Local officials resorted to advice from doctors and researchers outside the government, including those at the Immunization Partnership, a Texas nonprofit.

“The CDC had gone dark,” said Terri Burke, executive director of the partnership. “We had anticipated a measles outbreak, but we didn’t expect the federal government to be in collapse when it hit.”

Technically, the Trump administration’s freeze on federal communications had ended Feb. 1. However, CDC scientists told KFF Health News that they could not speak freely for weeks after.

“There was a lot of confusion and non-answers over what communications were allowed,” one CDC scientist said.

Tribal health officials work to fill vaccination gaps as measles outbreak spreads

Georges Benjamin, executive director of the American Public Health Association, said the situation was not unique to measles. “Like most public health organizations, we weren’t able to get ahold of our program people in February,” he said. Information trickled out through the CDC’s communications office, but CDC scientists gave no press briefings and went dark on their closest partners across the country. “The CDC was gagged,” he said.

Through private conversations, Benjamin learned that CDC experts were being diverted to remove information from websites to comply with executive orders. And they were afraid to resume communication without a green light from their directors or the Department of Health and Human Services as they watched the Trump administration lay off CDC staffers in droves.

“It’s not that the CDC was delinquent,” Benjamin said. “It’s that they had their hands tied behind their backs.”

A Feb. 3 email from Katherine Wells to a Texas state health official, Imelda Garcia, warns of a far larger measles outbreak than case numbers suggested. KFF Health News obtained emails through Freedom of Information Act requests to local health departments. The emails have been redacted to protect the privacy of individuals and facilities.

To work on the ground, the CDC needs an invitation from the state. But Anne Schuchat, a former CDC deputy director, said that during her 33 years with the agency, federal health officials didn’t need special permission to talk freely with local health departments during outbreaks. “We would always offer a conversation and ask if there’s anything we could do,” she said.

Lara Anton, a press officer at the Texas health department, said the state never prevented the CDC from calling county officials. To learn more about the state’s correspondence with the CDC, KFF Health News filed a public records request to the Texas health department. The department refused to release the records. Anton called the records “confidential under the Texas Health and Safety Code.”

Anton said the state sent vaccines, testing supplies, and staff to assist West Texas in the early weeks of February. That’s corroborated in emails from the South Plains Public Health District, which oversees Gaines County, the area hit hardest by measles.

“Texas will try to handle what it needs to before it goes to the CDC,” Zach Holbrooks, the health district’s executive director, told KFF Health News.

Responding to an outbreak in an undervaccinated community, however, requires enormous effort. To keep numbers from exploding, public health workers ideally would notify all people exposed to an infected person and ask them to get vaccinated immediately if they weren’t already. If they declined, officials would try to persuade them to avoid public spaces for three weeks so that they wouldn’t spread measles to others.

Holbrooks said this was nearly impossible. Cases were concentrated in close-knit Mennonite communities where people relied on home remedies before seeking medical care. He said many people didn’t want to be tested, didn’t want to name their contacts, and didn’t want to talk with the health department. “It doesn’t matter what resources I have if people won’t avail themselves of it,” Holbrooks said.

Historically, Mennonites faced persecution in other countries, making them leery of interacting with authorities, Holbrooks said. A backlash against Covid restrictions deepened that mistrust.

Another reason Mennonites may seek to avoid authorities is that some live in the United States illegally, having immigrated to Texas from Canada, Mexico, and Bolivia in waves over the past 50 years. Locals guess the population of Seminole, the main city in Gaines County, is far larger than the U.S. Census count.

“I have no idea how many cases we might have missed, since I don’t know how many people are in the community,” Holbrooks said. “There’s a lot of people in the shadows out here.”

Public health experts say the situation in Gaines sounds tough but familiar. Measles tends to take hold in undervaccinated communities, and therefore public health workers must overcome mistrust, misinformation, language barriers, and more.

About 450 people — including local health officials, CDC scientists, nurses, and volunteers — helped control a measles outbreak sparked in an Eastern European immigrant community in Clark County, Washington, in 2018.

Alan Melnick, Clark County’s public health director, said his team spoke with hundreds of unvaccinated people who were exposed. “We were calling them basically every day to see how they were doing and ask them not to go out in public,” he said.

A Feb. 5 email from Texas health official Scott Milton, obtained through a public records request. He wanted to reach scientists at the CDC who could answer urgent questions about measles from frontline workers in West Texas. Emails have been redacted to protect the privacy of individuals and facilities.

Melnick spoke with CDC scientists from the start, and the intensity of the response was buoyed by emergency declarations by the county and the state. Within a couple of months, the outbreak was largely contained. No one died, and only two people were hospitalized.

In New York, hundreds of people in the city’s health department responded to a larger measles outbreak in 2018 and 2019 concentrated among Orthodox Jewish communities. The work included meeting with dozens of rabbis and distributing booklets to nearly 30,000 households to combat vaccine misinformation.

The effort cost more than $7 million, but Jane Zucker, New York City’s assistant health commissioner at the time, said it yielded immense savings. The average medical bill for measles hospitalizations is roughly $18,500, according to data from prior outbreaks. Then there’s the cost of diverting hospital resources, of children missing school, of parents staying home from work to care for sick kids, and the lasting toll of some measles infections, including deafness or worse.

“I don’t think there’s a price tag to put on a child’s death that would otherwise be prevented,” Zucker said.

Local health departments in West Texas were understaffed from the start. About 18 people work at the South Plains health department, which oversees four vast rural counties. About 50 staff the department in Lubbock, where patients were hospitalized and health workers struggled to figure out who was exposed. In mid-February, Wells emailed a colleague: “I’m so overwhelmed.”

A death ignites a response

On Feb. 26, Texas announced that a 6-year-old child had died of measles. Wells heard from CDC scientists for the first time the following day. Also that day, the CDC issued a brief notice on the outbreak. The notice recommended vaccines, but it worried public health specialists because it also promoted vitamin A as a treatment under medical supervision.

In emails, Texas health officials privately discussed how the CDC’s notice might exacerbate a problem: Doctors were treating children with measles for toxic levels of vitamin A, suggesting that parents were delaying medical care and administering the supplements at home. A local Lubbock news outlet reported on a large drugstore where vitamin A supplements and cod liver oil, which contains high levels of vitamin A, were “flying off the shelf.”

Too much vitamin A can cause liver damage, blindness, and dire abnormalities during fetal development.

Milton worried that parents were listening to misinformation from anti-vaccine groups — including one founded by Kennedy — that diminished the need for vaccination by inaccurately claiming that vitamin A staved off the disease’s worst outcomes.

“How many people will choose vitamin A and not a vaccine because it appears to them there are two options?” Milton asked in an email.

Scientists at the CDC privately fretted, too. “HHS pressed us to insert vitamin A into all of our communications with clinicians and health officials,” one CDC scientist told KFF Health News, referring to the agency’s notices and alerts. “If pregnant women took too much vitamin A during the outbreak, their babies could be profoundly disabled. We haven’t seen those babies born yet.”

Another CDC official said they’ve had to “walk a fine line” between protecting the public based on scientific evidence and aligning with HHS.

While CDC scientists held their tongues, Kennedy exaggerated the power of nutrition and vitamin A while furthering mistrust in vaccines. “We’re providing vitamin A,” Kennedy said in an interview on Fox News. “There are many studies, some showing 87% effectiveness,” he claimed, “against serious disease and death.”

The studies Kennedy referenced were conducted in low-income countries where children are malnourished. Evidence suggests that vitamin A supplementation is seldom useful against measles in the United States, because deficiency is exceedingly rare.

A March 9 email from Katherine Wells announcing the arrival of CDC scientists in Lubbock, Texas, some six weeks after the first cases were detected. Emails obtained by KFF Health News have been redacted to protect the privacy of individuals and facilities.

Kennedy deflected criticism from those who call him anti-vaccine, saying that any parent in Texas who wants a measles vaccine can get one. He followed this with dangerously inaccurate statements. “There are adverse events from the vaccine. It does cause deaths every year,” he said. “It causes all the illnesses that measles itself causes, encephalitis and blindness, et cetera.” There is no evidence that measles vaccines “cause deaths every year.” Scores of studies show that the vaccine doesn’t cause encephalitis, that most potential side effects resolve quickly on their own, and serious adverse reactions are far rarer than measles complications.

In another interview, Kennedy said, “The MMR vaccine contains a lot of aborted fetus debris.” The measles, mumps, and rubella, or MMR, vaccine does not contain an iota of fetal cells.

HHS spokesperson Andrew Nixon and spokespeople at the CDC did not respond to queries from KFF Health News.

‘Staff are exhausted’

Despite national attention after the country’s first measles death in a decade, West Texas was overwhelmed. In late February and March, hospital administrators and health officials exchanged emails about how to lobby for resources.

“Local hospitals are at capacity,” wrote Jeffrey Hill, a senior vice president at the University Medical Center Health System in Lubbock. “The state reports emergency funds that typically cover a response like the measles outbreak are not available from the federal government right now,” he added.

“I am writing to express our urgent need for additional staff and funding,” Ronald Cook, medical director for Lubbock, said in an email, drafted with other Lubbock health authorities, to the deputy city manager. “Our Capacity is Stretched Thin: The health department has been operating seven days a week since February 2nd. Staff are exhausted.”

The city of Lubbock fronted money to help the local health department hire temporary staff. The state did not provide money, but it asked the CDC to send epidemiologists. Some came to Texas in early March. Then Texas requested federal funds.

None arrived, even as the outbreak approached 500 cases. It spread to Mexico when an unvaccinated Mennonite child returned home after visiting family in Seminole. This would fuel the largest outbreak Mexico has seen in decades, with at least 3,700 cases and 13 deaths in the state of Chihuahua.

Then another child in West Texas died of measles.

In a rare moment of openness, CDC scientist David Sugarman mentioned the outbreak at a vaccine advisory meeting in late April. “There are quite a number of resource requests coming in, in particular from Texas,” Sugarman said. “We are scraping to find the resources and personnel needed to provide support to Texas and other jurisdictions.”

As measles resurges in U.S., are primary and urgent care clinics prepared?

Federal funds arrived in Texas on May 21, said Anton, the state health department spokesperson. By then, the crisis was fading. The outbreak seemed to have burned until every unvaccinated person in Seminole was infected, said Richard Eby, a doctor at Permian Regional Medical Center who treated some measles patients. Hundreds, if not thousands, of cases have probably gone undetected, he said. “A lot of people presumed their kids had measles,” he said, “and didn’t see the need to confirm it.”

On Aug. 18, health officials declared the West Texas outbreak over, but the consequences of the catastrophe will be lasting.

The outbreaks it sparked across the United States and Mexico are still spreading.

More are inevitable, Nuzzo said. A growing number of parents are deciding not to vaccinate their kids, spooked by unfounded rumors about the shots. Misinformation is flourishing, especially after Kennedy fired vaccine experts who advise the CDC and replaced them with doctors and researchers on the fringes of the scientific establishment. For example, one of his recent appointees, Robert Malone, blamed the deaths of children with measles on “medical mismanagement,” without evidence.

At the same time, states are downsizing programs for emergency response, disease surveillance, and immunization after the Trump administration clawed back more than $11 billion in public health funds earlier this year.

Amid Lubbock’s toughest months, Wells sent an email to the department’s exhausted staff. “The future is uncertain, and I know this is an unsettling time for many of us,” she wrote. “Every day we show up and do our jobs is an act of resilience.”

Amy Maxmen is Healthbeat’s national reporter through a partnership with KFF Health News.

Georgia’s kindergarten vaccination rates decline as more parents claim exemptions

2025-08-06T19:14:26+00:00

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New childhood vaccination data from the U.S. Centers for Disease Control and Prevention show that Georgia vaccination rates are decreasing, with 86.8% of the state’s children fully up-to-date on their required vaccines when they entered kindergarten last year.

The state’s exemption rate is also on the rise, at 4.8%, with most granted for religious rather than medical reasons. But that’s not the whole story. Some public health experts say the remainder of unvaccinated children likely includes some who weren’t able to access the shots. It’s hard to know for sure because data released by the state Department of Public Health is limited.

The falling vaccination rates raise concerns as children return to school this week, and the United States sees the highest number of measles cases since the early 1990s, according to CDC data. Georgia has reported six measles cases this year, all in unvaccinated people. Those cases were contained to members of two families.

According to CDC data released last week, Georgia has the lowest rate for the measles, mumps, and rubella vaccine uptake among Southern states, trailing behind Alabama, where the rate for MMR is 95.2%, and Mississippi, where it is 97.6%.

It’s a matter of time before the state faces a serious measles outbreak, said Scott Thorpe, a former public health official in South Carolina and Georgia who serves as executive director of the Southern Alliance for Public Health Leadership.

“What these numbers mean is that we have a growing vulnerability to disease outbreaks,” said Jodie Guest, a professor of epidemiology at Emory University. “Georgians should be very concerned that our kids are not going to be as well protected.”

Exemptions increase amid ‘swirling’ misinformation

Georgia has one of the highest vaccine exemption rates in the South, at 4.8%, or about 5,535 kindergartners. That’s second to only Florida at 5.1% and far higher than neighboring Alabama at 2.3%.

Most exemptions for last year’s entering kindergarten class – 4.7% – were for religious and not medical reasons, which made up just 0.1%.

Under Georgia law, if parents want to claim a religious exemption, they must file an affidavit with the child’s school or child care facility affirming that “vaccination is contrary to my religious beliefs, and that my objections to vaccination are not based solely on grounds of personal philosophy or inconvenience.”

Guest attributed the falling vaccine and rising exemption rates to “swirling inaccurate information” about the safety and efficacy of vaccines.

“We are still in our state not doing a great job of addressing the inaccurate information that is out there about vaccines,” she said. That’s been fueled by top health leaders questioning the efficacy of vaccines, Guest said, referring to U.S. Health and Human Services Secretary Robert F. Kennedy Jr., who has opposed vaccines.

Kennedy removed all 17 members of the CDC’s Advisory Committee on Immunization Practices, which develops recommendations for childhood and adult vaccines, and replaced them with people whose expertise has been questioned by groups including the American Medical Association. Several professional medical societies, including the American Academy of Pediatrics, have sued the HHS over changes to vaccine policy.

“Sometimes it’s a lack of accurate information that’s easy for parents to understand and digest, or a relationship with a trusted health care provider to communicate that information,” said Melissa Haberlen DeWolf, research and policy director at Voices for Georgia’s Children, a nonprofit advocacy group.

There’s also a lapse in collective memory about the harms of deadly childhood diseases that have been eliminated in the United States.

“People tend to forget that the reason we haven’t seen many of these illnesses is because of widespread vaccination,” DeWolf said. “Diseases like polio have been eradicated in the U.S. thanks to decades of successful vaccination efforts, and we cannot take that progress for granted.”

Access to health care plays a role in vaccination rates

Exemptions aren’t the only reason children may lack immunization, Thorpe said. Some Georgia families face barriers to accessing the shots.

“I don’t think that’s being driven exclusively by ideology or personal beliefs or religious beliefs. A lot of what’s driving that is kids struggling with access to health care, and their families struggling with access to health care,” Thorpe said.

“If you’re a mom or a dad dealing with living in an extended stay motel, you just know that getting your kid vaccinated is just not going to be priority number one,” Thorpe said. “You’ve got a lot of other things in your life that make it hard to get your kid vaccinated.”

Many health department clinics and doctors offices have limited hours that make it tough for working parents – especially those without reliable transportation – to get their children to appointments, Thorpe said.

The federal Vaccines for Children program provides free vaccines to un- and under-insured children. But not all pediatricians are registered with the program, Thorpe said.

Chattahoochee County, near Columbus, had the lowest MMR vaccination rate for children between 19 and 35 months in Georgia, at 66.1%, according to the latest county-level data available from the state DPH, from the third quarter of 2023. (Children typically get two MMR vaccines, between 12 and 15 months of age and between ages 4 and 6 years.)

According to state data, Chattahoochee County has one provider enrolled in Vaccines for Children, Thorpe said.

“The counties with some of the lower vaccination rates also have access issues,” Thorpe said. “It’s not the only issue – but it’s certainly one…. There are 23 other counties in Georgia in the same boat.”

His organization plans to work in South DeKalb County to learn where the gaps are and try to increase access, he said.

“We know from data from a review of national immunization trends that vaccine coverage is lower among uninsured children, and uninsured children are more likely to live below poverty level, have no health care visits in previous 12 months, and be less likely to receive follow-up doses of multidose vaccines,” if they got the first dose, Guest said. “Access is always an issue.”

Georgia releases limited data on child vaccination

Thorpe and others said more granular data from the state about the number and location of unvaccinated children would help better target areas of need. “The data we have in Georgia (beyond that headline statewide number) is pretty limited,” he said.

The new CDC data is based on states’ self-reports, and Georgia doesn’t follow the same methods as many others, reporting only whether entering kindergarteners are fully compliant with all vaccines, instead of vaccine-specific data. For example, a child missing one shot would be categorized as unvaccinated.

For this reason, Georgia’s vaccination rate for the MMR, polio, DTAP (diphtheria, tetanus and pertussis), chicken pox, and Hepatitis B are all listed as 86.8%, down from 88.4% for the prior year. A decade ago, the rate was 94% in Georgia, according to the CDC.

The state DPH has posted online only immunization reports by county for children ages 19 to 35 months, not for older children like those entering kindergarten. Those reports have not been updated since the third quarter of 2023.

The state is in the process of updating the information, DPH spokesperson Nancy Nydam Shirek said. It collects detailed vaccination information via its online Georgia Registry of Immunization Transactions and Services.

“The data hasn’t been posted online yet because epidemiologists were improving the data cleaning process, adding geocoding, and changing how coverage by insurance was calculated,” Nydam Shirek said. “They are finalizing their review of the reports and will prioritize publishing them online once they receive final review and approval from leadership.”

Nydam Shirek provided Healthbeat with a report on vaccination rates for young children for the entire state, but not each county, as of June 30, 2025. It shows that 87.2% of children ages 19 to 35 months in the second quarter of 2025 had received the MMR vaccine.

In comparison, neighboring states Tennessee and North Carolina post data about kindergarten vaccinations at the school level.

Detailed, local level data is important because “vaccination behavior and vaccine exemption behavior is a very socially and spatially clustered behavior,” Alison Buttenheim, a professor at the University of Pennsylvania’s nursing school said during a June media briefing. “We tend to see it in clumps.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

NY health update: West Nile virus, Covid uptick, air quality after congestion pricing

2025-07-25T13:11:25+00:00

It’s never a dull week in the world of New York public health. This week we’re reporting on the first West Nile Virus cases of the season, increasing Covid-19 levels in New York City, measles in New Jersey, the first peek at air quality data from congestion pricing, and celebrating a couple of public health wins. Let’s jump in.

West Nile Virus in humans in upstate New York

This week, New York state confirmed its first two human cases of West Nile Virus in 2025, reported in Erie and Onondaga Counties. While the numbers are still low, it’s an early sign the season is heating up.

Mosquito surveillance also found two new WNV-positive mosquito pools (groups of mosquitoes “pooled” for testing) in Rockland and Suffolk Counties.
New York City has reported 52 WNV-positive mosquito pools so far (including Richmond, the Bronx, and Queens).
There have been no WNV detections in horses or blood donors.

Mosquitoes in New York can also carry the virus that causes Eastern Equine Encephalitis, which is rarer and usually more serious than WNV. So far in 2025, they have only detected EEE in mosquitos in Onondaga County.

While risk to the general public remains low, now’s the time to double down on prevention. WNV and EEE are spread by mosquitoes — not people — so it’s all about bite protection:

Wear repellent (DEET, picaridin), especially at dawn and dusk. If you are using sunscreen, apply sunscreen first and insect repellent second.
Cover up: Wear long sleeves if it’s not too hot.
Dump standing water (think flower/plant saucers, buckets, fountains, toys that have been sitting outside, etc.) to eliminate mosquito habitats.

COVID is increasing in New York City

Wastewater data is showing that Covid-19 is starting to increase in New York City, signaling that the summer surge is underway.

New York City average Covid-19 wastewater concentrations.

On average, Covid-19 levels remain low across the rest of the state.

Wastewater Covid-19 concentrations in New York state.

We are noticing some hot spots though. Onondaga County has a very high Covid-19 wastewater level, while Warren County is high. And we’re starting to see this reflected in the increasing number of hospitalizations in New York. The good news is that they are still relatively low.

Update on New Jersey measles

The New Jersey health department is now reporting two measles cases in the state, though they are unrelated to each other. The cases are in Ocean County (which we highlighted last week) and in Hudson County.

Anyone who visited the following locations during the specified times may have been exposed. Potentially exposed people should contact a healthcare provider if they develop any measles symptoms, which usually start like a cold and progress to a rash.

If you do develop symptoms, it’s important to call your doctor or clinic before you visit in person so special precautions can be taken to prevent further spread. Reminder—if you are fully vaccinated, you are well protected.

Initial look at air quality following congestion pricing

Congestion pricing in Manhattan has been in effect since January. (We wrote about it here.) Last week, a report shared a first look at air quality data since the program’s start.

The report looked at data for fine particle air pollution (PM2.5) from locations inside and outside the tolling zone, three months before the tolling started (from October to December 2024) and three months after tolling began (from January to March 2025).

PM2.5 is important to track because long-term exposure increases risk of lung and heart disease, and short-term exposure increases risk of asthma.

Inside the zone: PM2.5 held steady or ticked down.
Outside the zone: Most monitors mirrored that trend, suggesting traffic — and pollution — aren’t simply shifting elsewhere. The lone exception, Hamilton Bridge, registered a rise even though traffic counts barely budged, so the cause remains unclear.

The initial data look good, but it’s for a short period of time, and PM2.5 is heavily influenced in the winter by heating and boiler use. We’ll need more data to draw conclusions on how effective this program is at reducing air pollution in New York City.

For some good news, here are some NY public health wins

DuPont settlement

After a decade-long legal battle, the chemical maker DuPont agreed to pay a $27 million settlement to the 3,000-person town of Hoosick Falls for contaminating local drinking water with PFOA, a “forever chemical” linked to cancer that lingers in the body for decades.

The suit began in 2016 when residents of Hoosick Falls found PFOA levels in their blood more than 30 times the national average. PFOA was used to make Teflon at a Hoosick Falls facility.

Following the finding of drinking water contamination, the manufacturing facility was declared a superfund site by the EPA. As part of the remediation, Honeywell and Saint-Gobain (other companies involved) agreed to pay $45 million, including funding the replacement of all drinking water lines in Hoosick Falls. The drinking line replacement was completed this March.

NYC doula program met its goals

New York City Mayor Adams and Health Commissioner Morse announced last week that several milestones had been reached for the NYC Citywide Doula Initiative. The program provides free access to home visits and doula support for moms and parenting families. A doula is a professional, trained childbirth assistant who provides non-medical support.

So far the program has:

Provided doula services to 1,128 new clients in 2024, exceeding its goal of 1,000.
Served 3,245 people over the last three years.
Not had a single maternal death among program participants.
Seen a 25% increase in doula coverage for NYC residents since 2022.
Served a large proportion of women of color, shelter residents, and non-English-speakers.

Families are eligible for free doula services through the program if they live in areas hit hardest by Covid-19 and other health and socioeconomic disparities.

Bottom line

You’re all caught up on New York public health news. See you next week!

Love,

Your NY Epi

Tribal health officials work to fill vaccination gaps as measles outbreak spreads

2025-07-24T13:41:22+00:00

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RAPID CITY, S.D. — Cassandra Palmier had been meaning to get her son the second and final dose of the measles vaccine. But car problems made it difficult to get to the doctor.

So she pounced on the opportunity to get him vaccinated after learning that a mobile clinic would be visiting her neighborhood.

“I was definitely concerned about the epidemic and the measles,” Palmier, a member of the Oglala Sioux Tribe, said at the June event. “I wanted to do my part.”

So did her son, Makaito Cuny.

“I’m not going to be scared,” the 5-year-old announced as he walked onto the bus containing the clinic and hopped into an exam chair.

Makaito sat still as a nurse gave him the shot in his arm. “I did it!” he said while smiling at his mother.

The vaccine clinic was hosted by the Great Plains Tribal Leaders’ Health Board, which serves tribes across Iowa, Nebraska, and the Dakotas. It’s one way Native American tribes and organizations are responding to concerns about low measles vaccination rates and patients’ difficulty accessing health care as the disease spreads across the country.

Meghan O’Connell, the board’s chief public health officer, said it is also working with tribes that want to host vaccine clinics.

Elsewhere, tribal health organizations have launched social media campaigns, are making sure health providers are vaccinated, and are reaching out to the parents of unvaccinated children.

This spring, Project ECHO at the University of New Mexico hosted an online video series about measles aimed at health care professionals and organizations that serve Native American communities. The presenters outlined the basics of measles diagnosis and treatment, discussed culturally relevant communication strategies, and shared how tribes are responding to the outbreak.

Participants also strategized about ways to improve vaccination rates, said Harry Brown, a physician and an epidemiologist for the United South and Eastern Tribes, a nonprofit that works with 33 tribes in the Atlantic Coast and Southeast regions.

“It’s a pretty hot topic right now in Indian Country and I think a lot of people are being proactive,” he said.

U.S. facing largest measles outbreak since 1992

Measles can survive for up to two hours in the air in a space where an infected person has been, sickening up to 90% of people who aren’t vaccinated, according to the Centers for Disease Control and Prevention.

The United States has had 1,319 confirmed cases of measles this year as of Wednesday, according to the CDC. It’s the largest outbreak in the United States since 1992. Ninety-two percent of the 2025 cases involve unvaccinated patients or people with an unknown vaccination status. Three people had died in the United States, and 165 had been hospitalized as of Wednesday.

O’Connell said data on Native Americans’ vaccination rates is imperfect but that it suggests a lower percentage of them have received measles shots than the overall U.S. population.

The limited national data on measles vaccination rates for Native Americans are based on small surveys of people who self-identify as Native American. Some show that Native Americans have slightly lower measles vaccination rates, while others show significant gaps.

Data from some states, including South Dakota and Montana, show that Native Americans are less likely than white children to be vaccinated on schedule.

The Oyate Health Center serves Native Americans in Rapid City, South Dakota, and surrounding areas. The center’s response to the measles outbreak has included hosting mobile vaccine clinics like this one outside the community center of a predominantly Native American neighborhood.

The national measles vaccination rate is significantly lower for Native Americans who use the mostly rural Indian Health Service. About 76% of children 16 to 27 months old had gotten the first shot, according to data collected by the agency during recent patient visits at 156 clinics. That’s a 10-percentage-point drop from 10 years ago.

But the IHS data shows that its patients are at least as likely as other children to have received both recommended measles shots by the time they’re 17. O’Connell said it’s unclear if currently unvaccinated patients will continue the trend of eventually getting up to date on their shots or if they will remain unvaccinated.

The immunization rate is probably higher for older children since schools require students to get vaccinated unless they have an exemption, Brown said. He said it’s important that parents get their children vaccinated on time, when they’re young and more at risk of being hospitalized or dying from the disease.

Many Native Americans distrust health care system

Native Americans may have lower vaccination rates due to the challenges they face in accessing shots and other health care, O’Connell said. Those on rural reservations may be an hour or more from a clinic. Or, like Palmier, they may not have reliable transportation.

Another reason, O’Connell said, is that some Native Americans distrust the Indian Health Service, which is chronically underfunded and understaffed. If the only nearby health care facility is run by the agency, patients may delay or skip care.

O’Connell and Brown said vaccine skepticism and mistrust of the entire health care system are growing in Native American communities, as has occurred elsewhere nationwide.

“Prior to social media, I think our population was pretty trustful of childhood vaccination. And American Indians have a long history of being severely impacted by infectious disease,” he said.

European colonizers’ arrival in the late 1400s brought new diseases, including measles, that killed tens of millions of Indigenous people in North and South America by the early 1600s. Native Americans have also had high mortality rates in modern pandemics, including the 1918-20 Spanish flu and Covid-19.

Georgia confirms second measles case in unvaccinated metro Atlanta family

The Great Plains Tribal Leaders’ Health Board reacted quickly when measles cases began showing up near its headquarters in South Dakota this year. Nebraska health officials announced in late May that a child had measles in a rural part of the state, close to the Pine Ridge Indian Reservation. Then, four people from the Rapid City area got sick later that month and into the middle of June.

“Our phones really rang off the hook” once that news came out, said Darren Crowe, a vice president at the board’s Oyate Health Center in Rapid City. He said parents wanted to know if their children were up to date on their measles vaccines.

Crowe said the health board ordered extra masks, created a measles command team that meets daily, and called parents when its online database showed their children needed a shot.

Brown praised that approach.

“It takes a concerted outreach effort that goes individual to individual,” he said, adding that his organization helped the Mississippi Band of Choctaw Indians and the Alabama-Coushatta Tribe of Texas with similar efforts.

Brown said reaching specific families can be a challenge in some low-income Native American communities, where many people’s phone numbers frequently change since they use temporary prepaid plans.

Once a health worker reaches a parent, Brown said, they should listen and ask questions before sharing the importance of the vaccine against measles, mumps, and rubella.

“Rather than trying to preach to somebody and beat them over the head with data or whatever to convince them that this is what they need to do, you start out by finding out where they are,” he said. “So, ‘Tell me about your experience with vaccination. Tell me what you know about vaccination.’”

Most people agree to immunize their children when presented with helpful information in a nonjudgmental way, Brown said.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

How to protect against NYC summer health threats: Floods, mosquitoes, and ticks

2025-07-18T13:33:11+00:00

There’s a ton going on in the world of New York public health. This week we’ll cover measles, Covid, tick bites, and West Nile virus. Let’s dig in.

Flooding in New York

Extreme rainfall early this week paired with old sewer systems caused flooding in parts of New York and New Jersey. Central Park recorded its second-wettest hour in history, with over 2 inches of rainfall in an hour Monday night. Inundated roads and subway lines disrupted transportation. Sadly, two people in New Jersey died after being swept away in a river. The governor issued a state of emergency.

While the waters have since receded, this event once again revealed our community vulnerability to floods, and the need to be prepared. Just last month, the New York City Department of Health identified flooding as a top public health hazard for New Yorkers.

What can we do to prepare for floods in New York?

FloodHelpNY is an online resource hub for New York residents, created through the Governor’s Office of Storm Recovery, the Federal Emergency Management Agency and other partners. Enter your address to assess your specific flood risk.
Sign up for NYC Emergency Alerts or NOAA Weather Radio for notifications.

Flooding is NYC’s most pressing public health threat, new city report says

Be prepared to shelter safely during floods or extreme rain events. Move to higher ground — if you live in a basement apartment, be prepared to move to a higher floor during periods of heavy rain. Never drive or walk through floodwaters - just 6 inches can sweep a person away.

YLE national offered suggestions in a piece this week tied to the floods in Texas.

Measles in Ocean County, New Jersey

New Jersey is reporting a measles case in Ocean County. The health department is investigating the case, but so far there isn’t a ton of information. Contact tracing is underway, and people who may have been exposed are being notified. Potentially exposed individuals, if infected, could develop symptoms as late as July 22.

The recommendation to stay up to date with MMR vaccinations remains the same. New Jersey and New York state departments of health are also urging anyone not fully vaccinated to get the measles vaccine before traveling internationally or to any U.S. region with a measles outbreak.

They recommend:

Being fully vaccinated with the MMR vaccine at least two weeks before departure.
If the trip is less than two weeks away, and the traveler is not immunized, getting one dose of MMR is advised.

As always, consult your medical provider to discuss what’s right for you and your family.

In case you missed it, Katelyn Jetelina and Kristin Panthagani’s YLE National post last week contextualized why public health is raising alarms about record high measles cases in the United States.

Covid still low in New York

We still aren’t seeing much COVID activity in New York—welcome news for the summer! As always, I’ll share updates when I have them.

Tick bites are still very high in the Northeast

The Fordham Tick Index, which measures the risk of being bitten by a tick in the tri-state area (Southern New York, Connecticut, and Northern New Jersey) is 9 out of 10 — very high risk. The index is based on current and historical data from the Fordham’s Biological Field Station in Westchester County, New York.

We see this playing out in emergency department visits for tick bites in the Northeast, which have been higher this year than last.

In New York, we are most concerned about Lyme disease, which is transmitted by black-legged ticks (aka deer ticks). New York reports some of the highest numbers of Lyme disease in the country, with more than 9,000 cases annually. Lyme is found in every region of New York, including urban centers like New York City.

Tick populations have surged in the Northeast. Here’s how to keep you and your pets safe this summer.

Protecting yourself and family means avoiding ticks:

Use repellent that contains 20% or more DEET, picaridin, or IR3535 on exposed skin.
Treat clothing and gear with products containing 0.5% permethrin.
Walk in the center of trails and avoid brushing against tall plants.
Do tick checks after spending time outdoors. For kids, especially check under arms, in and around ears, in the belly button, and in their hair.
Toss your clothes in a hot dryer for 10 minutes to kill any hidden hitchhikers.
Treat dogs for ticks. Dogs are very susceptible to tick bites and may also bring ticks into your home.

If you find a tick attached to your skin, remove it promptly with tweezers and monitor for symptoms. Early treatment is key to preventing severe illness.

Mosquitoes test positive for West Nile virus in NYC

We are in the thick of mosquito season in New York, and we can expect the pests to hang around until about November when temperatures start to drop.

Most mosquitoes do not carry pathogens that can hurt us. Among those that do, the most common is West Nile virus, and even that is relatively rare. In 2024, 100 human cases were reported across New York state, including in New York City. While most people who get West Nile virus won’t show symptoms, the virus can be more dangerous for those who are over 60 years old or have immunocompromising conditions.

In New York City, the virus has been detected in mosquitoes in the Bronx, Queens, and Staten Island so far this season. There have been no human cases. We are still waiting for New York state to post their data and will be back with updates when that happens.

The best thing you can do is avoid mosquito bites:

Wear EPA-approved mosquito repellent outside, especially during peak mosquito activity time: dawn and dusk. If you are using sunscreen, apply sunscreen first and insect repellent second.
Avoid being outside when mosquitoes are most active (the morning and evening) — but this can be really hard.
If it’s not too hot, long sleeves and long pants can protect against bites.
Dump standing water (think flower/plant saucers, buckets, fountains, toys that have been sitting outside, etc.) to eliminate mosquito habitats.

There aren’t any spraying events currently scheduled, but I’ll be back with an update when that happens.

Bottom Line

You’re all caught up with New York health. See you next week!

Love,

Your NY Epi

Georgia reports sixth case of measles of the year, health officials confirm

2025-06-18T18:35:14+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

The Georgia Department of Public Health announced Wednesday that a third member of an unvaccinated family has contracted measles.

The outbreak began after one relative living in metro Atlanta contracted measles abroad. The first case was confirmed in May, followed by a second family member earlier this month.

The latter two patients had been in home quarantine after exposure, and “there were no additional exposures,” DPH spokesperson Nancy Nydam Shirek said in a news release.

The first two patients have fully recovered, she said.

The latest case is the sixth this year in Georgia and marks the second outbreak in the state. An outbreak is defined as three related cases. In 2024, the state saw a total of six cases.

In late January, an unvaccinated child from Gwinnett County contracted measles after domestic travel. That spread to two unvaccinated siblings.

Measles misinformation is on the rise — and Americans are hearing it, survey finds

Nationally, 1,197 cases have been reported as of Thursday, according to the Centers for Disease Control and Prevention. Most of the cases are connected to a large outbreak in west Texas and New Mexico. Two Texas children and a New Mexico adult – all unvaccinated – have died.

“More than 95% of the people who receive a single dose of MMR will develop immunity to all three viruses,” Nydam Shirek said. “A second dose boosts immunity, typically enhancing protection to 98%.”

Symptoms of measles include a high fever, cough, runny nose, red watery eyes, and a characteristic red rash.

People who suspect they or their child have measles are urged to contact their health care providers rather than go to a hospital, clinic, or office without calling first, because the disease is very contagious, according to DPH. It can infect up to 9 of 10 unvaccinated people nearby.

Georgia confirms fifth measles case of the year in unvaccinated families

2025-06-06T17:24:14+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

The Georgia Department of Public Health announced Friday it has confirmed a fifth case of measles this year.

The new case involves a metro Atlanta resident who is related to a person who acquired measles abroad and whose infection was confirmed in May, DPH spokesperson Nancy Nydam Shirek said. Neither had been vaccinated for measles.

The department did not disclose the identity or age of the patients. Nydam Shirek said officials will monitor about a dozen people who may have been exposed for another week and have administered measles vaccines and antibodies to reduce the risk of spread.

No new cases have been identified outside the family, Nydam Shirek said. The latest person to be infected had been quarantining at home due to their family member’s case.

In late January, in an unrelated case, an unvaccinated child from Gwinnett County contracted measles after domestic travel. That spread to two unvaccinated siblings. Georgia had six measles cases last year.

Metro Atlanta measles outbreak contained by ‘all hands on deck’ response, but low vaccination rates keep Georgia vulnerable

Nationwide, a total of 1,088 measles cases have been confirmed as of May 29. That’s much higher than in 2024, when the United States had 285 confirmed cases for the whole year.

Many of this year’s cases are related to a large outbreak in west Texas and New Mexico. Two Texas school-age children and a New Mexico adult – all unvaccinated – have died.

Measles symptoms include a high fever, cough, runny nose, red, watery eyes, and a characteristic red rash. Measles is highly contagious, but two doses of the vaccine, typically administered in childhood, are highly effective at preventing the disease.

Epidemiologists recommend a “herd immunity” vaccination rate of about 95% to prevent transmission of measles, but the latest data from Georgia shows that young children and kindergarten vaccination rates are below that. Only about 88.4% of kindergarteners in Georgia had received both doses, according to 2023-24 data from the Centers for Disease Control and Prevention.

Uptake rates for the MMR (measles, mumps and rubella) vaccine are falling in Georgia and nationwide amid an increase in measles misinformation.

Local doctors emphasize that the vaccine is safe and that it’s the best way to protect against measles. Vaccinations are available at public health departments and pediatricians’ offices, often for no cost.

“I vaccinated my own children, and I would have not done that unless I thought it was in their best interest,” pediatric infectious disease specialist Dr. Preeti Jaggi of Children’s Healthcare of Atlanta told Healthbeat recently.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

New York public health update: Salmonella outbreak in cucumbers, measles at Shakira concert, Covid vaccines

2025-05-28T15:30:13+00:00

I hope you all had a restful Memorial Day weekend. For those honoring loved ones lost in service, my heart is with you, and I’m deeply grateful.

Let’s get into this week’s dose of New York public health news, what you can do, and why it matters.

Cucumber recall affecting New York

A multistate Salmonella outbreak has been traced to cucumbers grown in Florida. As of Friday, 26 people across 15 states — including New York— have fallen ill, with nine hospitalized.

The Food and Drug Administration has issued a nationwide recall of cucumbers grown by Florida-based Bedner Growers and distributed by Fresh Start Produce Sales.

The affected cucumbers were:

Sold between April 29 and May 19.
Distributed to various retailers, restaurants, and food service providers. In New York these include Albertsons, Walmart, and other grocery stores.
Added to sushi rolls, salads, and other veggie mixes.

What this means for you

If you have cucumbers, or cucumber-containing premade salads or sushi at home that was purchased between April 29 and May 19, it’s safest to throw them out. Sanitize any surfaces that may have come into contact with the cucumbers. If you are eating out, consider asking the restaurant if they’re aware of the recall before ordering foods with cucumbers.

Symptoms of Salmonella infection include diarrhea, fever, and stomach cramps, which typically appear 12 to 72 hours after consumption. The Centers for Disease Control and Prevention reports an average of 420 Salmonella-related deaths annually in the United States. Children under 5 years old, adults over age 65, and people with weakened immune systems are at highest risk for severe illness.

Measles exposures in New Jersey

New Jersey has reported two possible measles exposures in the past week: one at Newark Airport and one at the MetLife Shakira concert. Anyone who visited the following locations during the specified times may have been exposed. Potentially exposed people should contact a health care provider if they develop any measles symptoms, which usually start like a cold and progress to a rash.

Newark Liberty International Airport, Terminal B. May 12, 12:30-4 p.m. Monitor for symptoms until Monday.
MetLife Stadium at the Shakira concert. May 15, 7:30 p.m.-1 a.m. Monitor for symptoms until June 6.

So far, no cases have been identified following these two exposure events. If you do develop symptoms, it’s important to call your doctor or clinic before you visit in person so special precautions can be taken to prevent further spread.

With measles continuing to spread in Texas and other states — and more than 1,060 cases reported nationwide — it’s not entirely surprising to see exposures at large events like the Shakira concert. Around 55,000 people attended (and as a Shakira fan, I’m a little jealous).

What this means for you

If you went to the concert or were at Newark Airport during the exposure period, monitor your symptoms over the next two weeks. If you are vaccinated, you likely have little to worry about. Fortunately, the Shakira concert mostly had adults in attendance, and most adults are vaccinated against measles, which helps limit the risk of an outbreak.

Being fully vaccinated is still the best way to prevent getting measles. Here are common FAQs on the vaccine from YLE National.

Tuberculosis in Suffolk County

A tuberculosis case was reported at Sachem High School East in Suffolk County, Long Island. On May 15, more than 120 students and staff were notified via letter about potential exposure to an individual diagnosed with TB.

TB is an infectious disease that’s transmitted mainly through the air. It primarily affects the lungs and can be serious if untreated. Symptoms include persistent cough, fatigue, fever, and weight loss. Public health officials take any TB exposure seriously because the disease is relatively rare in the United States, and infections can cause serious illness.

Tuberculosis is on the rise in NYC. Here’s why — and what to know about the disease.

The Suffolk County Department of Health is offering free testing to those with prolonged contact with the infected person. For TB, prolonged contact means several hours in close proximity, not just passing them in the hallway. Unlike measles and other pathogens, TB infection generally requires a longer period of exposure. So it’s common to only test people who have had prolonged close contact. In college, I was tested for TB after spending several hours near someone in my dorm who was later diagnosed. (I tested negative.)

In 2024, there were 250 confirmed TB cases in New York state, a 19% increase from 2023. Suffolk County reported 52 TB cases in 2024, the highest in New York.

2024 tuberculosis cases in New York counties.

What this means for you

TB is treatable if identified, and it’s much better to get it treated before symptoms start. So if you got a letter from the county health department, getting tested is a good idea. This TB FAQ from the New York Health Department is helpful.

Update on Medicaid cuts

Last week, the House of Representatives passed multiple health care revisions as part of the budget reconciliation bill. According to analysis done by Gov. Kathy Hochul’s office, these bills have two significant implications for health care in New York:

A potential annual loss of nearly $13.5 billion for New Yorkers’ health care sector, and
Nearly 1.5 million New Yorkers could lose Medicaid coverage and become uninsured

The bills would cut over $7.5 billion in federal funding from the Essential Plan (New York’s Medicaid expansion) and shift almost $3 billion of other costs to New York state. This means that the state would have to take on those costs or reduce funding for health care. We cover this in more detail in our recent Medicaid deep dive here.

Another major change included in the bill is a new work requirement: Starting in 2029, adults without children who are not disabled need to prove they’re working at least 80 hours per month to qualify for Medicaid. Community service, work training programs, and going to school also qualify.

Work requirements for Medicaid are being proposed to reduce federal spending — by shrinking the number of people who qualify — and to encourage employment. There are a couple of important issues with this:

Administrative difficulties would reduce access. When work requirements for Medicaid eligibility were tested in Arkansas, over 18,000 people lost coverage, and 60% delayed medical treatment due to costs, without increasing employment in the state. The study found that most of those who lost coverage were working and still eligible for Medicaid, but struggled with new reporting requirements, paperwork, and red tape.
The health insurance-work feedback loop. Research shows that having health insurance improves someone’s ability to find and maintain work, while poor health is associated with job loss. Taking away someone’s health insurance could leave them without health resources, making finding or keeping a job harder.

From my perspective, no matter how you slice it, reducing Medicaid funding and adding work requirements will result in millions losing health care coverage. When people lose access to health care, they are more likely to wait until they are sicker to get care, and often depend on emergency rooms. This will increase health care costs for people.

What happens next?

The bills will move on to the Senate for debate and approval. Congress will vote on them later this summer. You can call your representatives to let them know how you feel about the budget proposals. Here are some tips. Find their contact information here. If you’re a Medicaid recipient, it will be important to keep up to date with the latest information and reporting requirements as this evolves, so your coverage doesn’t fall through the cracks.

Changes to Covid-19 vaccine availability

Big changes may be coming to Covid-19 vaccine access in the United States, including here in New York. Last week, FDA Commissioner Marty Makary and his new adviser, Vinay Prasad, proposed limiting new Covid vaccine access to only people over 65 or those with chronic conditions. That means if you’re generally healthy and under 65, you may not be eligible for a booster this fall, or your insurance may not cover the shot. For more details, see YLE National’s deep dive.

If the proposed FDA policy goes through, the eligible chronic conditions are as follows:

Conditions for Covid-19 vaccine eligibility under the new proposed guidelines.

Judging from the New York State Department of Health estimates of chronic disease rates and our age demographics, only about half of New Yorkers may still qualify for Covid vaccines if the proposed changes go through. But nothing is final yet. The decision also depends on what specific vaccine the FDA recommends, who the CDC recommends should get it, and if a new formula is needed if a new variant comes onto the scene.

We’ll be watching closely and providing updates. This could impact millions of New Yorkers — and your ability to stay protected this respiratory season.

Bottom line

You’re all caught up! See you next week. 🙂

Love,

Your NY Epi

As measles resurges in U.S., are primary and urgent care clinics prepared?

2025-05-21T11:00:00+00:00

This is a guest essay for Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

After decades of progress and the elimination of domestic transmission in 2000, measles is once again becoming a threat in the United States. Primary and urgent care facilities are the front line of detection and response in measles outbreaks, but most are insufficiently prepared.

Will measles become endemic in the United States?

A study published in JAMA confirmed what many of us in public health began fearing after childhood vaccine rates declined, and the anti-vaccine movement grew stronger during the peak of the Covid-19 pandemic: Measles is poised to return to endemic levels in the United States.

Even at current vaccination rates, the study estimates that over 850,000 measles cases could occur over the next 25 years. With just a 10% decline in measles vaccine coverage, that number climbs to over 11 million. And, if vaccination rates were to fall by 50%, the model predicts over 50 million cases and nearly 160,000 deaths.

No other vaccine-preventable disease examined in the study — rubella, diphtheria, or poliovirus — was projected to become endemic under current coverage levels.

Whenever an infectious disease emerges in the United States — such as Ebola, Zika, or Covid-19 — health care facilities need to implement new protocols for screening, case management, and infection control. Given the extreme contagiousness of measles and absence of effective treatments, the challenges are enormous.

Recognizing measles symptoms: Are today’s doctors prepared?

For decades, clinicians trained in the United States have not needed to worry about measles. When I trained in the 1990s, I never saw a single case, and I suspect most physicians practicing today would say the same.

The initial symptoms — fever, cough, conjunctivitis, and congestion — are similar to many other infections. Clinicians, therefore, need to learn how to detect Koplik’s spots, which are small white marks that often appear on the inside of the cheeks before the onset of the measles rash.

While examining patients with a rash, clinicians need to consider that it may not appear the same as in their textbooks. Most pictures I learned from only showed the appearance of the rash on light-colored skin, a documented problem with medical instructional material. A measles patient with light-colored skin will have a rash composed of bright red spots that can be so numerous that that they coalesce together. In contrast, a measles patient with darker skin tones may have spots that appear purple or that may only be identifiable as small, raised bumps without any distinguishing color.

State officials report fourth measles case of 2025 in Georgia

Clinicians also need to consider that measles can cause illness long after the acute infection has resolved. First, measles patients may develop encephalitis months to years after infection. Second, measles causes immune amnesia, suppressing the immune system and leaving patients susceptible to bacterial and viral infections, including ones that were previously vaccinated against, for years. It is unclear whether patients who recover from measles should get repeat dosages of other childhood vaccines that they received before they had measles.

Front office staff and medical assistants also need updated training. These team members are often the first to interact with patients — checking them in, collecting vitals, and assigning them to rooms. They need clear protocols for identifying patients with febrile rash illnesses and for initiating airborne precautions immediately. In most clinics, this means putting a high-quality respirator on the patient and quickly moving them to an area with better ventilation or isolation capacity.

How can measles infection control be improved in outpatient clinics?

During the Covid-19 pandemic, many primary care offices upgraded their infection control procedures, screening patients for respiratory symptoms, and mandating mask usage by patients and providers.

For anyone working in an outpatient facility, now is the time to revisit Covid-19 infection control policies. Before they arrive, patients need to be asked about symptoms that could be measles, and high-quality respirators should be readily available and used for any patient with a suspected airborne respiratory infection. Clinics should improve indoor air quality by using portable HEPA filtration units for all exam rooms unless the facility has a heating ventilation and air-conditioning system with MERV-13 filters.

Providers must ensure that all staff in their facilities are up to date on the measles vaccination. While most will have received the measles, mumps, rubella shots in childhood, documentation may be lacking. Some may have incomplete series, or immunity may have waned.

Office staff need to ensure meticulous record keeping about which patients, family members, and staff are in the facility at all times. If an infectious case comes to the clinic, anyone in that clinic from the time of the visit to several hours afterward will need to be notified, given the ability of the measles virus to stay suspended in the air.

Do clinics have the supplies to diagnose, manage, and prevent measles?

Most outpatient facilities are used to ordering vaccines based on the number of children they expect to see for routine care. That typically includes 1-year-olds for the first measles vaccine dose, and 4- to 6-year-olds for the second.

In an outbreak, clinics will face demand from other groups, including: infants 6-11 months old who may benefit from an early measles vaccine dose; teenagers who never got their second dose; unvaccinated adults and parents concerned they may have been exposed.

In the United States, the supply chain for the MMR vaccine is not designed for surges. While manufacturers generally keep some buffer inventory, providers may find themselves waiting days or weeks for new shipments.

The same goes for measles diagnostic testing supplies and immune globulin for post-exposure prevention. People running pediatric practices and urgent care clinics need to know which labs will perform PCR or serologic testing for measles on short notice and be prepared to offer or refer people (including the parents of measles patients) for post-exposure prevention.

Planning for these contingencies now will save time and, possibly lives, later.

How should clinics handle unvaccinated families?

Few issues are as polarizing in medicine today as vaccine refusal. While the ethical considerations are nuanced, clinicians are permitted to discharge families from care if they refuse vaccines after repeated counseling.

To do so, clinics must develop clear, written policies for how to manage patients and families who refuse measles vaccines. These should be communicated to families in a respectful, culturally sensitive manner. Policies should also account for exceptions, such as those who can’t take the vaccines for medical reasons, or temporary delays due to illness or access issues.

The goal, of course, is not to punish families who refuse to vaccinate, but to protect patients and staff from preventable harm.

Are there federal funds to help with primary care clinic measles preparedness?

Emergency preparedness has most often been treated as a large hospital issue, even though primary care facilities are the first to identify patients, the first to report cases, and often the first to provide treatment or post-exposure prevention.

Unfortunately, even investment in large facilities is at risk. Covid-19 funding that was allocated for other infectious disease responses has been cut from states, and federal grants for health care system preparedness are at risk. That means fewer resources for training, fewer rapid response teams, and fewer dollars to support clinic upgrades.

Will clinics be ready for measles and other emerging infectious diseases?

We are entering a new phase in American public health in which diseases once considered eliminated are returning, and the systems we built to protect against them are under threat. For primary care and urgent care facilities, this will require making new investments in measles infection prevention and control.

Dr. Jay K. Varma is a physician and epidemiologist. An expert in the prevention and control of infectious diseases, he has led epidemic responses, developed global and national policies, and implemented large-scale programs that saved hundreds of thousands of lives in Asia, Africa, and the United States.

State officials report fourth measles case of 2025 in Georgia

2025-05-19T22:14:53+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

A fourth measles case has surfaced in Georgia in an unvaccinated person, the state Department of Public Health said Monday.

The person contracted the disease while traveling internationally. The state health department did not disclose the identity or age of the person, who lives in metro Atlanta. State officials are working to identify anyone who may have been exposed to measles through contact with this person between May 10 and May 18.

Measles is a highly contagious disease that can infect up to 9 of 10 unprotected people nearby.

The latest Georgia case comes as the disease count nationwide has passed 1,000, up over a total of 285 last year. Most of those contracted the disease in a large outbreak in west Texas and New Mexico. Two Texas school-age children and a New Mexico adult – all unvaccinated – have died.

Symptoms of measles include a high fever, cough, runny nose, red watery eyes, and a characteristic red rash.

People who think they or their child might have measles should contact their health care providers rather than go to a hospital, clinic, or office without calling first, because the disease is very contagious, according to DPH.

Cases are transmissible for up to four days before infected people get a rash, a common symptom, said Dr. Jane Seward, who retired in 2016 after about a decade at the U.S. Centers for Disease Control and Prevention, where she worked as the deputy director of the Division of Viral Diseases. People can be exposed to the virus in a supermarket, airport, hotel lobby, or other public venues.

The best way to protect against the disease is with vaccination, public health officials say. Vaccinations are available at public health departments and pediatricians’ offices, often for no cost. Most Americans are vaccinated for the disease. But vaccination rates for the MMR (measles, mumps and rubella) vaccine are falling in Georgia and nationwide.

Children typically get two doses of vaccine as part of the MMR regimen. The first should be between age 12 and 15 months, and the second should be between ages 4 and 6 years, the CDC says.

“The measles vaccine is the best way to prevent measles transmission — period,” said Dr. Stephen Patrick, a neonatologist and professor at Emory University’s Rollins School of Public Health. “The outbreaks we’re seeing now are preventable.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Three measles cases confirmed in Orange County, New York. Here’s what to know.

2025-05-09T15:58:53+00:00

Three unvaccinated kids under 5 have tested positive for measles in Orange County, New York, according to the state and local health departments. All three cases were linked to international travel and were identified after returning home.

The children are isolating, and so far, no community exposures have been reported. That means there’s no sign of community spread —welcome news for those most at risk, including immunocompromised individuals, infants under 1, and others who are unvaccinated.

TLDR: There is not a measles outbreak in New York at this time. If you’re up to date on your vaccines, you’re protected. Keep reading for more background and context.

Is this an outbreak?

No. A measles outbreak is defined as at least three connected cases, meaning cases who spent time together while infectious. Not all three Orange County cases are connected, so this is not yet officially an “outbreak.” We’ll know more in the coming days.

We don’t know if it will turn into an outbreak. The potential for an outbreak depends on a combination of luck, the swiftness of local public health teams, cooperation from people exposed, and local vaccination rates. Fortunately, the health department reports no other known exposures outside immediate family members. This likely means that when the kids started showing symptoms, they were quickly isolated and didn’t expose others — good news and less chance of an outbreak.

Community vaccination coverage also plays a big role. Orange County, where these patients with measles live, has one of the lowest coverage rates in the state — about 65% of 2-year-olds have one dose of MMR. This means 35% of the youngest kids in Orange County have no protection against measles.

Measles is highly infectious and can linger in the air for 2 hours. It can also take up to 3 weeks to develop symptoms after exposure. So we probably won’t know until the end of May whether these cases lead to additional infections.

What can you do?

If you’re up to date with vaccinations, you’re very well protected.

“Up-to-date” means:

Two doses of MMR or MMRV (MMR combined with varicella —chickenpox) by kindergarten.
If you were born before 1957, you are assumed to have had measles during its widespread era and are therefore fully protected.

One group who may need a booster is adults who received the inactivated vaccine between 1963 and 1967 (or aren’t sure which version they got). Most people at the time received the more effective live vaccine, but if you’re unsure, talk to your health care provider.

Here are the top 10 FAQs about your measles protection.

If you have a child under 12 months, they can get a vaccine as young as 6 months. But at this moment, this is not an outbreak and is not spreading across the community.

If you’re traveling soon, check your vaccination status

Families planning summer travel should plan to be caught up on MMR vaccines at least 2 weeks before travel. Recent cases in New York and New Jersey, including the Orange County cases, were due to international travel.

MMR Travel Vaccination Schedule.

Babies as young as 6 months should get one dose of the MMR vaccine if they are traveling abroad or to U.S. areas with outbreaks (like Texas or New Mexico). After travel, these babies should then continue to get their next two MMR vaccines on schedule for a total of three vaccines.

Bottom line

The best actions you can take now are to check your MMR vaccination status and consider vaccinations your family might need before travel. I’ll keep you updated as we learn more! We are also wishing these little ones a smooth and quick recovery.

Love,

Your NY Epi

Measles misinformation is on the rise — and Americans are hearing it, survey finds

2025-04-23T15:24:05+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

While the most serious measles epidemic in a decade has led to the deaths of two children and spread to 27 states with no signs of letting up, beliefs about the safety of the measles vaccine and the threat of the disease are sharply polarized, fed by the anti-vaccine views of the country’s most senior health official.

About two-thirds of Republican-leaning parents are unaware of an uptick in measles cases this year, while about two-thirds of Democratic ones knew about it, according to a KFF survey released Wednesday.

Republicans are far more skeptical of vaccines and twice as likely (1 in 5) as Democrats (1 in 10) to believe the measles shot is worse than the disease, according to the survey of 1,380 U.S. adults.

Some 35% of Republicans answering the survey, which was conducted April 8-15 online and by telephone, said the discredited theory linking the measles, mumps, and rubella vaccine to autism was definitely or probably true — compared with just 10% of Democrats.

The trends are roughly the same as KFF reported in a June 2023 survey. But in the new poll, 3 in 10 parents erroneously believed that vitamin A can prevent measles infections, a theory Health and Human Services Secretary Robert F. Kennedy Jr. has brought into play since taking office during the measles outbreak.

About 900 cases have been reported in 27 U.S. states, mostly in a West Texas-centered outbreak.

Georgia contained a measles outbreak. But low vaccination rates keep the state vulnerable.

“The most alarming thing about the survey is that we’re seeing an uptick in the share of people who have heard these claims,” said co-author Ashley Kirzinger, associate director of KFF’s Public Opinion and Survey Research Program. KFF is a health information nonprofit that includes KFF Health News.

“It’s not that more people are believing the autism theory, but more and more people are hearing about it,” Kirzinger said. Since doubts about vaccine safety directly reduce parents’ vaccination of their children, “that shows how important it is for actual information to be part of the media landscape,” she said.

“This is what one would expect when people are confused by conflicting messages coming from people in positions of authority,” said Kelly Moore, president and CEO of Immunize.org, a vaccination advocacy group.

Numerous scientific studies have established no link between any vaccine and autism. But Kennedy has ordered HHS to undertake an investigation of possible environmental contributors to autism, promising to have “some of the answers” behind an increase in the incidence of the condition by September.

The deepening Republican skepticism toward vaccines makes it hard for accurate information to break through in many parts of the nation, said Rekha Lakshmanan, chief strategy officer at The Immunization Partnership, in Houston.

Lakshmanan on Wednesday was to present a paper on countering anti-vaccine activism to the World Vaccine Congress in Washington. It was based on a survey that found that in the Texas, Louisiana, Arkansas, and Oklahoma state assemblies, lawmakers with medical professions were among those least likely to support public health measures.

“There is a political layer that influences these lawmakers,” she said. When lawmakers invite vaccine opponents to testify at legislative hearings, for example, it feeds a deluge of misinformation that is difficult to counter, she said.

Eric Ball, a pediatrician in Ladera Ranch, California, which was hit by a 2014-15 measles outbreak that started in Disneyland, said fear of measles and tighter California state restrictions on vaccine exemptions had staved off new infections in his Orange County community.

“The biggest downside of measles vaccines is that they work really well. Everyone gets vaccinated, no one gets measles, everyone forgets about measles,” he said. “But when it comes back, they realize there are kids getting really sick and potentially dying in my community, and everyone says, ‘Holy crap; we better vaccinate!’”

Ball treated three very sick children with measles in 2015. Afterward his practice stopped seeing unvaccinated patients. “We had had babies exposed in our waiting room,” he said. “We had disease spreading in our office, which was not cool.”

Although two otherwise healthy young girls died of measles during the Texas outbreak, “people still aren’t scared of the disease,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, which has seen a few cases.

But the deaths “have created more angst, based on the number of calls I’m getting from parents trying to vaccinate their 4-month-old and 6-month-old babies,” Offit said. Children generally get their first measles shot at age 1, because it tends not to produce full immunity if given at a younger age.

Arthur Allen is a reporter for KFF Health News, Healthbeat’s national reporting partner.

Metro Atlanta measles outbreak contained by ‘all hands on deck’ response, but low vaccination rates keep Georgia vulnerable

2025-04-16T19:56:10+00:00

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Georgia successfully contained an outbreak of three measles cases early this year with an “all hands on deck” response as the disease surged nationwide, with seven outbreaks and 712 confirmed cases as of last week.

But the state remains vulnerable, with overall measles vaccination rates below national averages — and below the 95% rate needed to prevent widespread community transmission, known as herd immunity. Georgia’s vaccination rates have been on the decline for years and lag those of neighboring states.

The January outbreak involved three unvaccinated children from the same Gwinnett County family. The first child to fall ill had traveled to New York City. Georgia alerted New York health officials, but no related cases were reported there, according to emails from Georgia health workers obtained by Healthbeat through an open records request.

The first suspected Georgia case was identified on Friday, Jan. 24. Keisha Francis-Christian, epidemiology manager for the Gwinnett, Newton and Rockdale health department, called for an “all hands on deck” response in an email to her team the following Monday.

By Feb. 11, public health workers had identified 290 close contacts, 31 of whom did not have measles immunity or were at high risk. Workers gave 21 of those people an MMR vaccine, state Department of Public Health epidemiology program manager Jessica Pavlick said in an email to colleagues.

“For 21 days, they have to report their symptoms to us. If they don’t report, we’re calling them.” That included working over weekends, Francis-Christian said at a February Gwinnett Board of Health meeting.

DPH did not respond to Healthbeat’s requests for information about the cost of the outbreak investigation, or whether the contact tracers who worked on it are among the 170 laid off due to recent federal funding cuts at the state agency.

The state last year saw six measles cases. This year’s nationwide 712 cases, including the three in Georgia, outstrip last year’s 285 cases. The outbreak centered in west Texas has spread to New Mexico and killed two children and an adult, all unvaccinated.

Georgia epidemiologist Dr. Cherie Drenzek said during a DPH board meeting last week that a widespread outbreak across the country is unlikely because “we do have good, for the most part, overarching MMR coverage.”

Measles vaccination rates have been declining in Georgia

Georgia’s measles vaccination rates have fallen over the past decade, and some counties report very low rates, according to available data from DPH and the Centers for Disease Control and Prevention. That could lead to increases in cases of the highly transmissible disease, which kills up to three in 1,000 unvaccinated people, experts said.

Children typically get two measles vaccinations as part of the “MMR” or measles, mumps, and rubella shot. The first should be between age 12 and 15 months, and the second should be between ages 4 and 6 years, the CDC says.

In most counties in Georgia – 150 of 159 – measles vaccination rates for young children are below the 95% recommended rate, according to the latest data about children between 19 and 35 months from DPH. Statewide, it’s at 87.8%, according to the data from early fall 2023.

DPH does not provide data online about older children’s vaccination rates, although some CDC data are available.

Since then, vaccination rates have decreased nationwide and in Georgia.

In the 2011-12 school year, 96.6% of Georgia kindergartners had received two doses of the MMR vaccine, above the herd immunity target.

Metro Atlanta pediatrician discusses the impact of Georgia measles outbreak

But last year, 2023-24, that was down to 88.4%, according to the CDC’s School Vax View.

Measles is a “highly contagious virus” that can spread up to two hours after a person with measles leaves a room, according to the CDC. Nine of 10 people exposed will get measles if they are not vaccinated.

Cases are transmissible for up to four days before infected people get a rash, a common symptom, said Dr. Jane Seward, who retired in 2016 after about a decade at the CDC, where she worked as the deputy director of the Division of Viral Diseases. People can be exposed to the virus in a supermarket, airport, or hotel lobby.

“Prevention of an outbreak depends entirely on local coverage rates,” said Charles LeBaron, an epidemiologist who retired from the CDC in 2017. “With a world awash in measles, and foreign travel essential to our economy, we can’t stop measles imports, but we can stop outbreaks.

“That’s entirely a function of the immunity rate in the first case’s immediate micro-environment (e.g., kindergarten class). If it’s above 95%, the immunity sprinkler system will put out the outbreak. If it’s lower, then spread is likely,” LeBaron said. “And sooner or later, it finds an immunocompromised or otherwise frail person (like an infant too young to be vaccinated), and somebody dies.”

Measles vaccination rates are even lower for Georgia’s youngest children, who need their first dose by 15 months, according to the CDC.

Slashed federal funding cancels vaccine clinics amid measles surge

Nearly a fifth of children born in Georgia in 2021 (18.3%) did not get the shot by 19 months old, four months after the recommended deadline, according to the most recent CDC data. In other words, just 81.7% of Georgia children born in 2021 got the shot on time, compared to 87.9% nationwide.

It hasn’t always been this way in Georgia. For children born in 2011, the MMR vaccination rate was more than 5 percentage points higher, at 87.2% for children at 19 months.

“For measles, you can’t afford to wait till school. … There’s a lot of susceptibility under [age] 6,” Seward said.

The three cases in Georgia this year, as well as 97% of cases in the outbreak that started in Texas, were in unvaccinated people.

Closer to home, Tennessee has reported four cases this year, and last year, all of Georgia’s neighboring states except for Alabama reported measles cases.

Which Georgia counties have the lowest measles vaccination rates?

There are some parts of Georgia where measles vaccination rates are especially low, according to county-level data about vaccinations for young children from DPH from July to September 2023, which has not been updated since then.

Among the five core Atlanta counties, Clayton had the lowest rate, at 86% in the third quarter of 2023. It was 89.6% in Cobb County, 88.4% in Gwinnett, 88.2% in DeKalb, and 86.7% in Fulton.

The low rates in metro Atlanta are worrying, said pediatric infectious disease specialist Dr. Preeti Jaggi of Children’s Healthcare of Atlanta.

“It makes me anxious in the sense that if we don’t have adequate community protection, we have more chance for transmission.” She pointed out that babies typically can’t get the measles vaccine until 12 months old, putting them and others who can’t get it for medical reasons at higher risk.

Dr. Stephen Patrick, a neonatologist and professor at Emory University’s Rollins School of Public Health, agreed, calling the metro Atlanta rates “too low.”

Jaggi and Patrick said they hear more concerns from parents about vaccine safety than in the past. Doctors emphasized the vaccine is safe and helps keep kids from getting sick.

“We have study after study after study …. We know that the MMR vaccine does not cause autism,” Patrick said. Jaggi said she tells parents, “I vaccinated my own children, and I would have not done that unless I thought it was in their best interest.”

“What we’ve seen has not been a change in access over the last few years, to my knowledge, but what we have seen is a change in attitude,” Patrick said, pointing to the rise of social media misinformation as a key reason for downward vaccination rates.

“Parents are just processing a slew of information and they just want to do what’s best for their child,” Patrick said. Conversations with “trusted messengers” like pediatricians and other parents can help reassure parents that vaccines are safe and help protect kids.

“The measles vaccine is the best way to to prevent measles transmission — period,” Patrick said. ”The outbreaks we’re seeing now are preventable.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Slashed federal funding cancels vaccine clinics amid measles surge

2025-04-09T19:31:22+00:00

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More than a dozen vaccination clinics were canceled in Pima County, Arizona.

So was a media blitz to bring low-income children in Washoe County, Nevada, up to date on their shots.

Planned clinics were also scuttled in Texas, Minnesota, and Washington, among other places.

Immunization efforts across the country were upended after the federal Centers for Disease Control and Prevention abruptly canceled $11.4 billion in Covid-related funds for state and local health departments in late March.

A federal judge temporarily blocked the cuts last week, but many of the organizations that receive the funds said they must proceed as though they’re gone, raising concerns amid a resurgence of measles, a rise in vaccine hesitancy, and growing distrust of public health agencies.

“I’m particularly concerned about the accessibility of vaccines for vulnerable populations,” former U.S. Surgeon General Jerome Adams told KFF Health News. Adams served in President Donald Trump’s first administration. “Without high vaccination rates, we are setting those populations and communities up for preventable harm.”

Measles cases are on the rise in the U.S. Here’s what to know about the disease in NYC.

The Department of Health and Human Services, which houses the CDC, does not comment on ongoing litigation, spokesperson Vianca Rodriguez Feliciano said. But she sent a statement on the original action, saying that HHS made the cuts because the Covid-19 pandemic is over: “HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago.”

Still, clinics have also used the money to address other preventable diseases such as flu, mpox, and measles. More than 500 cases of measles so far in a Texas outbreak have led to 57 hospitalizations and the deaths of two school-age children.

Pima County cancels 20 events with Covid, flu vaccines

In Pima County, Arizona, officials learned that one of its vaccination programs would have to end early because the federal government took away its remaining $1 million in grant money. The county had to cancel about 20 vaccine events offering Covid and flu shots that it had already scheduled, said Theresa Cullen, director of the county health department. And it isn’t able to plan any more, she said.

The county is home to Tucson, the second-largest city in Arizona. But it also has sprawling rural areas, including part of the Tohono O’odham Nation, that are far from many health clinics and pharmacies, she said.

The county used the federal grant to offer free vaccines in mostly rural areas, usually on the weekends or after usual work hours on weekdays, Cullen said. The programs are held at community organizations, during fairs and other events, or inside buses turned into mobile health clinics.

Canceling vaccine-related grants has an impact beyond immunization rates, Cullen said. Vaccination events are also a chance to offer health education, connect people with other resources they may need, and build trust between communities and public health systems, she said.

County leaders knew the funding would run out at the end of June, but Cullen said the health department had been in talks with local communities to find a way to continue the events. Now “we’ve said, ‘Sorry, we had a commitment to you and we’re not able to honor it,’” she said.

Cullen said the health department won’t restart the events even though a judge temporarily blocked the funding cuts.

‘What should I look out for?’ Pediatrician shares insights on measles and its metro Atlanta impact

“The vaccine equity grant is a grant that goes from the CDC to the state to us,” she said. “The state is who gave us a stop work order.”

The full effect of the CDC cuts is not yet clear in many places. California Department of Public Health officials estimated that grant terminations would result in at least $840 million in federal funding losses for its state, including $330 million used for virus monitoring, testing, childhood vaccines, and addressing health disparities.

“We are working to evaluate the impact of these actions,” said California Department of Public Health Director Erica Pan.

Money to pay vaccine workers running out

In Washoe County, Nevada, the surprise cuts in federal funding mean the loss of two contract staffers who set up and advertise vaccination events, including state-mandated back-to-school immunizations for illnesses such as measles.

“Our core team can’t be in two places at once,” said Lisa Lottritz, division director for community and clinical health services at Northern Nevada Public Health.

She expected to retain the contractors through June, when the grants were scheduled to sunset. The health district scrambled to find money to keep the two workers for a few more weeks. They found enough to pay them only through May.

Lottritz immediately canceled a publicity blitz focused on getting children on government insurance up to date on their shots. Vaccine events at the public health clinic will go on, but are “very scaled back” with fewer staff members, she said. Nurses offering shots out and about at churches, senior centers, and food banks will stop in May, when the money to pay the workers runs out.

“The staff have other responsibilities. They do compliance visits, they’re running our clinic, so I won’t have the resources to put on events like that,” Lottritz said.

The effect of the cancellations will reverberate for a long time, said Chad Kingsley, district health officer for Northern Nevada Public Health, and it might take years for the full scope of decreasing vaccinations to be felt.

“Our society doesn’t have a collective knowledge of those diseases and what they did,” he said.

Measles is top of mind in Missouri, where a conference on strengthening immunization efforts statewide was abruptly canceled due to the cuts.

The Missouri Immunization Coalition, which organized the event for April 24-25, also had to lay off half its staff, according to board president Lynelle Phillips. The coalition, which coordinates immunization advocacy and education across the state, must now find alternative funding to stay open.

“It’s just cruel and unthinkably wrong to do this in the midst of a measles resurgence in the country,” Phillips said.

Dana Eby, of the health department in New Madrid County, Missouri, had planned to share tips about building trust for vaccines in rural communities at the conference, including using school nurses and the Vaccines for Children program, funded by the CDC.

New Madrid has one of the highest childhood vaccination rates in the state, despite being part of the largely rural “Bootheel” region that is often noted for its poor health outcomes. Over 98% of kindergartners in the county received the vaccine for measles, mumps, and rubella in 2023-24 compared with the state average of about 91%, and rates in some other counties as low as 61%.

“I will say I think measles will be a problem before I retire,” Eby, 42, said.

Also slated to speak at the Missouri event was former surgeon general Adams, who said he had planned to emphasize the need for community collaboration and the importance of vaccinations in protecting public health and reducing preventable diseases. He said the timing was especially pertinent given the explosion in measles cases in Texas and the rise in whooping cough cases and deaths in Louisiana.

“We can’t make America healthy again by going backwards on our historically high U.S. vaccination rates,” Adams said. “You can’t die from chronic diseases when you’re 50 if you’ve already died from measles or polio or whooping cough when you’re 5.”

California correspondent Christine Mai-Duc contributed to this article, which was originally published at KFF Health News, Healthbeat’s national reporting partner.

Montana may start collecting immunization data again amid U.S. measles outbreak

2025-04-01T13:35:39+00:00

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When epidemiologist Sophia Newcomer tries to evaluate how well Montana might be able to ward off the measles outbreak spreading across the United States, she doesn’t have much data to work with.

A federal state-by-state survey last year showed that just over 86% of Montana’s 2-year-olds had recently received the measles, mumps, and rubella immunization. That figure has decreased in recent years, according to earlier surveys, and Newcomer, an associate professor at the University of Montana, said the latest rate is “well below” the ideal 95% threshold for community protection against highly contagious diseases.

But beyond that statewide estimate, information about Montana’s local and regional immunization trends is hard to come by. State officials no longer collect aggregated vaccination reports from schools and child care centers, or the included data about medical and religious exemptions. The administration of Republican Gov. Greg Gianforte discontinued the practice after he signed a 2021 bill striking the requirement.

The last of the localized reports were from the 2018-19 school year, before the disruptions of Covid-19. Without the information, Newcomer said, local and state officials have struggled to strategically prevent the spread of vaccine-preventable disease.

“State averages are helpful, but really drilling down to county level or smaller geographic levels are really what we need to assess risk of outbreaks,” she said.

Move to ensure medical privacy created gap in data

Montana is the only state that no longer collects immunization reports from local schools, creating a data gap for the Centers for Disease Control and Prevention. The information shortage also affects city and county health officials who may not have their own data-sharing agreements with school districts.

Supporters of the 2021 measure to stop collecting data said they were aiming to protect students’ personally identifiable information and medical records and did not intend to cancel the reporting system in its entirety.

‘What should I look out for?’ Pediatrician shares insights on measles

“I wasn’t trying to bomb the system. I was just trying to make sure children had their privacy respected,” said Jennifer Carlson, a former Republican legislator and the sponsor of the bill the state health department cites as the reason for discontinuing the data collection.

State lawmakers are considering a bill to undo the 2021 policy, while keeping privacy protections for individual student records. After stalling earlier this session, the Democratic-sponsored HB 364 advanced in March with bipartisan support, clearing the House with a 66-31 vote.

The bill, sponsored by Democratic Rep. Melody Cunningham, has also received support from the state health department, an agency within the Gianforte administration.

Republican Rep. John Fitzpatrick said he believes the bill is good policy for the state.

“It’s important that public health authorities have access to aggregate information so they can track where vaccinations are not being used,” he said.

Montana hasn’t confirmed a case of measles since 1990. But with more than 480 cases reported across Texas, New Mexico, and 17 other states, one child confirmed to have died from the disease, and another death under investigation, Newcomer said she and other disease experts are “on edge” about Montana’s defenses. Three cases have been confirmed in March south of Calgary, in the Canadian province of Alberta, which shares a border with Montana.

“I like to say that when vaccination rates drop in a community, it is not a question of if. It’s a question of when measles is going to come, because it is so incredibly contagious,” said David Higgins, a pediatrician and researcher at the University of Colorado Anschutz Medical Campus.

Higgins used to work in Montana when the law requiring schools and state officials to share data was still in place. He said he’s disappointed in the 2021 rollback, given how outbreaks begin at the hyperlocal level.

“When community leaders don’t have a good understanding of the local level of vaccination and community immunity, that’s a significant challenge,” Higgins said. “They’re hamstrung without having that data readily available.”

Measles is dangerous and spreads easily

Measles is one of the world’s most contagious diseases, according to the World Health Organization, much more so than Covid. It can be very dangerous, especially for infants and children under 5 who have not completed the two-dose vaccination series. Infectious particles can hang in the air and on surfaces for up to two hours. People carrying the virus can spread it up to four days before they begin showing symptoms.

“If we do have a measles case arrive in Montana, and particularly if it arrives in a community that has low vaccination coverage, we’re going to see spread over like a multi-week or even multi-month period,” Newcomer said. “So an unvaccinated person can get sick simply by going into a school, store, or home where someone infected with measles recently was.”

The infection can have short-term and long-term consequences for people who are not immunized, including encephalitis, pneumonia, deafness, blindness, and death. State and community health departments have been advertising free MMR vaccinations at clinics throughout the state for anyone who needs them.

While HB 364 is aimed at increasing data collection, other vaccine measures in the state legislature are advancing that would make it easier for children to be exempted from standard immunizations required to attend schools or child care centers.

Two measles cases have emerged in New York City. Here’s what to know and how to protect yourself.

A recent version of SB 474, which has been amended several times, would create an “informed consent” exemption in which a parent or guardian could decline immunizations for school-age children without stating a reason.

Supporters of the bill said that some families struggle to receive exemptions on the grounds of religious beliefs or medical causes and want broader flexibility to opt out of requisite vaccinations against measles and other infectious diseases, such as pertussis. According to Montana’s most recent reporting, from the 2018-19 school year, roughly 3% of children in public schools had a religious or medical exemption.

SB 474 also would strike another part of state law that allows schools and day cares to deny admission to children because they are unvaccinated, an exemption included in a 2021 law aimed at protecting unvaccinated people from discrimination. The lawmaker sponsoring the current bill called the carve-out for schools and day cares an “aberration” in Montana law.

“There’s no reason that they should be discriminating based on vaccine status,” Republican Sen. Daniel Emrich said during a March debate on the Senate floor.

Emrich and others framed the bill as enabling individual decision-making around vaccinations based on how well a parent knows their own child.

“Vaccines are pretty effective,” Emrich said. “If you’re concerned about unvaccinated children, you have the option to get your kid a vaccine to protect them in whatever way you want. This bill is really about choice.”

During the debate, opponents of the bill contended that the lower Montana’s overall immunization rate drops, the more at risk many community members are, including those who, because of age or medical issues, can’t be vaccinated.

Sen. Cora Neumann, a Democrat representing Bozeman, said that vaccinated Montanans, including children, are acting as “shields” against contagious diseases like measles and pertussis. But if vaccination rates continue to drop, Neumann said, that protection will only get weaker.

“We just saw a kid die of measles [in Texas]. It’s going to continue, and it is going to be scary. It is going to be deadly,” Neumann said. “It feels like a luxury right now. We can choose. It is not going to be if we continue down this path.”

The bill passed the state Senate on a 28-21 vote. It is now under consideration in the House.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

As flu recedes in Georgia, health officials warn of measles, whooping cough threats

2025-03-28T18:23:42+00:00

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Even as one of the most severe Georgia flu seasons in recent years continues to recede, health workers in the metro Atlanta area continue to express caution about respiratory, vaccine-preventable diseases.

Throughout March, hospitalizations and health care visits for flu have continued to decline in the state, according to data from the Centers for Disease Control and Prevention. Although there were some signs that local Covid cases could be on the rise, this week’s CDC wastewater update indicates that the virus’ levels are beginning to drop.

These declines represent a shift from a flu season that has killed 130 Georgians since early October, according to the state’s Department of Public Health. The agency’s archives indicate it’s the highest number of seasonal Georgia deaths through the last week of March since 2018.

“Hopefully we won’t have any more flu activity,” Cobb and Douglas Public Health epidemiology director Rachel Franklin said at Thursday’s Cobb County Board of Health meeting. “Sometimes we see a little bump in the springtime with flu B. But so far, we’re looking pretty good.”

The CDC recently estimated that under 40% of adults in the state have been vaccinated against the flu this season. At the Cobb County meeting, local health director Dr. Janet Memark said under-vaccination against other preventable diseases could lead to a rise in a variety of sicknesses in the near future.

‘What should I look out for?’ Pediatrician shares insights on measles and its metro Atlanta impact

Memark and Franklin spoke about recent measles outbreaks throughout the United States, including along the Texas and New Mexico border that have infected at least 444 residents. They highlighted the Georgia cluster from earlier this winter, which Franklin said was contained to just three children, and a 2019 outbreak that was centered in Cobb County.

Memark said public health investigators like herself contacted over 3,000 people in the 2019 outbreak.

Janet Memark, the Cobb and Douglas Public Health director, speaks at the Cobb County Board of Health meeting in Marietta, GA, on March 27.

“We’ve already had multiple outbreaks in the metro area,” she told the board. “So please, get your kid vaccinated and make sure you follow the recommendations.”

She also brought up a rise in Georgia cases of pertussis, also known as whooping cough. In adults, the disease can cause coughing fits severe enough to induce vomiting or crack ribs. In babies, the bacteria can stop them from breathing.

As of Thursday, the Georgia DPH had identified 125 confirmed or probable cases of whooping cough this year, according to agency spokesperson Nancy Nydam. That puts on the state on pace for more cases than in 2024, when the health department warned about a rise in the disease.

The CDC recommends a series of whooping cough vaccines for children and a single shot for some adults, like people 65 or older and health care workers who are frequently exposed to the disease. Dr. Paula Greaves, a Cobb County Board of Health member and an OB-GYN at WellStar Health system, said at the Thursday meeting the case increase is a good reminder for expecting parents to get vaccinated

“If you’re seeing an uptick in pertussis, then that means that we have to uptick our campaign for prevention,” she told Memark.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Long Island measles case reported, possible public exposure at Queens hospital

2025-03-12T16:23:23+00:00

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The New York State Department of Health has reported a case of measles in a Long Island child, the state’s first case confirmed outside of New York City this year.

The Health Department announced the case on Tuesday, describing the patient as a Suffolk County resident under the age of 5. The child was unvaccinated, according to the Suffolk County Department of Health Services. The announcement follows two cases of measles confirmed in infants in New York City earlier this year, bringing the state’s total number of measles cases in 2025 to three.

Measles is a highly contagious respiratory disease that is preventable through the measles-mumps-rubella (MMR) vaccine. For those who are unvaccinated, particularly children, the disease can lead to serious complications or even death.

New York’s recent measles cases have emerged amid a rapidly growing outbreak on the Texas-New Mexico border, which has resulted in two deaths. Other measles outbreaks have been reported in a dozen jurisdictions across the country this year, including in Georgia and New Jersey.

Two measles cases have emerged in New York City. Here’s what to know and how to protect yourself.

The Long Island measles patient is being treated at Cohen Children’s Medical Center in Queens, which is part of Northwell Health, according to public health officials. The state and local health departments warned the public of at least two potential public measles exposures at the hospital from the case. Members of the public who visited the hospital’s pediatric emergency department from Mar. 3 to Mar. 4, or the Medicine 3 inpatient unit from Mar. 3 to Mar. 6, may be at risk of a measles exposure. Visitors who believe they may have been exposed should contact their local health department, or reach out to their doctor or pediatrician.

The child did not attend daycare or school while infectious, and other potential exposures are being assessed, according to the local health department.

“We are actively working with public health officials under established exposure protocols to ensure no further cases arise from this incident,” Northwell Health spokesperson Joseph Kemp said in a statement. “The situation underscores the critical importance of vaccinations, including the MMR vaccine, and the need for them to help prevent diseases like measles and minimize the risk of spreading these diseases.”

Public health officials urged residents to ensure that they are up-to-date on measles vaccinations.

“Measles can be very serious. It’s much more than just a rash as complications can include pneumonia and inflammation of the brain, and often results in hospitalization,” State Health Commissioner Dr. James McDonald said in a statement. “The most important thing people can do to protect themselves is to ensure they’ve been properly immunized against measles and immediately get a shot if they are not.”

Children should receive the first dose of the MMR vaccine at 12 months of age, followed by a second dose at 4 to 5 years of age, according to the childhood immunization schedule. Two doses of the MMR vaccine are 97% effective at preventing measles.

Public health experts stress that the MMR vaccine is safe and effective. But vaccination levels in some parts of New York state have fallen below the 95% threshold of immunization coverage needed to reach herd immunity, or widespread community protection.

In Suffolk County, only 82.6% of children had received one dose of the MMR vaccine by 2 years of age as of January 1, according to data from the state Health Department.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Two measles cases have emerged in New York City. Here’s what to know and how to protect yourself.

2025-03-07T22:46:50+00:00

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With measles cases on the rise in the United States, public health experts in New York are encouraging vaccination against the highly contagious virus.

Measles spreads easily and can lead to serious complications, or death, among those who are unvaccinated. New York City has confirmed two cases of measles so far this year, according to Chantal Gomez, a spokesperson for the Department of Health and Mental Hygiene. Both cases involved unvaccinated infants, who have since recovered. The cases were unrelated.

In nearby New Jersey, three connected measles cases have been confirmed this year. A significant measles outbreak has also emerged on the Texas-New Mexico border, with more than 200 cases reported as of Friday. Last week, an unvaccinated child in Texas died from measles — the first known measles fatality in a decade — and on Thursday, officials announced the death of an unvaccinated adult with measles in New Mexico.

Dr. Jennifer Duchon, the pediatric hospital epidemiologist and director of antimicrobial stewardship at the Mount Sinai Kravis Children’s Hospital, emphasized that measles is preventable through vaccination.

“We don’t need to have measles outbreaks,” she said. “We have a preventative strategy. People don’t need to get sick, and children don’t need to die from this disease.”

Here’s what to know about measles and how to protect yourself and your family.

How contagious is measles?

Measles is far more transmissible than the flu or Covid-19. The virus remains active and contagious in the air or on infected surfaces for up to two hours, according to the World Health Organization.

That means that if someone with measles enters a room of unvaccinated people, everyone would likely become infected, said Dr. Mark Jit, chair and professor of the Department of Global and Environmental Health at the NYU School of Global Public Health.

In the 1950s, before the development of vaccine, nearly all children had measles by the age of 15, according to the U.S. Centers for Disease Control and Prevention. Of the three million to four million Americans infected each year, about 400 to 500 people died.

The measles vaccine became available in the 1960s, followed by the combination measles-mumps-rubella (MMR) vaccine in 1971. In subsequent decades, as vaccination coverage increased, measles cases fell.

In 2000, measles was declared eliminated in the United States. Today, most measles cases that emerge in the United States are imported through travel to countries with high rates of the disease.

What do we know about measles cases in New York City?

In addition to New York City’s two confirmed measles cases, Montgomery County, Pennsylvania, reported a confirmed case of measles in an unvaccinated child who traveled by bus last week from John F. Kennedy International Airport in Queens to Philadelphia.

The Health Department is aware of that case, but New York City residents were not considered at risk, said Dr. Jennifer Rosen, the Health Department’s director of epidemiology and surveillance. She did not elaborate on how the agency made that determination.

Since New York City is a global travel hub, it’s not uncommon to see measles cases emerge through travel to other countries, she said. But outbreaks are rare.

“That’s really a testament to high vaccination coverage overall in New York City, and particularly among school-aged children,” she said.

Still, vaccination coverage is not equally distributed, and areas with low vaccination rates can increase the risk of local outbreaks.

That’s what happened in 2018, when an unvaccinated child returned to the city from a trip abroad, sparking a large outbreak among Orthodox Jewish communities in Brooklyn, with more than 600 cases by the following summer. The outbreak caused serious illness, particularly among unvaccinated children, but no deaths were reported.

For Rosen, that outbreak highlighted the importance of prompt vaccination and achieving herd immunity, which refers to the percentage of immunized people needed to ensure that a disease can’t spread widely in a community. For measles, herd immunity requires about 95% of the population to be vaccinated, according to the WHO.

“If most people in the community are protected, then even if one person gets measles, they can’t transmit it to anyone, because everyone around them is vaccinated,” Jit said.

How high are New York City vaccination rates?

Overall, MMR vaccination rates in New York City are very high. By kindergarten age, 98% of children have received two doses of the MMR vaccine, according to Health Department data.

But the rate of vaccination among younger children is lower, and has fallen in recent years. For children ages 24 to 36 months, the current coverage for one dose of the MMR vaccine is 81%, a decline from 88% in 2019, according to the Health Department.

The lower rate of vaccination for younger children indicates that “we have work to do,” Rosen said.

It’s a concern for the rest of the state as well. In a recent release, the state Health Department warned that current MMR vaccination rates among 2-year-olds have fallen below herd immunity levels in all counties outside of New York City. Only 81.2% of 2-year-olds statewide, excluding New York City, have received one dose of the MMR vaccine, and some counties have rates under 65%.

What are measles symptoms and how are they treated?

Measles symptoms typically appear a week or two after contact with the virus, and can include a high fever, cough, runny nose, red eyes, or a rash, according to the CDC.

Initially, symptoms can be quite general, making it hard for caregivers or health care providers to differentiate measles from other diseases, Duchon said.

But there are telltale signs. Children experiencing the initial stages of the disease are more “miserable” than they would be with a typical cold or cough, and often have a high fever, Duchon said. About three to five days after initial symptoms, a rash typically develops, which turns white when pressed. The rash tends to start in the face and spread across the body.

Not all measles symptoms look the same, and effects can vary as well, she added.

The disease can lead to encephalitis, an inflammation of the brain, which can be deadly. Measles can also weaken the immune system, making a patient vulnerable to secondary infections like pneumonia. A patient’s diminished immune system can persist for years.

There is no treatment for measles, Duchon said, and care for a patient tends to be supportive. On average, one to three in every 1,000 children infected with measles die.

How can you protect against measles?

Vaccination is the best way to avoid becoming sick with measles, according to doctors and public health experts.

The CDC recommends that children get two doses of the MMR vaccine, with a first dose at 12 months old and a second dose at 4 to 6 years old. Two doses of the MMR vaccine are 97% effective at preventing measles. Most people vaccinated against measles are protected for life.

“The vaccine is safe and efficacious,” Duchon said.

In the late 1990s, a now-debunked study by a British researcher connected an increase in autism diagnoses to the MMR vaccine. Overwhelming scientific evidence shows that the vaccine is not associated with an increased risk of autism.

An early dose of the MMR vaccine is also recommended for children ages 6 to 11 months who are traveling internationally or in the case of a local outbreak. Those children will still need to receive the full two-dose course of the vaccine at 12 months and at 4 to 6 years old.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

What congestion pricing and measles mean for New York City’s public health

2025-03-05T14:00:00+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

Congestion pricing and measles outbreaks are making national headlines. One could change the air we breathe, the other reminds us how tragic infectious disease outbreaks can be. Both have implications for New York. Here’s what you need to know.

Congestion pricing: It matters for your health

Manhattan’s congestion pricing is being debated at the federal level. While it makes its way through the courts, its downstream effects on New York City traffic directly and indirectly affect the health of New Yorkers.

There are significant benefits of reducing traffic through congestion pricing including:

Fewer traffic-related accidents
Safer streets for pedestrians and cyclists
Increased public transit, walking, or biking — increasing physical activity and overall health
Cleaner air

In other big cities, like London and Stockholm, congestion pricing programs directly reduced air pollution and improved health outcomes.

Manhattan congestion pricing relief zone.

One potential con is traffic diversion. In 2022, MTA found congestion pricing could lead to a 2.5% increase in truck traffic in the Bronx, specifically on the Cross Bronx Expressway. Increasing pollution even slightly could worsen health disparities.

How does traffic affect respiratory health?

Children and adults who live near high-traffic areas are disproportionately exposed to air pollution, putting them at greater risk for respiratory conditions, like asthma.

Traffic air pollution includes a lot of particles, including fine particulate matter (PM2.5) and ozone (smog), that irritate and inflame lungs, can worsen asthma, and cause other chronic illnesses like heart disease. In New York, long-term exposure to PM2.5 (from traffic and other sources, like buildings and construction) is estimated to cause ~2,000 deaths from lung and heart disease each year — accounting for about 1 out of every 25 deaths citywide.

The impact is especially severe in high-traffic neighborhoods, like parts of the Bronx, where childhood asthma rates are among the highest in the nation.

New York City asthma emergency department visits (ages 4 and under) in 2020 by community district.

Monitoring changes in air pollution will be key

Last week, the New York City DOHMH released a plan to monitor and evaluate changes to air quality following congestion pricing implementation. In fact, baseline data was already collected from monitoring stations across New York City in 2024. The baseline will be compared to air quality data over the next two years to assess the impacts of congestion pricing.

New York City Community Air Survey (gray dots) and real-time PM2.5 (red dots) monitoring sites where air quality from before and after congestion pricing will be assessed.

When the first air quality report is released at the end of this year, I’ll be looking out for any significant increases or decreases in PM2.5 and ozone across neighborhoods in New York. I’ll also be keeping a close eye on changes in asthma rates in the next year. (When Stockholm implemented congestion pricing, asthma rates in kids decreased within the first 7 months.)

Congestion pricing could impact public health and everyday life — New Yorkers spend about 117 hours stuck in traffic every year. But to see its true effects, we depend on data. Careful tracking and analysis will be crucial to understanding the policy’s outcomes.

Measles tragedy in Texas and what that means for New York

Tragedy struck a Texas family last week when a child died from measles — the first U.S. measles death in a decade. The child was unvaccinated and otherwise healthy. The Texas outbreak is now up to 158 cases, with 20 children hospitalized, many of them with severe breathing issues.

Measles can spread like wildfire — one person can expose an entire room two hours after they’ve left it.

Across the Hudson River from NYC, Bergen County, New Jersey, has reported three measles cases in unvaccinated children. Before being diagnosed, at least one of the cases visited a hospital and spent time in the waiting room. Anyone who visited the Englewood Hospital Emergency Department on Feb. 9 between 11:30 a.m. and 5:30 p.m. may have been exposed and should contact their health provider immediately.

Thankfully, no new measles cases have been associated with the New Jersey outbreak in the past week, but unfortunately, that doesn’t mean we’re in the clear. Given how long it takes for measles symptoms to develop, potentially exposed individuals, if infected, could develop symptoms as late as March 6. We need to stay on high alert.

RFK Jr. shifts stance on MMR vaccine

Over the weekend, Robert F. Kennedy Jr. emphasized the importance of measles vaccination in an op-ed, stating that the “MMR vaccine is crucial to avoiding potentially deadly disease.” While there were parts of the op-ed that missed the mark, I was somewhat reassured to see our HHS secretary state so clearly the importance of vaccines as preventable measles cases and tragic outcomes continue to rise across the U.S.

While 98% of children in NYC have received two doses of the MMR vaccine by kindergarten, we have two vulnerabilities. Measles outbreaks occur at the community or school level, and we have some pockets of much lower vaccination rates. Also, coverage among younger children is significantly lower. Only 81% of children aged 24-35 months have received their first dose.

There have been two measles cases in New York City so far in 2025. Now is the time to check your child’s vaccination status. It’s the best way to protect them — and our communities.

Bottom line

Policies that govern public health are being debated on the national stage, shining a spotlight on issues facing us in New York. As congestion pricing and the measles outbreaks continue to evolve, tracking the data will be key to understanding their impact. I’ll keep my ears to the ground and break down what it all means for our health.

Love,

Your Local Epidemiologist

Dr. Marisa Donnelly, a senior epidemiologist with wastewater monitoring company Biobot Analytics, has worked in applied public health for over a decade, specializing in infectious diseases and emerging public health threats. She holds a PhD in epidemiology and has led multiple outbreak investigations, including at the California Department of Public Health and as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Marisa has conducted research in Peru, focusing on dengue and Zika viruses and the mosquitoes that spread them. She is Healthbeat’s contributing epidemiologist for New York in partnership with Your Local Epidemiologist, a Healthbeat supporter. She lives in New York City. Marisa can be reached at mdonnelly@healthbeat.org.

New York public health updates: Measles outbreak nearby, DOGE cuts to 9/11 first responder program reversed

2025-02-26T12:00:00+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

Here’s what happened this week in New York public health and why it matters.

Whiplash for the 9/11 first responder program

This week, the Department of Government Efficiency (DOGE) abruptly cut funding to an essential 9/11 first responder health program and fired 20% of its staff — only to reverse its decision two days later following political backlash.

When I think about what defines a New Yorker, one group immediately comes to mind: the first responders who ran head-first into the World Trade Center on Sept. 11, 2001. While 441 first responders made the ultimate sacrifice, thousands of survivors were exposed to significant amounts of dust, soot, and toxins from the fallen buildings. This has had a dramatic impact on their longevity:

Firefighters who responded to 9/11 had higher overall cancer rates, particularly prostate cancer (39% higher risk) and thyroid cancer (more than double the risk).
They were diagnosed at a younger age (around 56 vs. 59 years old) and were more likely to have cancer detected at an early stage.

Rates of prostate cancer in FDNY firefighters exposed to 9/11 (red), firefighters in other parts of the U.S. (navy), and the U.S. male population from the National Cancer Institute’s Surveillance, Epidemiology and End Results Program (green). Figure from the Career Firefighter Health Study.

We wouldn’t know this without the two-decade-long Career Firefighter Health Study, which tracks the long-term health impacts of 9/11-related diseases. It was funded through the Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health. Cutting this program would limit our ability to understand and provide better treatments for the long-term health impacts our first responders and heroes suffer as a result of their bravery.

What this means to you: Speaking out against programs that are valuable to New Yorkers works. Funding cuts to federal institutions can impact important local efforts to support even the bravest among us. This week, I’ll be calling my representatives to let them know that as a constituent, I deeply value continued funding for the CDC, the National Institutes of Health, and research like that carried out in the Cancer Firefighter Health Study. You can find contact information for your local representatives here.

Measles outbreak in Bergen County, New Jersey

Bergen County, New Jersey, right across the Hudson River from New York City, is experiencing a measles outbreak. As of Sunday, three cases have been reported. The first case was identified on Feb. 9 in a resident with recent travel. Two additional cases were identified last week — both had close contact with the first case. All three cases were unvaccinated.

The New Jersey Department of Health is warning that people who visited the Englewood Hospital Emergency Department on Feb. 9 between 11:30 and 5:30 p.m. may have been exposed and should contact their health provider immediately. The virus spreads easily through the air when someone coughs or sneezes and can remain in the air for up to two hours after an infected person leaves the area. Given how long it takes for measles symptoms to develop (the incubation period), potentially exposed individuals, if infected, could develop symptoms as late as March 6.

It’s too early to say if this will become a large outbreak, but it’s significant for a few reasons:

Measles is a serious disease. In the ongoing outbreak in Texas (with 90 cases identified), about 1 in 5 kids have been hospitalized.
The three cases are unvaccinated. The vaccine is highly effective at preventing infection, but unvaccinated kids are likely to be infected if they’re exposed.
Hospital exposure increases the probability of spread, given medically vulnerable patients.

Two things will help, though: 1. These three cases were a family (so hopefully, we can keep it contained to their household). 2. New York has one of the highest vaccination rates in the country. This will stop onward spread from getting out of control, as long as it doesn’t hit some tightly-knit unvaccinated communities (which we do have).

New York has had major measles outbreaks in the past — in 2019, 649 people (mostly kids under 5 years old) in New York City were sickened, and 49 were hospitalized. This outbreak was in a largely unvaccinated community. So far in 2025, only one measles case has been identified in New York City, but with cases across the river in New Jersey and large outbreaks elsewhere in the United States, we need to be on high alert.

What this means to you: This is exactly the time to ensure all our children are protected with the measles shot. YLE national also had a few other tips.

Flu in New York: High but slowing down

While the flu has peaked and started declining in New York City, the Metro Area, and Western New York, it continues to increase in Central New York and the Capital District.

Regional influenza hospitalizations from the New York State Influenza Surveillance Report.

Despite some regional decreases, flu levels remain pretty high across the state — we are at about the same number of hospitalizations as during the peak of last year’s flu season. Many New Yorkers are still getting sick with the flu and needing to be hospitalized.

Statewide influenza hospitalizations from the New York State Influenza Surveillance Report.

What this means to you: With such high flu circulation, it’s a good idea to take protective measures against getting sick, like wearing a mask in crowded spaces (the subway, supermarkets, while traveling, etc.) and avoiding social interactions if unwell. Flu usually has a second peak later in winter due to flu B circulation (right now, most is flu A), and infections can go into March or April, so it’s not too late to get your flu vaccine at a local pharmacy or clinic.

ACIP meeting postponed: Something to watch

Next week’s national Advisory Committee on Immunization Practices meeting — where experts review and recommend national vaccine guidance — has been postponed. ACIP plays a crucial role in shaping the CDC’s official vaccine guidance, which in turn informs New York health departments to determine policies, insurance coverage, and vaccine availability across the United States. Delaying this meeting delays national guidance and policy updates on new meningococcal and chikungunya vaccines and new recommendations for flu and RSV vaccinations.

Thankfully, New York has its own state ACIP, serving as an additional layer to evaluate vaccines and provide guidance in our state. The next New York ACIP meeting is March 6. We’ll bring you any updates from that.

Even though New York has taken a strong stance on vaccination policy, such as eliminating non-medical vaccine exemptions, the state still relies on national ACIP for guidance and may adjust policy in response to the committee’s recommendations, including Medicaid and Medicare coverage and vaccine availability at pharmacies — making it harder for people in New York (and across the United States) to access newly recommended vaccines.

States like New York, should proactively consider the downstream effects of these federal delays, for example, potential impacts on the Vaccines for Children program, which provides no-cost vaccines for eligible kids. Finding sustainable ways to reduce reliance on federal funding and recommendations could safeguard against potential future disruptions.

Stay tuned for updates on this.

Bottom line

Rapid changes in our federal public health systems are directly impacting New York — from threats to 9/11 first responder programs to delays in vaccine recommendations. At the same time, as epidemiologists like to say, “the bugs have ears,” and vaccine-preventable diseases, including flu and measles, are active in our region. We’ll continue to keep you informed as we work to protect our communities.

Love,

Your Local Epidemiologist

Texas measles outbreak nears 100 cases, raising concerns about undetected spread

2025-02-21T18:00:13+00:00

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Some private schools have shut down because of a rapidly escalating measles outbreak in West Texas. Local health departments are overstretched, pausing other important work as they race to limit the spread of this highly contagious virus.

Since the outbreak emerged three weeks ago, the Texas health department has confirmed 90 cases with at least 16 hospitalizations, as of Friday. Most of those infected are under age 18. Officials suspect that nine additional measles cases reported in New Mexico, across the border from the epicenter of the Texas outbreak in Gaines, are linked to the Texas outbreak. Ongoing investigations seek to confirm that connection.

Health officials worry they’re missing cases. Undetected infections bode poorly for communities because doctors and health officials can’t contain transmission if they can’t identify who is infected.

“This is the tip of the iceberg,” said Rekha Lakshmanan, chief strategy officer for The Immunization Partnership in Houston, a nonprofit that advocates for vaccine access. “I think this is going to get a lot worse before it gets better.”

An unknown number of parents may not be taking sick children to clinics where they could be tested, said Katherine Wells, the public health director in Lubbock, Texas. “If your kids are responding to fever reducers and you’re keeping hydrated, some people may keep them at home,” she said.

‘What should I look out for?’ Pediatrician shares insights on measles and its metro Atlanta impact

Most unvaccinated people will contract measles if they’re exposed to the airborne virus, which can linger for up to two hours indoors. Those infected can spread the disease before they have symptoms. Around 1 in 5 people with measles end up hospitalized, 1 in 10 children develop ear infections that can lead to permanent hearing loss, and about 1 in 1,000 children die from respiratory and neurological conditions.

Gaines has a large Mennonite population, which often shuns vaccinations. “We respect everyone’s right to vaccinate or not get vaccinated,” Albert Pilkington, CEO of the Seminole Hospital District, in the heart of the county, said in an interview with Texas Standard. “That’s just what it means to be an American, right?”

Local health officials have been trying to persuade the parents of unvaccinated children to protect their kids by bringing them to pop-up clinics offering measles vaccines.

“Some people who were on the fence, who thought measles wasn’t something their kids would see, are recalculating and coming forward for vaccination,” Wells said.

Schools close due to numerous sick children

Local health departments are also operating mobile testing units outside schools in an attempt to detect infections before they spread. They’re staffing clinics that can provide treatment prophylactically for infants exposed to the virus, who are too young for vaccination. Local health officials are advising day care centers on how to protect young children and babies, and educating school nurses on how to spot signs of the disease.

“I am putting 75% of my staff on this outbreak,” Wells said. Although Lubbock isn’t at the center of the outbreak, people infected have sought treatment there. “If someone infected was in the [emergency room], we need to identify everyone who was in that ER within two hours of that visit, notify them, and find out if they were vaccinated.”

Local health departments in rural areas are notoriously underfunded. Wells said the workload has meant pressing pause on other programs, such as one providing substance abuse education.

Zach Holbrooks, executive director of the South Plains Public Health District, which includes Gaines, said health officials were following Centers for Disease Control and Prevention guidelines, as of last year, by advising schools to keep unvaccinated children home for 21 days if they shared a classroom or the cafeteria with someone infected. This means that many parents may need to stay home from work to care for their kids.

“A lot of private schools have closed down because of a high number of sick children,” Holbrooks said.

Georgia health agencies work to contain metro Atlanta measles outbreak

The burden of measles outbreaks multiplies as the disease spreads. Curbing a 2018 outbreak in Washington state with 72 cases cost about $2.3 million, in addition to $76,000 in medical costs, and an estimated $1 million in economic losses due to illness, quarantines, and caregiving.

Public health researchers expect such outbreaks to become larger and more common because of scores of laws around the United States — pending and recently passed — that ultimately lower vaccine rates by allowing parents to exempt their children from vaccine requirements at public schools and some private schools.

CDC immunization committee meeting postponed

Such policies are coupled with misinformation about childhood vaccination now platformed at the highest levels of government. The new director of the Department of Health and Human Services, Robert F. Kennedy Jr., has erroneously blamed vaccines for autism, pointing to discredited theories shown to be untrue by more than a dozen scientific studies.

In Kennedy’s first week on the job, HHS postponed an important meeting of the CDC’s Advisory Committee on Immunization Practices, without saying when it would resume. In addition, the CDC’s letter template to school principals, advising unvaccinated children to remain home from school for 21 days if they’ve been exposed to the measles virus, is no longer on the agency’s website. An old version remains posted on its archive.

As a rule, at least 95% of people need to be vaccinated against measles for a community to be well protected. That threshold is high enough to protect infants too young for the vaccine, people who can’t take the vaccine for medical reasons, and anyone who doesn’t mount a strong, lasting immune response to it. Last school year, the number of kindergartners exempted from a vaccine requirement was higher than ever reported before, according to the CDC.

In Gaines, exemptions were far higher than the national average, approaching 20% in 2023-24. Gaines has one of the lowest rates of childhood vaccination in Texas. At a local public school district in the community of Loop, only 46% of kindergarten students have gotten vaccines that protect against measles.

Amid an outbreak that displays the toll of measles in under-vaccinated pockets of America, Texas lawmakers have filed about 25 bills in this year’s legislative session that could limit vaccination further. Lakshaman said the public — the majority of whom believe in the benefits of measles vaccination — should contact their representatives about the danger of such decisions. Her group and others offer resources to get involved.

“We’ve got children winding up in the hospital, and yet lawmakers who’ve got their blinders on,” she said, referring to pending policies that will erode vaccination rates. “It’s just mind-blowing.”

Amy Maxmen is Healthbeat’s national reporter through its partnership with KFF Health News.

‘What should I look out for?’ Pediatrician shares insights on measles and its metro Atlanta impact

2025-02-20T12:23:50+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Weeks into 2025, measles cases have been reported in communities across the United States, from Georgia to Alaska to New York. As of Tuesday, a single Western Texas outbreak of the vaccine-preventable disease had infected 58 people — over 20% of the number of 2024 U.S. measles cases.

In Georgia, state and county public health officials have worked to respond to a measles outbreak among three unvaccinated metro Atlanta residents, who are all part of the same family. Last week, Gwinnett, Newton, and Rockdale Public Health Departments Epidemiologist Keisha Francis-Christian said her staff had worked with the state Department of Public Health and other local health agencies to contact over 300 people who may have been exposed to the virus.

Georgia health agencies work to contain metro Atlanta measles outbreak

Healthbeat recently spoke with Dr. Roy Benaroch, a Roswell pediatrician and an Emory University adjunct assistant professor of pediatrics, about how the outbreak has affected his practice. He explains how measles can spread, what short-term and long-term effects measles can have on children, and steps parents can take to keep their kids and communities healthy.

This conversation has been edited for length and clarity.

How has the measles outbreak impacted your practice?

Certainly, parents are hearing about it. Parents are raising some concerns — I’m glad they know about it. We have not seen a case of measles here, but we’ve been over with the staff how to handle phone calls, triage calls. If someone has symptoms that are suggestive of measles, we have a pathway in place to protect them, to get them evaluated, but also to protect our staff and other patients. Because it is so, so contagious.

The first patient to test positive had apparently gone to three different health care facilities. How does something like that happen?

The initial symptoms of measles may not seem very distinctive. It can begin with an ordinary runny nose and cough — sometimes with red eyes, sometimes with a fever. It’s only several days later, three to five days after that, that the very characteristic rash begins. So when the child is somewhat ill with these less specific symptoms, it may not occur to anyone that it could be measles. There are so many more common viruses out there. There’s plenty of flu out there now, plenty of ordinary common cold viruses. So it can seem very much like something of that nature.

You need to really have your antenna up to be very, very, extra careful with a child who, for some reason — perhaps wasn’t vaccinated or has been traveling outside the country — has big risk factors. You have to think about it, but it’s a needle in a haystack problem.

Fortunately, most Georgians are vaccinated, which provides - if you’ve received both doses - 97%-plus protection, preventing you from catching and preventing you from spreading it. But if you happen to be in a community that has a high proportion of people who are unvaccinated, that’s really asking for trouble once that genie is out of the bottle. If it’s in a community that’s not well-vaccinated, it’s going to spread very quickly.

Do you have concerns our community could be approaching that sometime in the future?

That’s what we’re worried about. Although overall vaccine rates are high, there are pockets, there are communities and neighborhoods where vaccine rates have fallen. And they’re much more vulnerable.

Metro Atlanta measles case spreads to two unvaccinated family members

What have some of the conversations with parents lately about measles been like?

Some parents are certainly frightened of it. They want to know what’s going on. They’re concerned that the health department may no longer have the resources they need to tackle this, to track it.

Now, I’m not so sure that’s true. On a national level, there’re concerns about the national leadership and the changes of leadership at the CDC [Centers for Disease Control and Prevention] and these sorts of things. Those are important, but most of the work being done is really boots on the ground, county health departments. And I’m confident they’re on this. They’ve got the people and the resources to track this and do a careful job.

What else are parents talking about?

Parents want to know, “What should I look out for?” That’s the most common. “How do I know if my child could have measles?” And the first question I’ll ask after that is, “Has your child been fully vaccinated?” If a child’s been fully vaccinated, the risk of contracting measles is just about zero. It’s not impossible. The vaccines are never absolutely 100% protective. But with two doses of MMR [measles, mumps, and rubella vaccine], which all children should have by about 15 to 18 months of age, they’re essentially 100% protected. You have a vaccinated child, you really don’t need to worry about your child catching measles.

Now, you may still worry about your neighbors and your family, but the most important single thing for parents to do it just make sure their kids are fully vaccinated.

Researchers estimate that in the United States, 25% of people who get measles are hospitalized. What is the toll of getting a measles case, and what is the experience of getting a measles case in the United States right now?

If you do get measles, you’re in for a pretty rough time. Very high fevers, terrible cough. About 1 in 4 will be hospitalized for respiratory support and fluids. There’s no specific medication that can be used to treat measles, so it’s just supportive care in the hospital. Unfortunately, even after a case of acute measles, there’s a generalized immune suppression that goes on for several years. So children who make it through measles for several years afterward are more susceptible to many other infections. It’s kind of frightening, but it’s a unique thing that the measles virus does to the immune system.

And then, unfortunately, there is a complication that occurs probably in something like 1 in 3,000 or 1 in 5,000 children who contract measles. Years later, six to 10 years later, [they] can develop an untreatable degenerative brain condition called SSPE [Subacute Sclerosing Panencephalitis], which will be fatal. That’s not so common, but boy it’s common enough that people should realize that measles is more than a high fever and a rash.

You talked about how effective two doses of the MMR is for kids. As more vaccine skepticism rhetoric has risen at a national level, especially since the Covid-19 pandemic, have you seen parents be more skeptical of vaccines like MMR?

In my practice, the vast majority of families are really relying on their physicians’ advice, and they want to make sure their kids are fully protected. But this does vary by neighborhood. There are neighborhoods and communities where there’s more vaccine distrust. We know nationally, there’s data showing families are looking into vaccine exemptions, for instance, so their kids can go to school without being fully vaccinated. There are state legislatures that are considering withdrawing school vaccine requirements. And it’s unfortunate because that’s really being driven by a lot of fear and misinformation. If families were getting the best information available, the vast majority would want their kids to be vaccinated. But there’s a lot of fear, and it’s a little bit hard to fight that.

You talked a little bit about talking to parents who may worry about getting their children vaccinated. What are those conversations like?

For the measles vaccine in particular, especially since it’s been on the news, you can share with them the numbers. You can say, “This is what happens.” Measles, we know, is one of the most infectious, contagious illnesses that we’ve ever experienced. If a child who has the measles has been in a room — even after they’ve left the room for two hours, the air in the room literally can still transmit measles. Measles is much more contagious than Covid or flu. And at the same time, it really can be a serious illness. It can put kids in the hospital. There are short-term and long-term complications.

Measles outbreak mounts among children in one of Texas’ least vaccinated counties

And then you can say this is the vaccine. It has been around for a very, very long time. The rate of [lasting] side effects is very, very low. You can get mild symptoms that will occur maybe even a week later. But then they go away, and your kiddo is protected. And the protection, having had two doses of the vaccine, lasts the rest of your life with no important common side effects. Rare side effects can happen, but they’re really rare. I can say in my career, which is getting close to 30 years, I’ve never seen a serious complication from any vaccine. What I have seen [are] children sick with illnesses that could have been prevented with vaccines.

Earlier in this conversation, you said you thought the state and local health departments had done a really good job investigating cases. But you also referenced uncertainty around federal public health funding.

Both the state and local health departments get a lot of their funds from the federal government. If funding changed so these local health departments and the state health department can’t carry out these types of investigations, what risk does that pose for the communities you serve?

People have gotten used to safe food. People have gotten used to knowing when there is illness in the community — how to prevent it, and how to avoid it. We’ve all gotten complacent about the role of public health. When the public health system is working, we don’t notice it very much. That means you have an effective public health system, it means you can just go about your life without a good deal of worry.

But if the funding dries up or if the funding is just unreliable — just not knowing if a grant is going to come through — that could really lead to problems with tracking, with employment, with having the right people in the right place being able to jump in to investigate outbreaks, and to educate the public about how to stay healthy. I think right now, there’s just a lot of uncertainty.

Public health affects all of us. This isn’t something that’s just for certain neighborhoods or underserved neighborhoods. It doesn’t matter how wealthy you may be, or how fancy your house is. You need clean air, you need a dependable food supply, clean water. These are very, very basic things that we’ve been able to take for granted for so many years. But the reason these are reliable is because of public health, and [workers] quietly doing their jobs.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Georgia health workers handling flu surge, rare mpox case, measles outbreak

2025-02-14T19:45:43+00:00

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Influenza viruses have continued to steadily circulate within Atlanta and Georgia communities as the state contends with other concerning infectious diseases.

Health care visits for flu-like symptoms and community virus levels detected in wastewater sites remain near their highest marks of the winter, according to data released Friday from the Centers for Disease Control and Prevention. Close to 3,000 residents had overnight stays for the flu at metro Atlanta hospitals in January, according to the Georgia Department of Public Health.

None of these indicators have reached last year’s peak. But Dr. Mark Griffiths, an Emory University pediatric medicine associate professor and director of the Children’s Healthcare of Atlanta’s downtown emergency department, said his hospital is experiencing one of the largest flu surges he’s witnessed.

“We’re seeing higher levels of kids testing positive than probably seen the last decade or so,” he said. “And they are coming in of all ages.”

He attributes the spike in flu hospital visits to multiple factors. During the height of the Covid-19 pandemic, cases of other viruses fell to lower-than-normal rates. But now that some pandemic prevention steps have been relaxed, many airborne diseases have exceeded their baseline numbers.

Urgent CDC data and analyses on influenza and bird flu go missing as outbreaks escalate

Additionally, Griffiths said he’s seen fewer kids vaccinated against the flu compared to previous winters. The CDC estimates that as of early February, between 33% and 56% of children over 6 months old received this year’s shot.

He said the low vaccine uptake is concerning for the health of Georgia kids, as the shots add an extra layer of disease protection.

“Since Covid, we’ve seen the persistence of this vaccine hesitancy,” he said. “Now, we’re seeing it as these really high flu surges.”

Griffiths said it’s not too late for parents to have their children immunized this year, as traditional flu seasons last until March. Additionally, he highlighted new tools, like over-the-counter flu and Covid combination tests, and familiar protections, like wearing a mask when sick, as useful ways for people to prevent respiratory virus spread.

The state is also contending with a variety of other infectious diseases. Over the past few weeks, state and local public health officials have been responding to a small measles outbreak that has infected three members of the same family. None of the family members were vaccinated against measles. No other Georgia residents have tested positive, according to the state DPH.

A study published by the CDC on Thursday also found that public health officials detected a travel-associated Georgia case of Clade I mpox in January, the second case ever detected in the United States. The report says that Clade I cases lead to death more often than Clade II infections, which are still rare but more common domestically.

The Georgia patient’s case was not severe, according to the CDC study. Nancy Nydam, a DPH spokesperson, said the department monitored people who had been in contact with the patient for 21 days — the time in which symptoms usually appear — and none of them contracted the disease.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Measles outbreak mounts among children in one of Texas’ least vaccinated counties

2025-02-13T13:41:27+00:00

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A measles outbreak is growing in a Texas county with dangerously low vaccination rates.

In late January, two school-age children from Gaines County were hospitalized with measles. Since an estimated 1 in 5 people with the disease end up in the hospital, the two cases suggested a larger outbreak.

As of Wednesday, there were 24 cases, mainly children, with at least 14 hospitalizations, said Zach Holbrooks, executive director of the South Plains Public Health District, which includes Gaines. A few cases are in surrounding counties. The department is investigating many other potential cases in hopes of treating people quickly and curbing the spread of the virus.

“There may be active cases out there and the individual has chosen not to seek medical attention,” Holbrooks said.

Public health practitioners warn such outbreaks will become more common because of scores of laws around the United States — pending and passed — that ultimately lower vaccine rates. Many of the measures allow parents to more easily exempt their children from school vaccine requirements, and a swell of vaccine misinformation has led to record rates of exemptions.

As Robert F. Kennedy Jr., one of the most influential purveyors of dangerous vaccine misinformation, prepares to take the helm of the Department of Health and Human Services, researchers say such bills have a higher chance of passing and that more parents will refuse vaccines because of false information spread at the highest levels of government.

Georgia reports measles case in unvaccinated metro Atlanta patient

“Mr. Kennedy has been an opponent of many health-protecting and life-saving vaccines, such as those that prevent measles and polio,” scores of Nobel Prize laureates wrote in a letter to the Senate. Having him head HHS, they wrote, “would put the public’s health in jeopardy.”

Most people who aren’t protected by vaccination will get measles if exposed. Gaines County has one of the lowest rates of childhood vaccination in Texas. At a local public school district in the community of Loop, only 46% of kindergarten students have gotten vaccines against measles, mumps, and rubella. Vaccination rates may be even lower at private schools and within homeschool groups, which don’t always report the information.

Holbrooks’ team is scrambling to track transmission, ensure that kids and babies seek prompt care, and offer measles vaccines to anyone who hasn’t yet gotten them.

“We are going to see more kids infected. We will see more families taking time off from work. More kids in the hospital,” said Rekha Lakshmanan, chief strategy officer for The Immunization Partnership in Houston, a nonprofit that advocates for vaccine access. “This is the tip of the iceberg.”

Measles is extremely contagious, so health workers preemptively treated infants too young to be vaccinated who had shared the emergency room with children later diagnosed with the virus, said Katherine Wells, public health director in Lubbock, Texas. Some children from Gaines were hospitalized in that county. The disease can cause severe complications, and about one of every thousand children with measles die.

An outbreak among a largely unvaccinated population in Samoa in 2019 and 2020 caused 83 deaths, mainly among children, and more than 5,700 cases. Kennedy, who peddles misinformation about measles vaccines, had visited the island earlier on a trip arranged by a Samoan anti-vaccine influencer, according to a 2021 blog post by Kennedy.

Without evidence, Kennedy cast doubt on the fact that measles caused the tragedy in Samoa. “We don’t know what was killing them,” he said at his first confirmation hearing. Samoa’s top health official denounced this evasion as “a complete lie,” in an interview with The Associated Press.

Last school year, the number of kindergartners exempted from a vaccine requirement — 3.3% — was higher than ever reported before, according to the Centers for Disease Control and Prevention. Numbers were far higher than that in Gaines County, where nearly 1 in 5 children in kindergarten had a vaccine exemption for philosophical or religious reasons in 2023-24.

4 ways vaccine skeptics mislead you on measles and more

Over the past couple of years, several states have allowed more parents to obtain exemptions. Already, about 25 bills have been filed in the 2025 Texas legislative session that could limit vaccination in various ways.

“We’re seeing a level of momentum this legislative session that we’ve never seen in the past,” Lakshaman said. Changes are afoot at the local level, too. For example, a school board in the Houston area voted to remove references to vaccines in its curriculum. “There is a top-down and bottom-up assault on these protections,” Lakshaman said.

About 80% of the public believes that the benefits of the measles, mumps, and rubella vaccines outweigh the risks, according to a 2025 KFF poll.

“Lawmakers who put forth dangerous policies need to know the people they hear from don’t represent the majority,” Lakshaman said. Her group offers resources on its website to help people influence decisions on vaccination policies.

This story was updated on Feb. 13 to reflect news developments.

Amy Maxmen is Healthbeat’s national reporter through a partnership with KFF Health News.

Georgia health agencies work to contain metro Atlanta measles outbreak

2025-02-10T21:30:07+00:00

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Infectious disease specialists throughout Georgia have worked rapidly over the past few weeks to respond to a measles outbreak in the metro Atlanta area, according to the Gwinnett, Newton, and Rockdale Public Health Departments.

At the Gwinnett County Board of Health meeting Monday, epidemiology program manager Keisha Francis-Christian provided more information about how local health agencies have responded to the outbreak involving three members of the same family who were not vaccinated against measles. She told the board members that the first person to test positive, announced by the Georgia Department of Public Health in late January, sought health care at three locations before quarantining.

As a result of those visits, Francis-Christian and other epidemiologists have identified over 300 people who were exposed to the contagious person. She said residents in over 20 counties have been impacted by the disease investigation, including at least 114 in Gwinnett County. Francis-Christian said public health workers have tried to reach out to all these residents and have successfully made contact with most people.

Metro Atlanta measles case spreads to two unvaccinated family members

“We’re following them,” she said at the meeting. “For 21 days, they have to report their symptoms to us. If they don’t report, we’re calling them.”

GNR Public Health and other Georgia health departments have not found anyone with measles outside the initial family.

“It’s just a very labor-intensive kind of process just to, again, make sure that we’re not missing anyone,” Francis-Christian said.

In Gwinnett County, clinicians administered preventive measles, mumps and rubella vaccinations to nine people. If received within three days of exposure, the vaccine can help prevent infections in patients who were never immunized against the disease. Additionally, an infant and a pregnant woman in Gwinnett were treated with antibody medications designed to bolster the immune system against measles.

To try to contain the spread of the highly contagious disease, Francis-Christian said GNR Public Health and its partners have been helping exposed residents seven days a week. She said the agency’s epidemiology team alone worked about 100 hours the weekend after the state health department identified the first measles case.

“It’s a lot of work, but everyone’s all on board,” she said. “It’s a really, really great team.”

Francis-Christian also highlighted the first person to test positive had recently traveled domestically, but didn’t say where. She noted that in the United States, there was a nearly fivefold jump in identified measles infections between 2023 and 2024. This month, Texas health officials are responding to an outbreak of at least nine residents in one of the least vaccinated counties in the state.

“Overall, we’re seeing a lot less vaccination, a lot more travel, and ultimately that’s causing more disease,” Francis-Christian said.

Later in Monday’s meeting, she said GNR has detected rising levels of other infectious diseases. Just over a month into 2025, the agency has detected 10 pertussis cases and 6 varicella cases in Gwinnett. In all of 2024, there were just over 40 cases of each disease in the county.

Georgia and the United States as a whole have experienced more cases of pertussis, also known as whooping cough, since at least last summer. In December, the state’s DPH sent out a health advisory asking providers to test all patients with symptoms, report positive cases, and recommend vaccination for anyone who’s eligible to receive it.

“Over the last few years, we’re seeing these trending upward,” Francis-Christian told the board. “It’s a major concern.”

After her presentation, Dorian Freeman, GNR Public Health’s Director of Clinical Infectious Disease, told the board that her team was notified of an active case of pulmonary tuberculosis in a South Gwinnett High School student in December. To make sure the disease didn’t spread, the agency screened 159 staff and students at the school over the past two months and detected no other active cases. Freeman said GNR plans to conduct another round of screenings at Berkmar High School in late February.

Tuberculosis is the world’s deadliest infectious disease, killing around 1.3 million people each year. While effective medications for both latent and active cases are inaccessible in many parts of the world, they’re available in most parts of the United States. The bacteria spread is rare in school settings, said GNR Public Health Chief Clinical Officer Alana Sulka.

“When we do these screenings in the school, it’s out of an abundance of caution,” she told the board.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Metro Atlanta measles case spreads to two unvaccinated family members

2025-02-07T19:40:09+00:00

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Two family members of the metro Atlanta resident who tested positive for measles last week have also acquired the virus, officially creating an outbreak.

None of the three patients had been vaccinated against measles, the Georgia Department of Public Health said Friday in a press release. The agency added that so far in its contact tracing efforts, it hasn’t found any cases outside the family. Last week, the department said the first patient had acquired measles while traveling domestically.

The Centers for Disease Control and Prevention defines a measles outbreak as three or more related cases. As of Thursday, the agency was aware of two U.S. measles outbreaks and 14 total cases so far in 2025, although it’s unclear whether the trio of Georgia cases were included in either count.

In western Texas, a measles outbreak has infected at least nine residents and hospitalized at least two school-age children. It’s spreading in a highly vulnerable community where vaccine uptake is low. At a local school district, only 46% of kindergartners had received the highly effective immunization that prevents measles.

Measles outbreak mounts among children in one of Texas’ least vaccinated counties

The outbreaks come as the U.S. Senate is considering whether to confirm Robert F. Kennedy Jr., a repeated skeptic of vaccines, as the nation’s Health and Human Services Secretary.

Georgia, unlike Texas, doesn’t allow parents to enroll unvaccinated children in schools based on personal beliefs. But both states’ laws permit religious exemptions to the shots.

Meanwhile, other infectious diseases continue to circulate in Georgia as residents make their way through the respiratory illness season. Preliminary CDC data indicate that the number of people in the state hospitalized for Covid-19, flu, and respiratory syncytial virus remains high but may be declining. The combination of overnight hospital stays for the viruses has yet to approach last winter’s peak. But wastewater data show that flu is still spreading freely in many Georgia communities.

Whooping cough also continues to circulate at high rates. As of Monday, the Georgia DPH had detected 28 probable or confirmed cases. The January count will likely go up as the department retrospectively identifies more cases, but even that total is in line with a transmission pace that concerned the DPH in December. In its end-of-the-year health alert, the agency asked providers and local health departments to test patients with severe coughing for the disease.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

First Georgia measles case of the year detected in unvaccinated metro Atlanta patient

2025-01-28T21:59:05+00:00

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An unvaccinated metro Atlanta resident has tested positive for measles, the first case in Georgia this year of one of the most contagious vaccine-preventable diseases.

In a press release, the Georgia Department of Public Health announced Tuesday that the patient caught the airborne disease while traveling within the United States. The person was contagious between Jan. 19 and 24, and the agency is working to find residents who may have been exposed during that time.

The patient’s age and travel locations were not announced.

Last year, the department detected six measles cases in Georgia. It’s one of the highest recorded case totals over the past 10 years — second only to 2019, when a Cobb County outbreak contributed to 18 state cases. Most of those years, the agency detected no cases.

How measles, whooping cough, and worse could roar back on RFK Jr.’s watch

Researchers have repeatedly found that the disease’s vaccine — which protects against measles, mumps and rubella — is effective at preventing new infections. One dose prevents 93% of infections, and two doses prevent 97% of possible measles cases, according to the Centers for Disease Control and Prevention.

Childhood uptake of the MMR vaccine has declined in the United States and Georgia over the past few years. Some 88.4% of Georgia kindergartners had received the shot in the 2023-24 school year compared to 94% a decade earlier, according to the CDC. The state’s laws allow students in schools to receive religious and medical exemptions from their childhood vaccination requirements.

The first symptoms of measles — which include high fever and coughing — appear 7-14 days after catching the virus. A few days after these symptoms, people with the illness often develop small white dots in their mouths and red spots on their face. If Georgia residents notice symptoms for measles, the DPH asks that they call a health care provider before seeking treatment as measles is highly contagious.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Childhood vaccination rates, a rare health bright spot in struggling states, are slipping

2025-01-16T16:47:22+00:00

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Jen Fisher can do only so much to keep her son safe from the types of infections that children can encounter at school. The rest, she said, is up to other students and parents in their hometown of Franklin, Tennessee.

Fisher’s son Raleigh, 12, lives with a congenital heart condition, which has left him with a weakened immune system. For his protection, Raleigh has received all the recommended vaccines for a child his age. But even with his vaccinations, a virus that might only sideline another child could sicken him and land him in the emergency room, Fisher said.

“We want everyone to be vaccinated so that illnesses like measles and things that have basically been eradicated don’t come back,” Fisher said. “Those can certainly have a very adverse effect on Raleigh.”

For much of Raleigh’s life, Fisher could take comfort in the high childhood vaccination rate in Tennessee — a public health bright spot in a conservative state with poor health outcomes and one of the shortest life expectancies in the nation.

Mississippi and West Virginia, two similarly conservative states with poor health outcomes and short life expectancies, also have some of the highest vaccination rates for kindergartners in the nation — a seeming contradiction that stems from the fact that childhood vaccination requirements don’t always align with states’ other characteristics, said James Colgrove, a Columbia University professor who studies factors that influence public health.

“The kinds of policies that states have don’t map neatly on to ‘red’ versus ‘blue’ or one region or another,” Colgrove said.

More parents opting out of vaccines for kids

Advocates, doctors, public health officials, and researchers worry such public health bright spots in some states are fading: Many states have recently reported an increase in people opting out of vaccines for their kids as Americans’ views shift.

During the 2023-24 school year, the percentage of kindergartners exempted from one or more vaccinations rose to 3.3%, the highest ever reported, with increases in 40 states and Washington, D.C., according to Centers for Disease Control and Prevention data. Tennessee and Mississippi were among those with increases. Nearly all exemptions nationally were for nonmedical reasons.

Vaccine proponents worry anti-vaccine messaging could accelerate a growing “health freedom” movement that has been pushed by leaders in states such as Florida. Momentum against vaccines is likely to continue to grow with the election of Donald Trump as president and his proposed nomination of anti-vaccine activist Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services.

Pediatricians in states with high exemption rates, such as Florida and Georgia, say they’re concerned by what they see — declining immunization levels for kindergartners, which could lead to a resurgence in vaccine-preventable diseases such as measles. The Florida Department of Health reported nonmedical exemption rates as high as 50% for children in some areas.

“The religious exemption is huge,” said Brandon Chatani, a pediatric infectious disease doctor in Orlando. “That has allowed for an easy way for these kids to enter schools without vaccines.”

In many states, it’s easier to get a religious exemption than a medical one, which often requires signoff from a doctor.

Over the past decade, California, Connecticut, Maine, and New York have removed religious and philosophical exemptions from school vaccination requirements. West Virginia has not had them.

Idaho, Alaska, and Utah had the highest exemption rates for the 2023-24 school year, according to the CDC. Those states allow parents or legal guardians to exempt their children for religious reasons by submitting a notarized form or a signed statement.

Florida and Georgia, with some of the lowest reported minimum vaccination rates for kindergartners, allow parents to exempt their children by submitting a form with the child’s school or day care.

Both states have reported declines in uptake of the measles, mumps, and rubella vaccine, which is one of the most common childhood shots. In Georgia, MMR coverage for kindergartners dropped to 88.4% in the 2023-24 school year from 93.1% in 2019-20, according to the CDC. Florida dropped to 88.1% from 93.5% during the same period.

Andi Shane, a pediatric infectious disease specialist in Atlanta, traces Georgia’s declining rates to families who lack access to a pediatrician. State policies on exemptions are also key, she said.

“There’s lots of data to support the fact that when personal belief exemptions are not permitted, that vaccination rates are higher,” she said.

Mississippi starts allowing religious exemptions

In December, Georgia public health officials put out an advisory saying the state had recorded significantly more whooping cough cases than in the prior year. According to CDC data, Georgia reported 280 cases in 2024 compared with 96 the year before.

Until 2023, Mississippi was one of the few states that allowed parents to opt out of vaccinating their kids only for medical reasons — and only with the approval of a doctor. That gave it among the highest vaccination rates in the nation as of the 2023-24 school year.

“It’s one of the few things Mississippi has done well,” said Anita Henderson, a pediatrician who has practiced in the southern part of the state for nearly 30 years. In terms of health, she said, childhood vaccination rates were the state’s one “shining star.”

But that changed in April 2023 when a federal judge ordered state officials to start allowing religious exemptions. The ruling has emboldened many families, Henderson said.

“We are seeing more and more skepticism, more and more vaccine hesitancy, and a lack of confidence because of this ruling,” she said.

State officials have granted more than 5,000 religious exemptions since the court order allowing them, according to the state health department. Daniel Edney, the state health officer, said most of the requests have come from “more affluent” residents in “pockets” of the state.

“Most people listen to the expert opinions of their pediatricians and family medicine doctors to stay on the vaccine schedule, because it’s what is best to protect their children,” he said.

West Virginia’s vaccine law — which hasn’t allowed nonmedical exemptions — also could soon change, Matthew Christiansen said in December before he resigned as the state’s health officer.

A bill that would have broadened exemptions made it through the legislature last year but was vetoed by outgoing Republican Gov. Jim Justice. The new governor, Republican Pat Morrisey, has been a vocal critic of vaccine mandates. And just a day after being inaugurated, he issued an executive order to propose provisions by Feb. 1 that could allow religious and conscientious exemptions.

“I want to send a message that if you have a religious belief, then we’re going to have an exception,” he said at a Tuesday press conference. “We’re not going to be the outlier.”

People asserting their personal freedoms to decline vaccines for their kids can ultimately curtail the ability of others to live full lives, Christiansen said. “Kids getting measles and mumps and polio and being paralyzed for their whole life is an impediment on personal freedom and autonomy for those kids,” he said.

Since the Covid pandemic, anti-vaccine sentiment has been growing in Tennessee. One organization, Stand for Health Freedom, drafted a letter for constituents to send to their state lawmakers calling for the resignation of the medical director of Tennessee’s Vaccine-Preventable Diseases and Immunization Program. The group said she demonstrated a “lack of respect for the informed consent rights” of the people.

“They feel emboldened by the idea that this presidential administration seems to feel very strongly that a lot of these issues should be taken back to the states,” said Emily Delikat, director of Tennessee Families for Vaccines, a pro-vaccine group.

Ultimately, like many effective public health interventions, vaccines are a victim of their own success, said Henderson, the Mississippi pediatrician. Most people haven’t seen outbreaks of measles or polio, so they forget how dangerous the diseases are, she said.

“It may unfortunately take a resurgence of those diseases to raise awareness to the fact that these are dangerous, these are deadly, these are preventable,” she said. “I hope it doesn’t come to that.”

Daniel Chang and Sam Whitehead are reporters with KFF Health News, Healthbeat’s national reporting partner.

Doctor who helped end smallpox reflects on Jimmy Carter, today’s politics, and restoring trust in science

2025-01-09T12:00:00+00:00

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When Jimmy Carter started his nongovernmental organization in Atlanta soon after leaving the White House, he reached out to his former CDC director to run it.

Dr. Bill Foege, who after leaving the Centers for Disease Control and Prevention launched what became The Task Force for Global Health, was known for his role in leading the eradication of smallpox in the 1970s. He wasn’t ready to give up his global public health work.

“‘Would it make a difference if I also became interested in global health?’” Carter asked Foege.

It made all the difference. In the ensuing decades, the Carter Center was credited with public health improvements around the world, fighting diseases like malaria, river blindness, and Guinea worm.

As Carter is laid to rest this week after his Dec. 29 death, Foege, 88, spoke with Healthbeat about his work on public health with Carter, his worries about the incoming Trump administration, and how to help win people’s trust in science.

The conversation has been edited for length and clarity.

What do you consider President Jimmy Carter’s public health legacy to be?

When he first approached me about being executive director at the Carter Center, I had real reservations. I told him I spent my life in global health. There aren’t enough people working in global health, and this was quite some time ago, and it was true, and I said it just didn’t seem right for me to leave it.

He came back a day or so later and said, “Would it make a difference if I also became interested in global health?” And of course, it’s incredible to have that sort of opportunity.

What he did was demonstrate to me what we should know, which is public health people and politicians have to work together because we’re totally dependent on appropriations that come from politicians making decisions on what they will fund. Sometimes you see public health people very distressed that politicians are involving themselves. Yet there’s no option; we have to get them involved, not just in appropriations, but to have them invested in a health outcome. And that’s what President Carter could do.

What Jimmy Carter taught us about public health: Peace, faith, science can work together

If I went to Africa, I could probably quite easily get an appointment with the minister of health. I could not get an appointment with the minister of finance, and they’re the crucial ones, and I certainly could not get an appointment with the head of state.

President Carter would go right to the head of state. Head of state would get a Cabinet meeting, including the minister of health and the minister of finance. When Carter would sell him on onchocerciasis [river blindness], or Guinea worm, or schistosomiasis, or other things, and the head of state would say, “This is something we want to do,” the minister of health and the minister of finance are going to just trip all over themselves to please the head of state. He showed what a politician could do working with public health.

What is the most effective thing public health leaders can do to build trust in their work and in science?

I often use the word trust because it’s the glue that holds together a coalition. It was certainly the glue that held together the coalition in India, as we were doing smallpox eradication.

With public health, there are three things that I often tell public health students that [they must do] in order to get trust.

Former CDC Director Bill Foege, right, walks with President Jimmy Carter at the CDC headquarters in Atlanta in 1985.

Number one, start with the best science. We’ll all make mistakes on science. No question about that. Admit them when you find them, go back and correct them and continue to do the best science possible. And [British biologist Thomas] Huxley once said that science is simply common sense at its best, that it’s not anything that people can’t understand. Nowadays, there are people who think they can’t understand science, and therefore they don’t trust it. No, it’s just common sense at its best. We have to become better at describing the science so that people do understand it.

Number two, add art. The first scientist that we know in history was an Egyptian by the name of Imhotep. He was a physician, but he was also an architect. He designed the step pyramid, and then he supervised the building of the step pyramid. The reason this is important is it brings creativity into the process. Instead of just common sense at its best, you have creative common sense at its best.

‘Protect our children’: Vaccine expert on why immunization remains crucial

And then, the third ingredient: I go back to Roger Bacon, who about 800 years ago, was asked to do a summary of science for the pope. And it’s been 50 years since I’ve read that, but I still remember so clearly that he said, “Science has no moral compass.” It means you have to provide scientists with a moral compass in order to bring all three of these together for moral, creative common sense at its best. That’s the way we regain trust — by keeping those things in mind.

What is your biggest worry about public health right now?

You hit it with the trust issue. The public health people have to take this very seriously, and this is part of why we have to reach out to politicians. We need them to fund our projects, and if they don’t fund the projects, then we can’t provide what we should to the public. I’m very concerned about this anti-science, anti-government movement, the anti-vaxxers, for instance.

The first vaccine that we have was developed by Edward Jenner in 1796. The first anti-vax group developed in 1796. This is an old, old problem. Because the smallpox vaccine was taken from cowpox, they would make cartoons of people who had the head of a cow growing out of their arm to warn people not to get vaccinated.

This 1980 photograph, taken at the Centers for Disease Control, depicted three former directors of the Global Smallpox Eradication Program, as they read the good news that smallpox had been eradicated on a global scale. From left to right: Dr. J. Donald Millar, who was director 1966–70, Dr. Bill Foege, who was director 1970-73, and Dr. J. Michael Lane, who was director 1973-81.

This anti-science, anti-government movement has to be countered with good information. Parents are not trying to hurt their children when they keep them from being vaccinated. They believe that the vaccines are harmful, and why shouldn’t they? Because now they don’t have the disease and the risk of the disease to compare to the risk of the vaccine. When I was young, you had no trouble convincing people to take the polio vaccine, because they saw what happened, the crippling of polio. You had no trouble in Africa getting people to take the measles vaccine, because 7% of all children were dying of measles in Africa.

Now you don’t have the disease, so people can’t make that comparison, and they only look at the risk of the vaccine, and they forget that the risk of the disease has gone down because of a social contract that we all have. The problems are gigantic, there’s no question about it. We have to be so careful about presenting the best information and figuring out how to get the grass roots to solve this on their own.

How do you expect public health to change under the new Trump administration? What do you tell colleagues who are worried about Trump’s policies or the officials he’s choosing?

I worry about what could happen over the next four years, and I worry about some of these ideas of stopping polio vaccines. Polio will come back.

We were at a very low point with measles. When I started working in Africa in the ’60s, 7% of children were dying of measles. The introduction of the measles vaccine was unbelievably important, and it went down from 3 million children a year dying of measles in the world to 2 million to 1 million to half a million, and we were down to about 100,000 – still far too many. But now measles is resurging in places because people are worried about giving the vaccine, or they’re competing with Covid and other things. There’s a real task for public health, and I worry about what will happen in this country.

We went through the ’90s and the early 2000s with almost no cases of the usual childhood diseases, but they’ve started coming back.

Why should Americans care about global public health?

Every place in the world is both local and global simultaneously, so no matter where you’re working on public health, you’re working on global public health.

You have one objective, which is global health equity. Those three words, you can’t take any of those three away and have it mean the same thing, and you can add 200 and not improve on it. Global health equity is the objective, and everyone working in public health is doing that.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

How measles, whooping cough, and worse could roar back on RFK Jr.’s watch

2024-12-06T13:46:55+00:00

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The availability of safe, effective Covid vaccines less than a year into the pandemic marked a high point in the 300-year history of vaccination, seemingly heralding an age of protection against infectious diseases.

Now, after backlash against public health interventions culminated in President-elect Donald Trump’s nominating Robert F. Kennedy Jr., the country’s best-known anti-vaccine activist, as its top health official, infectious disease and public health experts and vaccine advocates say a confluence of factors could cause renewed, deadly epidemics of measles, whooping cough, and meningitis, or even polio.

“The litany of things that will start to topple is profound,” said James Hodge, a public health law expert at Arizona State University’s Sandra Day O’Connor College of Law. “We’re going to experience a seminal change in vaccine law and policy.”

“He’ll make America sick again,” said Lawrence Gostin, a professor of public health law at Georgetown University.

State legislators who question vaccine safety are poised to introduce bills to weaken school-entry vaccine requirements or do away with them altogether, said Northe Saunders, who tracks vaccine-related legislation for the SAFE Communities Coalition, a group supporting pro-vaccine legislation and lawmakers.

Even states that keep existing requirements will be vulnerable to decisions made by a Republican-controlled Congress as well as by Kennedy and former House member Dave Weldon, should they be confirmed to lead the Department of Health and Human Services and the Centers for Disease Control and Prevention, respectively.

Both men — Kennedy as an activist, Weldon as a medical doctor and congressman from 1995 to 2009 — have endorsed debunked theories blaming vaccines for autism and other chronic diseases. (Weldon has been featured in anti-vaccine films in the years since he left Congress. Both have accused the CDC of covering up evidence this was so, despite dozens of reputable scientific studies to the contrary.

Kennedy’s staff did not respond to requests for comment. Karoline Leavitt, the Trump campaign’s national press secretary, did not respond to requests for comment or interviews with Kennedy or Weldon.

Kennedy recently told NPR, “We’re not going to take vaccines away from anybody.”

It’s unclear how far the administration would go to discourage vaccination, but if levels drop enough, vaccine-preventable illnesses and deaths might soar.

Make America Healthy Again: Unconventional movement may have found its moment

“It is a fantasy to think we can lower vaccination rates and herd immunity in the U.S. and not suffer recurrence of these diseases,” said Gregory Poland, co-director of the Atria Academy of Science & Medicine. “One in 3,000 kids who gets measles is going to die. There’s no treatment for it. They are going to die.”

During a November 2019 measles epidemic that killed 80 children in Samoa, Kennedy wrote to the country’s prime minister falsely claiming that the measles vaccine was probably causing the deaths. Scott Gottlieb, who was Trump’s first FDA commissioner, said on CNBC on Friday that Kennedy “will cost lives in this country” if he undercuts vaccination.

Kennedy’s nomination validates and enshrines public mistrust of government health programs, said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“The notion that he’d even be considered for that position makes people think he knows what he’s talking about,” Offit said. “He appeals to lessened trust, the idea that ‘There are things you don’t see, data they don’t present, that I’m going to find out so you can really make an informed decision.’”

Infectious disease threats are on the rise

Hodge has compiled a list of 20 actions the administration could take to weaken national vaccination programs, from spreading misinformation to delaying FDA vaccine approvals to dropping Department of Justice support for vaccine laws challenged by groups like Children’s Health Defense, which Kennedy founded and led before campaigning for president.

Kennedy could also cripple the National Vaccine Injury Compensation Program, which Congress created in 1986 to take care of children believed harmed by vaccines — while partially protecting vaccine makers from lawsuits.

Before the law passed, the threat of lawsuits had shrunk the number of companies making vaccines in the United States — from 26 in 1967 to 17 in 1980 — and the remaining pertussis vaccine producers were threatening to stop making it. The vaccine injury program “played an integral role in keeping manufacturers in the business,” Poland said.

Kennedy could abolish the CDC’s Advisory Committee on Immunization Practices, whose recommendation for using a vaccine determines whether the government pays for it through the 30-year-old Vaccines for Children program, which makes free immunizations available to more than half the children in the United States. Alternatively, Kennedy could stack the committee with allies who oppose new vaccines, and could, in theory at least, withdraw recommendations for vaccines like the 53-year-old measles-mumps-rubella shot, a favorite target of the anti-vaccine movement.

Meanwhile, infectious disease threats are on the rise or on the horizon. Instead of preparing, as a typical incoming administration might, Kennedy has threatened to shake up the federal health agencies. Once in office, he’ll “give infectious disease a break” to focus on chronic ailments, he said at a Children’s Health Defense conference last month in Georgia.

What to know about RFK Jr.’s stances on key health issues and what he could do at HHS

The H5N1 virus, or bird flu, that has spread through cattle herds and infected at least 55 people could erupt in a new pandemic, and other threats like mosquito-borne dengue fever are rising in the United States.

Traditional childhood diseases are also making their presence felt, in part because of neglected vaccination. The United States has seen 16 measles outbreaks this year — 89% of cases are in unvaccinated people — and a whooping cough epidemic is the worst since 2012.

“So that’s how we’re starting out,” said Peter Hotez, a pediatrician and virologist at the Baylor College of Medicine. “Then you throw into the mix one of the most outspoken and visible anti-vaccine activists at the head of HHS, and that gives me a lot of concern.”

The share prices of drug companies with big vaccine portfolios have plunged since Kennedy’s nomination. Even before Trump’s victory, vaccine exhaustion and skepticism had driven down demand for newer vaccines like GSK’s RSV and shingles shots.

Kennedy has ample options to slow or stop new vaccine releases or to slow sales of existing vaccines — for example, by requiring additional post-market studies or by highlighting questionable studies that suggest safety risks.

Kennedy, who has embraced conspiracy theories such as that HIV does not cause AIDS and that pesticides cause gender dysphoria, told NPR there are “huge deficits” in vaccine safety research. “We’re going to make sure those scientific studies are done and that people can make informed choices,” he said.

Kennedy’s nomination “bodes ill for the development of new vaccines and the use of currently available vaccines,” said Stanley Plotkin, a vaccine industry consultant and inventor of the rubella vaccine in the 1960s. “Vaccine development requires millions of dollars. Unless there is prospect of profit, commercial companies are not going to do it.”

Vaccine advocates, with less money on hand than the better-funded anti-vaccine advocates, see an uphill battle to defend vaccination in courts, legislatures, and the public square. People are rarely inclined to celebrate the absence of a conquered illness, making vaccines a hard sell even when they are working well.

While many wealthy people, including potion and supplement peddlers, have funded the anti-vaccine movement, “there hasn’t been an appetite from science-friendly people to give that kind of money to our side,” said Karen Ernst, director of Voices for Vaccines.

RFK Jr. is ‘serious as hell’

“RFK Jr. was a punch line for a lot of people, but he’s serious as hell,” Ernst said. “He has a lot of power, money, and a vast network of anti-vaccine parents who’ll show up at a moment’s notice.” That’s not been the case with groups like hers, Ernst said.

On Oct. 22, when an Idaho health board voted to stop providing Covid vaccines in six counties, there were no vaccine advocates at the meeting. “We didn’t even know it was on the agenda,” Ernst said. “Mobilization on our side is always lagging. But I’m not giving up.”

The kaleidoscopic change has been jarring for Walter Orenstein, who persuaded states to tighten school mandates to fight measles outbreaks as head of the CDC’s immunization division from 1988 to 2004.

“People don’t understand the concept of community protection, and if they do they don’t seem to care,” said Orenstein, who saw some of the last cases of smallpox as a CDC epidemiologist in India in the 1970s, and frequently cared for children with meningitis caused by H. influenzae type B bacteria, a disease that has mostly disappeared because of a vaccine introduced in 1987.

“I was so naïve,” he said. “I thought that Covid would solidify acceptance of vaccines, but it was the opposite.”

Lawmakers opposed to vaccines could introduce legislation to remove school-entry requirements in nearly every state, Saunders said. One bill to do this has been introduced in Texas, where what’s known as the vaccine choice movement has been growing since 2015 and took off during the pandemic, fusing with parents’ rights and anti-government groups opposed to measures like mandatory shots and masking.

“The genie is out of the bottle, and you can’t put it back in,” said Rekha Lakshmanan, chief strategy officer at the Immunization Partnership in Texas. “It’s become this multiheaded thing that we’re having to reckon with.”

In the last full school year, more than 100,000 Texas public school students were exempted from one or more vaccinations, she said, and many of the 600,000 homeschooled Texas kids are also thought to be unvaccinated.

In Louisiana, the state surgeon general distributed a form letter to hospitals exempting medical professionals from flu vaccination, claiming the vaccine is unlikely to work and has “real and well established” risks. Research on flu vaccination refutes both claims.

The biggest threat to existing vaccination policies could be plans by the Trump administration to remove civil service protections for federal workers. That jeopardizes workers at federal health agencies whose day-to-day jobs are to prepare for and fight diseases and epidemics. “If you overturn the administrative state, the impact on public health will be long-term and serious,” said Dorit Reiss, a professor at the University of California’s Hastings College of Law.

Billionaire Elon Musk, who has the ear of the incoming president, imagines cost-cutting plans that are also seen as a threat.

“If you damage the core functions of the FDA, it’s like killing the goose that laid the golden egg, both for our health and for the economy,” said Jesse Goodman, the director of the Center on Medical Product Access, Safety and Stewardship at Georgetown University and a former chief science officer at the FDA. “It would be the exact opposite of what Kennedy is saying he wants, which is safe medical products. If we don’t have independent skilled scientists and clinicians at the agency, there’s an increased risk Americans will have unsafe foods and medicine.”

Outbreaks of vaccine-preventable illness could be alarming, but would they be enough to boost vaccination again? Ernst of Voices for Vaccines isn’t sure.

“We’re already having outbreaks. It would take years before enough children died before people said, ‘I guess measles is a bad thing,’” she said. “One kid won’t be enough. The story they’ll tell is, ‘There was something wrong with that kid. It can’t happen to my kid.’”

Arthur Allen is a reporter for KFF Health News, Healthbeat’s national reporting partner.

‘Protect our children’: Vaccine expert on why immunization remains crucial

2024-11-25T22:32:50+00:00

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The Task Force for Global Health’s Center for Vaccine Equity, based in Decatur, has a worldwide view of efforts to eradicate infectious diseases like polio, measles, and hepatitis B. With recent declines in U.S. childhood vaccination rates, the center has work to do at home, too.

Dr. Alicia Fry, the center’s director, has worked to prevent, monitor, and treat respiratory infections on the local, national and global level — from the Centers for Disease Control and Prevention to the Fulton County Board of Health. The tools of that work — like vaccines and access to them — are often the same anywhere.

Fry spoke with Healthbeat about the center’s work to make it easier for people to access life-saving immunizations, and the challenges to the mission, from war and political strife abroad to misinformation at home.

Dr. Alicia Fry is the Task Force for Global Health's Center for Vaccine Equity director. Before joining the Task Force, she worked for the Fulton County Board of Health and the Centers for Disease Control and Prevention.

This conversation has been edited for clarity and brevity.

Could you talk about your public health background? How did you get started working in infectious disease prevention?

I’m an internist with a sub-specialty in infectious diseases, so I always was drawn toward infectious diseases. My work in public health really started when I came to the CDC to be an Epidemic Intelligence Service officer in 1999. I’ve been doing public health for a long time, and I love it.

I was working with a group that worked on bacterial diseases that cause respiratory illnesses. We worked to understand and promote the use of the pneumococcal vaccine … I transitioned to other places in CDC, but I ended up my last 15 years working in the influenza division and focusing on influenza vaccines, antivirals, and epidemiology.

It looks like you’ve done infectious disease work at a global level with the CDC and a local level with Fulton County Board of Health. Can you speak about how those responsibilities overlapped and how they were connected?

The tools to prevent the spread of infectious diseases are really the same — whether you’re a local, county, or state [government], you’re CDC at the national level, or you’re a country anywhere in the world.

First, you want to prevent infection, and we know vaccines are one of the best tools to prevent infection if available. The second tool is surveillance and rapid response to prevent the spread once you detect it.

At a local health level, [departments] work very closely with the schools to assure immunization rates are high and recorded. They also offer free or inexpensive vaccines to make it easy to get children vaccinated, do surveillance, and respond if they detect any cases of certain infectious diseases.

At the global level, the Task Force for Global Health works with local ministries of health in countries around the world to both prevent infectious diseases and other illnesses, and also to detect and respond to them locally. These tools are really used across public health.

Can you tell us a bit about the work the Center for Vaccine Equity does?

The Task Force for Global Health was founded 40 years ago specifically to reduce childhood mortality by promoting the use of vaccines, help low- and middle-income countries have access to vaccines, and improve [those countries’] vaccine coverage. Over time, it’s evolved to work on other diseases, some of them without vaccines. The Center for Vaccine Equity was founded in 2011. As the task force grew, the vaccine work became more concentrated in one center.

We have several different programs in the Center for Vaccine Equity, and our overall goals are to prevent infections and work toward the elimination of some [diseases], such as polio or hepatitis B, and to improve childhood vaccine coverage. We also have a program that works on educating [United States] parents, providing vaccine information to parents and working toward decreasing misinformation out there.

Most of our work is international, but we also have some domestic work. We touch on both.

Inherent in the name Center for Vaccine Equity is that you are addressing inequity. Can you speak about global vaccine inequity?

This goes back to when the task force was founded. Poor access to vaccines — whether it’s an inability to purchase them because they’re too expensive, or not having the infrastructure in a Ministry of Health — all of those things create inequity. When you work to reduce inequity, you’re trying to touch on all those different aspects.

There are many other partners working on this to reduce inequity by improving access to vaccines and lowering costs. It’s not just working to get vaccines in countries but also to help local health departments set up their immunization programs so they can deliver vaccines to children, monitor vaccine coverage, and do disease surveillance.

By working with local partners to help them establish those systems, you’re improving their ability to have higher vaccine coverage for their children. And you’re reducing inequity.

Why should Americans care about vaccine availability around the world and global public health in general?

Infectious diseases don’t really know boundaries. If an unvaccinated person either travels to a country where there is an infectious disease circulating freely in the community and then travels back home, they basically import that infectious disease to that country. Then [there’s risk] for anyone who’s susceptible, which includes people who aren’t vaccinated, but also children who are too young to be vaccinated.

But the other reason is because vaccines save lives. Globally, vaccination has prevented millions of deaths, especially in low-income countries. If we only look at measles vaccinations, 60 million deaths among children have been prevented between 2000 and 2023. Now, despite these great accomplishments, we still need to work to ensure that all children have access to and are vaccinated with these life-saving vaccines.

4 ways vaccine skeptics mislead you on measles and more

During the Covid-19 pandemic, there were some disruptions in health services globally and in the U.S. that affected vaccination rates. The drop in immunization rates was most notable in low-income countries. Many partners, including the task force, have tried very hard to improve vaccine rates, but those rates have stagnated.

And we’ve already seen the consequences of this. During 2023, the number of measles cases more than doubled globally, and the number of outbreaks has increased. This means that we really need renewed efforts to prevent measles globally, and we need to remain vigilant and protect our children here in the U.S. by maintaining a high vaccination level.

What has changed in global infectious disease public health work since the Covid-19 pandemic began?

In the U.S. and globally, we’ve seen a drop in immunization rates. During the height of the pandemic, that was likely due to health clinics closing and resources being diverted to control the pandemic. But since Covid has decreased, we haven’t seen a great increase. We’ve seen a continuing lower vaccine coverage.

Part of that is thought to be due to misinformation about vaccines. We know in the U.S., there’s certainly some misinformation about vaccines, and that’s affecting pediatric vaccination. The slow, downward trend is very concerning, so working to provide good information out there is new for the whole global community.

Vaccine misinformation has been around for a long time. I think with social media, it’s just more widespread. That is new since Covid, and that’s something the global and U.S. vaccine communities need to work on.

What are the biggest threats to equitable vaccine distribution?

I think it’s a combination of things. There are still parts of the world where there’s war and political strife so that the health system is not functional in the country. For example, in Gaza, vaccine coverage dropped because the infrastructure for vaccination was destroyed during the war. There’re climate disasters, flooding, and other things where people are displaced. Then the normal health infrastructure gets disrupted, and you have children who are not vaccinated and vulnerable. There’s a lot of reasons why we continue to have children who aren’t vaccinated around the world.

In places that have good infrastructure and are unable to reach high vaccine coverage, misinformation plays a role. Also, vaccines are still costly, and the global community is still working hard to make sure there are vaccines that are accessible to all countries.

From global health to domestic health: You touched on the misinformation aspect, but are there other factors at the local, state, and national levels that impact the metro Atlanta vaccination rates?

State legislation for school immunizations is very critical. All 50 states have immunization laws. These laws were put in place in the [19]70s and early ’80s because even after the measles vaccine became available, there were still cases of measles. Some of those kids had swelling in the brain and pneumonia. There were still deaths.

These school immunization programs really increased vaccine coverage, and that [created] a recognition around the country for the need for this. That is one of the main tools state and local health departments have to ensure they have high vaccine coverage — because it mobilizes the local health department to work with the schools and mobilizes the schools to educate the parents.

There is misinformation out there that is likely contributing to lower vaccine coverage for children, and it’s really dangerous for their health. Because it makes them susceptible if an infectious disease like measles or pertussis is introduced to the school.

What to know about RFK Jr.’s stances on key health issues and what he could do at HHS

One of our programs specifically works to inform families about vaccines and has a very helpful webpage that parents can go to get more information. [And] there’s a group of people whose primary job it is to take care of children and keep them healthy, and that is nurses and doctors in the pediatric office and local health clinics. If parents have questions about vaccines, they should ask those people who work hard to keep children healthy about the vaccine. Getting information from the right sources is probably an important way to counter some of the misinformation out there.

As we enter into a new federal administration, what lessons from the past can help continue our efforts to prevent infectious disease spread?

The tools to prevent infectious disease spread have been known for decades, and the U.S. has really worked hard to reduce infectious diseases in children. Our high vaccine coverage of children has really been a source of pride. That is because our pediatricians are great at working with parents so they understand how important vaccines are, and then the local and state health departments promote that. Hopefully, we can look historically at why vaccines are important so we don’t have to experience what low vaccine coverage means for our children.

I just hope we can continue to have a good discourse. It’s conversation, discourse, and being willing to remember those days before we had high vaccine coverage and what that meant for our children.

What’s your hope for the future of vaccine equity, both globally and domestically, for the next 10-20 years?

My hope would be that we can move toward high vaccine coverage, especially for some of the more infectious diseases like measles, globally. That we continue to move toward polio, measles, and hepatitis B eradication — all of these goals that were set by the [World Health Organization] and the World Health Assembly. Working toward everybody having a chance at a healthy life. I hope that we continue to move toward that and not away from it.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Childhood vaccine coverage remains high, but we can't let our guard down

2024-10-16T11:00:00+00:00

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New data on childhood vaccinations shows many states are sweating because coverage continues to decline after taking a big hit during the pandemic.

However, New Yorkers have a different story: We continue to be one of the state leaders in vaccine coverage. It’s something to celebrate, but importantly, we can’t let our guard down.

New York has very high vaccination rates.

Recent data on kindergartners during the 2023-24 school year show that New York’s MMR (Measles, Mumps, and Rubella) vaccine coverage is 97.7%, making it the third-highest state in vaccine coverage.

Importantly, 97% is above the threshold needed to reach herd immunity for measles (95% must be vaccinated to prevent outbreaks). Measles is one of the most contagious viruses, so we need a very high vaccination rate to prevent outbreaks.

Measles, mumps, and rubella (MMR) vaccination rates among kindergarteners for the 2023-24 school year.

Why does New York have high rates?

One big reason is the elimination of non-medical vaccine exemptions. There was a major measles outbreak in New York City in 2019: 605 cases in a community with low vaccination coverage (79.5%), leading to 20 kiddos going to the intensive-care unit. Outbreaks like these not only harm the health of individuals and communities but are very expensive — it’s estimated that the 2019 outbreak cost the city $8.4 million.

Shortly after, New York passed a law that made us the fifth U.S. state to address increasing pediatric undervaccination by eliminating non-medical exemptions (like for religious reasons). This directly increased vaccination coverage in public and private schools.

Vaccination coverage increased at public and private schools after New York eliminated non-medical exemptions.

All states, including New York, still allow medical exemptions, such as when someone is allergic to a vaccine component.

Does this mean we are in the clear?

Not really. While the state average is high, there are still counties with very low rates. These unvaccinated pockets — like Rockland, Yates, and Orange — have vaccination rates between 54% and 58%. All these counties need is a spark — an infected person traveling — to spread measles like wildfire.

Receipt of 1 MMR dose by 2 years of age. Rates shown here are lower than the New York state average because they are for individuals up to 2 years of age, while the state average MMR coverage rate is for kindergarteners. Vaccination is required to start kindergarten which explains the higher rate.

And there are sparks out there. This year there have been 13 measles cases in New York City and at least one in New York outside the city.

Polio and whooping cough are out there, too.

In 2022, a young, unvaccinated man was paralyzed by polio in Rockland County, an area with historically low vaccination rates. Wastewater monitoring showed polio was circulating in other New York counties as well. (This isn’t a surprise because, for every one case of paralysis from polio, about 100 people are infected.) Any detection of polio in the United States is considered a public health emergency.

We are also seeing an exponential rise in whooping cough — called pertussis — that can be prevented with a Tdap or DTaP vaccine.

New York City: Cases in 2024 are up 169% compared to 2023, with 427 cases reported so far.
New York state: Cases are up over 300% in 2024.

Ensure your kids, grandkids, neighbors, and friends are vaccinated.

Childhood vaccinations are safer than getting the disease itself. Over the past 30 years, childhood vaccinations prevented 508 million cases of illness, 32 million hospitalizations, and 1,129,000 deaths.

In New York, children must have the following vaccinations to enroll in New York schools:

All students (child care and prekindergarten through 12th grade):

Diphtheria and tetanus toxoid-containing vaccine and pertussis vaccine (DTaP or Tdap)
Hepatitis B vaccine
Measles, Mumps and Rubella vaccine (MMR)
Polio vaccine
Varicella (chickenpox) vaccine

Children under 5 in child care or pre-K:

Haemophilus influenzae Type B conjugate vaccine (HiB)
Pneumococcal Conjugate Vaccine (PCV)

Middle school and high school:

Tdap vaccine for Grades 6-12
Meningococcal conjugate vaccine (MenACWY) for Grades 7-12
- Students in Grade 12 need an additional booster dose of MenACWY on or after their 16th birthday.

How can I persuade hesitant people?

It takes listening, time, and hearing the right things from a trusted source. Research shows health care providers are among the most influential factors in whether parents vaccinate their children.

Local health departments in New York state provide annual training to clinicians about evidence-based strategies to increase vaccination among populations with low or lagging rates, considering vaccine hesitancy.
Training can also be targeted to areas of the state identified as hotspots for vaccine hesitancy.

Talk to your local health department for their next training date.

Bottom line

New York has some of the highest vaccination rates in the country. And we should be proud of that. But we can’t let our guard down, as pockets of under-vaccination still pose a serious risk for outbreaks.

Love,

Your Local Epidemiologist

How the anti-vaccine movement pits parental rights against public health

2024-08-02T15:42:09+00:00

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Gayle Borne has fostered more than 300 children in Springfield, Tennessee. She’s cared for kids who have rarely seen a doctor — kids so neglected that they cannot speak. Such children are now even more vulnerable because of a law Tennessee passed last year that requires the direct consent of birth parents or legal guardians for every routine childhood vaccination. Foster parents, social workers, and other caregivers cannot provide permission.

In January, Borne took a foster baby, born extremely premature at just over 2 pounds, to her first doctor’s appointment. The health providers said that without the consent of the child’s mother, they couldn’t vaccinate her against diseases like pneumonia, hepatitis B, and polio. The mother hasn’t been located, so a social worker is now seeking a court order to permit immunizations. “We are just waiting,” Borne said. “Our hands are tied.”

Tennessee’s law has also stymied grandmothers and other caregivers who accompany children to routine appointments when parents are at work, in drug and alcohol rehabilitation clinics, or otherwise unavailable. The law claims to “give parents back the right to make medical decisions for their children.”

Framed in the rhetoric of choice and consent, it is one of more than a dozen recent and pending pieces of legislation nationwide that pit parental freedom against community and children’s health. In actuality, they create obstacles to vaccination, the foundation of pediatric care.

Such policies have another effect. They seed doubt about vaccine safety in a climate rife with medical misinformation. The trend has exploded as politicians and social media influencers make false claims about risks, despite studies showing otherwise.

Doctors traditionally give caregivers vaccine information and get their permission before delivering more than a dozen childhood immunizations that defend against measles, polio, and other debilitating diseases.

But now, Tennessee’s law demands that birth parents attend routine appointments and sign consent forms for every vaccine given over two or more years. “The forms could have a chilling effect,” said Jason Yaun, a Memphis pediatrician and past president of the Tennessee chapter of the American Academy of Pediatrics.

“People who promote parental rights on vaccines tend to downplay the rights of children,” said Dorit Reiss, a vaccine policy researcher at the University of California Law-San Francisco.

Vaccination rates are dropping

Misinformation coupled with a parental rights movement that shifts decision-making away from public health expertise has contributed to the lowest childhood vaccine rates in a decade.

This year, legislators in Arizona, Iowa, and West Virginia have introduced related consent bills. A “Parents’ Bill of Rights” amendment in Oklahoma seeks to ensure that parents know they can exempt their children from school vaccine mandates along with lessons on sex education and AIDS. In Florida, the medical skeptic leading the state’s health department recently defied guidance from the Centers for Disease Control and Prevention by telling parents they could send unvaccinated children to a school during a measles outbreak.

Last year, Mississippi began allowing exemptions from school vaccine requirements for religious reasons because of a lawsuit funded by the Informed Consent Action Network, which is listed as a leading source of anti-vaccine disinformation by the Center for Countering Digital Hate. A post on ICAN’s website said it “could not be more proud” in Mississippi to “restore the right of every parent in this country to have his or her convictions respected and not trampled by the government.”

Even if some bills fail, Reiss fears, the revived parental rights movement may eventually abolish policies that require routine immunizations to attend school. At a recent campaign rally, Republican presidential candidate Donald Trump said, “I will not give one penny to any school that has a vaccine mandate.”

The movement dates to the wake of the 1918 influenza pandemic, when some parents pushed back against progressive reforms that required school attendance and prohibited child labor. Since then, tensions between state measures and parental freedom have occasionally flared over a variety of issues. Vaccines became a prominent one in 2021, as the movement found common ground with people skeptical of Covid-19 vaccines.

“The parental rights movement didn’t start with vaccines,” Reiss said, “but the anti-vaccine movement has allied themselves with it and has expanded their reach by riding on its coattails.”

Lawmakers silence health experts

In Tennessee, anti-vaccine activists and libertarian-leaning organizations railed against the state’s health department in 2021 when it recommended Covid vaccines to minors, following CDC guidance. Gary Humble, executive director of the conservative group Tennessee Stands, asked legislators to blast the health department for advising masks and vaccination, suggesting the department “could be dissolved and reconstituted at your pleasure.”

Backlash also followed a notice sent to doctors from Michelle Fiscus, then the state’s immunization director. She reminded them that they didn’t need parental permission to vaccinate consenting adolescents 14 or older, according to a decades-old state rule called the Mature Minor Doctrine.

In the weeks that followed, state legislators threatened to defund the health department and pressured it into scaling back Covid vaccine promotion, as revealed by The Tennessean. Fiscus was abruptly fired. “Today I became the 25th of 64 state and territorial immunization program directors to leave their position during this pandemic,” she wrote in a statement. “That’s nearly 40% of us.” Tennessee’s Covid death rate climbed to one of the nation’s highest by mid-2022.

By the time two state legislators introduced a bill to reverse the Mature Minor Doctrine, the health department was silent on the proposal. Despite obstacles for foster children who would require a court order for routine immunizations, Tennessee’s Department of Children’s Services was silent, too.

Notably, the legislator who introduced the bill, Republican Rep. John Ragan, was among those simultaneously overseeing a review of the agency that would determine its leadership and budget for the coming years. “Children belong to their families, not the state,” said Ragan as he presented the bill at a state hearing in April 2023.

Democratic Rep. Justin Pearson spoke out against the bill. It “doesn’t take into account people and children who are neglected,” he told Ragan. “We are legislating from a point of privilege and not recognizing the people who are not privileged in this way.”

Rather than address such concerns, Ragan referenced a Supreme Court ruling in favor of parental rights in 2000. Specifically, judges determined that a mother had legal authority to decide who could visit her daughters. Yet the Supreme Court has also done the opposite. For instance, it sided against a legal guardian who removed her child from school to proselytize for the Jehovah’s Witnesses.

Still, Ragan swiftly won the majority vote. Tennessee Gov. Bill Lee, a Republican, signed the bill in May, making it effective immediately. Deborah Lowen, then the deputy commissioner of child health at the Department of Children’s Services, was flooded with calls from doctors who now face jail time and fines for vaccinating minors without adequate consent. “I was and remain very disheartened,” she said.

Kindergartners are at risk

Yaun, the Memphis pediatrician, said he was shaken as he declined to administer a first series of vaccines to an infant accompanied by a social worker. “That child is going into a situation where they are around other children and adults,” he said, “where they could be exposed to something we failed to protect them from.”

“We have had numerous angry grandparents in our waiting room who take kids to appointments because the parents are at work or down on their luck,” said Hunter Butler, a pediatrician in Springfield, Tennessee. “I once called a rehabilitation facility to find a mom and get her on the phone to get verbal consent to vaccinate her baby,” he said. “And it’s unclear if that was OK.”

Childhood immunization rates have dropped for three consecutive years in Tennessee. Nationwide, downward trends in measles vaccination led the CDC to estimate that a quarter million kindergartners are at risk of the highly contagious disease.

Communities with low vaccination rates are vulnerable as measles surges internationally. Confirmed measles cases in 2023 were almost double those in 2022 — a year in which the World Health Organization estimates that more than 136,000 people died from the disease globally. When travelers infected abroad land in communities with low childhood vaccination rates, the highly contagious virus can spread swiftly among unvaccinated people, as well as babies too young to be vaccinated and people with weakened immune systems.

“There’s a freedom piece on the other side of this argument,” said Caitlin Gilmet, communications director at the vaccine advocacy group SAFE Communities Coalition and Action Fund. “You should have the right to protect your family from preventable diseases.”

In late January, Gilmet and other child health advocates gathered in a room at the Tennessee Statehouse in Nashville, offering a free breakfast of fried chicken biscuits. They handed out flyers as legislators and their aides drifted in to eat. One pamphlet described the toll of a 2018-19 measles outbreak in Washington state that sickened 72 people, most of whom were unvaccinated, costing $76,000 in medical care, $2.3 million for the public health response, and an estimated $1 million in economic losses due to illness, quarantine, and caregiving.

Barb Dentz, an advocate with the grassroots group Tennessee Families for Vaccines, repeated that most of the state’s constituents support strong policies in favor of immunizations. Indeed, seven in 10 U.S. adults maintained that public schools should require vaccination against measles, mumps, and rubella, in a Pew Research Center poll last year. But numbers have been dropping.

“Protecting kids should be such a no-brainer,” Dentz told Republican Rep. Sam Whitson, later that morning in his office. Whitson agreed and reflected on an explosion of anti-vaccine misinformation. “Dr. Google and Facebook have been such a challenge,” he said. “Fighting ignorance has become a full-time job.”

Whitson was among a minority of Republicans who voted against Tennessee’s vaccine amendment last year. “The parental rights thing has really taken hold,” he said, “and it can be used for and against us.”

This story originally published on March 12, 2024 at KFF Health News, Healthbeat’s national reporting partner.

4 ways vaccine skeptics mislead you on measles and more

2024-07-29T15:58:50+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Measles is on the rise in the United States. In the first quarter of this year, the number of cases was about 17 times what it was, on average, during the same period in each of the four years before, according to the Centers for Disease Control and Prevention. Half of the people infected — mainly children — have been hospitalized.

It’s going to get worse, largely because a growing number of parents are deciding not to get their children vaccinated against measles as well as diseases like polio and pertussis. Unvaccinated people, or those whose immunization status is unknown, account for 80% of the measles cases this year. Many parents have been influenced by a flood of misinformation spouted by politicians, podcast hosts, and influential figures on television and social media. These personalities repeat decades-old notions that erode confidence in the established science backing routine childhood vaccines. KFF Health News examined the rhetoric and explains why it’s misguided:

The no-big-deal trope

A common distortion is that vaccines aren’t necessary because the diseases they prevent are not very dangerous, or too rare to be of concern. Cynics accuse public health officials and the media of fear-mongering about measles even as 19 states report cases.

For example, an article posted on the website of the National Vaccine Information Center — a regular source of vaccine misinformation — argued that a resurgence in concern about the disease “is ‘sky is falling’ hype.” It went on to call measles, mumps, chicken pox, and influenza “politically incorrect to get.”

Measles kills roughly 2 of every 1,000 children infected, according to the CDC. If that seems like a bearable risk, it’s worth pointing out that a far larger portion of children with measles will require hospitalization for pneumonia and other serious complications. For every 10 measles cases, one child with the disease develops an ear infection that can lead to permanent hearing loss. Another strange effect is that the measles virus can destroy a person’s existing immunity, meaning they’ll have a harder time recovering from influenza and other common ailments.

Measles vaccines have averted the deaths of about 94 million people, mainly children, over the past 50 years, according to an April analysis led by the World Health Organization. Together with immunizations against polio and other diseases, vaccines have saved an estimated 154 million lives globally.

Some skeptics argue that vaccine-preventable diseases are no longer a threat because they’ve become relatively rare in the U.S. (True — due to vaccination.) This reasoning led Florida’s surgeon general, Joseph Ladapo, to tell parents that they could send their unvaccinated children to school amid a measles outbreak in February. “You look at the headlines and you’d think the sky was falling,” Ladapo said on a News Nation newscast. “There’s a lot of immunity.”

As this lax attitude persuades parents to decline vaccination, the protective group immunity will drop, and outbreaks will grow larger and faster. A rapid measles outbreak hit an undervaccinated population in Samoa in 2019, killing 83 people within four months. A chronic lack of measles vaccination in the Democratic Republic of the Congo led to more than 5,600 people dying from the disease in massive outbreaks last year.

The ‘you never know’ trope

Since the earliest days of vaccines, a contingent of the public has considered them bad because they’re unnatural, as compared with nature’s bounty of infections and plagues. “Bad” has been redefined over the decades. In the 1800s, vaccine skeptics claimed that smallpox vaccines caused people to sprout horns and behave like beasts. More recently, they blame vaccines for ailments ranging from attention-deficit/hyperactivity disorder to autism to immune system disruption. Studies don’t back the assertions. However, skeptics argue that their claims remain valid because vaccines haven’t been adequately tested.

In fact, vaccines are among the most studied medical interventions. Over the past century, massive studies and clinical trials have tested vaccines during their development and after their widespread use. More than 12,000 people took part in clinical trials of the most recent vaccine approved to prevent measles, mumps, and rubella. Such large numbers allow researchers to detect rare risks, which are a major concern because vaccines are given to millions of healthy people.

To assess long-term risks, researchers sift through reams of data for signals of harm. For example, a Danish group analyzed a database of more than 657,000 children and found that those who had been vaccinated against measles as babies were no more likely to later be diagnosed with autism than those who were not vaccinated. In another study, researchers analyzed records from 805,000 children born from 1990 through 2001 and found no evidence to back a concern that multiple vaccinations might impair children’s immune systems.

Nonetheless, people who push vaccine misinformation, like presidential candidate Robert F. Kennedy Jr., dismiss massive, scientifically vetted studies. For example, Kennedy argues that clinical trials of new vaccines are unreliable because vaccinated kids aren’t compared with a placebo group that gets saline solution or another substance with no effect. Instead, many modern trials compare updated vaccines with older ones. That’s because it’s unethical to endanger children by giving them a sham vaccine when the protective effect of immunization is known. In a 1950s clinical trial of polio vaccines, 16 children in the placebo group died of polio and 34 were paralyzed, said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and author of a book on the first polio vaccine.

The too-much-too-soon trope

Several bestselling vaccine books on Amazon promote the risky idea that parents should skip or delay their children’s vaccines. “All vaccines on the CDC’s schedule may not be right for all children at all times,” writes Paul Thomas in his bestselling book “The Vaccine-Friendly Plan.” He backs up this conviction by saying that children who have followed “my protocol are among the healthiest in the world.”

Since the book was published, Thomas’ medical license was temporarily suspended in Oregon and Washington. The Oregon Medical Board documented how Thomas persuaded parents to skip vaccines recommended by the CDC, and reported that he “reduced to tears” a mother who disagreed. Several children in his care came down with pertussis and rotavirus, diseases easily prevented by vaccines, wrote the board. Thomas recommended fish oil supplements and homeopathy to an unvaccinated child with a deep scalp laceration, rather than an emergency tetanus vaccine. The boy developed severe tetanus, landing in the hospital for nearly two months, where he required intubation, a tracheotomy, and a feeding tube to survive.

The vaccination schedule recommended by the CDC has been tailored to protect children at their most vulnerable points in life and minimize side effects. The combination measles, mumps, and rubella vaccine isn’t given for the first year of a baby’s life because antibodies temporarily passed on from their mother can interfere with the immune response. And because some babies don’t generate a strong response to that first dose, the CDC recommends a second one around the time a child enters kindergarten because measles and other viruses spread rapidly in group settings.

Delaying MMR doses much longer may be unwise because data suggests that children vaccinated at 10 or older have a higher chance of adverse reactions, such as a seizure or fatigue.

Around a dozen other vaccines have discrete timelines, with overlapping windows for the best response. Studies have shown that MMR vaccines may be given safely and effectively in combination with other vaccines.

‘They don’t want you to know’ trope

Kennedy compares the Florida surgeon general to Galileo in the introduction to Ladapo’s new book on transcending fear in public health. Just as the Roman Catholic inquisition punished the renowned astronomer for promoting theories about the universe, Kennedy suggests that scientific institutions oppress dissenting voices on vaccines for nefarious reasons.

“The persecution of scientists and doctors who dare to challenge contemporary orthodoxies is not a new phenomenon,” Kennedy writes. His running mate, lawyer Nicole Shanahan, has campaigned on the idea that conversations about vaccine harms are censored and the CDC and other federal agencies hide data due to corporate influence.

Claims like “they don’t want you to know” aren’t new among the anti-vaccine set, even though the movement has long had an outsize voice. The most listened-to podcast in the U.S., “The Joe Rogan Experience,” regularly features guests who cast doubt on scientific consensus. Last year on the show, Kennedy repeated the debunked claim that vaccines cause autism.

Far from ignoring that concern, epidemiologists have taken it seriously. They have conducted more than a dozen studies searching for a link between vaccines and autism, and repeatedly found none. “We have conclusively disproven the theory that vaccines are connected to autism,” said Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong in Australia. “So, the public health establishment tends to shut those conversations down quickly.”

Federal agencies are transparent about seizures, arm pain, and other reactions that vaccines can cause. And the government has a program to compensate individuals whose injuries are scientifically determined to result from them. Around 1 to 3.5 out of every million doses of the measles, mumps, and rubella vaccine can cause a life-threatening allergic reaction; a person’s lifetime risk of death by lightning is estimated to be as much as four times as high.

“The most convincing thing I can say is that my daughter has all her vaccines and that every pediatrician and public health person I know has vaccinated their kids,” Meyerowitz-Katz said. “No one would do that if they thought there were serious risks.”

This story originally published May 22, 2024 at KFF Health News, Healthbeat’s national reporting partner.