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Editor’s Note, 2/26/2025, 3:31 p.m.: Following the first reported death from measles in Texas in many years on Wednesday, WFAA reported on Wednesday afternoon that the Texas Department of Health and Human Services has confirmed the first case of measles in North Texas, in Rockwall County.
Original article below:
A measles death has been reported in West Texas amid the largest outbreak of the communicable disease in the state in over 20 years, The Associated Press reported Wednesday. The outbreak, traced back to an insular traditionalist religious group in West Texas is raising concerns for the continued spread of the disease across the Lone Star State.
The 124 confirmed cases reported by Texas Health and Human Services are concentrated in West Texas. Out of all those cases, however, only five of the infected were reportedly vaccinated. Eighteen of the cases in West Texas have resulted in hospitalizations. But Dr. Lara Johnson, a pediatrician and the chief medical officer at Covenant Children’s Hospital in Lubbock, told NBC News the count is likely much higher.
The breakout originated in Gaines County, an hour-and-a-half south of Lubbock, and has rapidly spread across New Mexico and Texas, resulting in the largest outbreak in Texas since 1992 and the largest outbreak in the country since 2019. As of Feb. 26, the measles count in Texas is 124, and 81% of all affected are younger than 18.
At the heart of the health crisis is a community of Old Colony Mennonites, a deeply conservative religious group that believes in total isolation from the outside world, speaks in a Low German dialect and dresses modestly. The Old Colony Mennonites settled in Seminole, a tiny town in Gaines County. Seminole has the largest Mennonite population in Texas, and a 2010 report from The Lubbock Avalanche-Journal estimated a fifth of Gaines County identified as Mennonite.
The group is a sector of Anabaptism, a Christian movement that retains traditional religious ideologies and practices. Some denominations of Anabaptism, like the Amish, also believe in rejecting all modernism, including Western medicine. According to the Texas Department of State Health Services, 18% of kindergarteners in Gaines County in 2023 had vaccine exemptions. Texas allows children to forego typically required vaccinations for several reasons, including religious beliefs.
To reach a level of “herd immunity,” the point at which enough of a population is immune to infection so that those who aren’t immune are much less likely to come in contact with those infected, 95% of a population must be vaccinated or otherwise immune. That leaves Gaines County well below the standard and highly susceptible to communicable diseases.
The Mennonite community in Seminole can be seen radical in its belief system, as the U.S. Conference of Mennonite Brethren, a collection of 200 Mennonite congregations, encourages vaccinations. During the onslaught of COVID-19, USMB released a statement regarding vaccination exemptions.
“Our current and historical practices do not provide the necessary rationale for granting a religious exemption based on the theological convictions of the denomination. … Carefully and with personal integrity, consider whether that objection is rooted in your own personal religious convictions or if it is rooted in other concerns and/or fears,” it said.
The sentiment is repeated by Dallas’ own Mennonite congregation, Peace Mennonite Church.
“Peace, and Mennonite Church USA, strongly encourage vaccination as a lifesaving intervention and a faithful witness to Christ’s call to love our neighbors,” said Samuel Voth Shrag of Peace Mennonite Church. “It is a simple way to help protect those around us, and it is a mistake not to get vaccinated or to vaccinate your children.”
What Is Measles?
Measles is a highly contagious airborne viral disease, signified by cold-like symptoms paired with a spotty full-body rash. Symptoms don’t appear until 7-21 days after exposure, but the disease is at its most communicable 3-4 days before the telltale rash appears.
The measles vaccine, developed in 1968, has a 97% efficacy rate when given in two doses. The vaccine is commonly distributed to infants between 12 to 15 months, and then a booster shot is given between the ages of 4-6, before a child enters school.
In 1978, the Centers for Disease Control and Prevention aimed to eliminate measles from the United States within four years. It missed this goal but by 1981, the number of reported cases reduced by 80%. In 1993, within the first 30 days of his term, President Bill Clinton signed the Comprehensive Childhood Immunization Act, which made the measles vaccine free for children. The disease was declared eliminated from the United States in 2000, despite random breakouts in the last 25 years.
Without the vaccination, nine out of 10 individuals exposed to the measles virus will contract the disease. The Infectious Diseases Society of America says three out of 1,000 people who contract measles will die, and one in 20 will get pneumonia. Before the vaccine, an estimated 500 people died from the disease in the United States and 1,000 suffered brain swelling annually on average.
The 2025 Texas Measles Spread
Since the outbreak started Jan. 23, reports of measles exposure in South and Central Texas and Houston have emerged. Reports of positive measles tests came in Houston in late January, and measles alerts have been issued in San Marcos, San Antonio and New Braunfels. A Gaines County resident tested positive for measles a week after visiting Texas State University, where the campus has been placed under high alert.
“[The outbreak] still has a lot of energy and steam behind it,” Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development told USA Today. “And that energy and steam are all the unvaccinated kids.”
Lara Anton, a spokesperson for Texas’ health department, told USA Today that the lack of healthcare access in rural Texas was accelerating the spread of measles. She said that people living in “under-vaccinated” areas where the disease is most rampant have to travel 30 to 40 miles to get preventative care.
Texas Health and Human Services is directing concerned individuals in West Texas to the South Plains District Health District Clinic in Seminole to receive a vaccine.
The measles outbreak is poorly timed with the recent appointment of Robert F. Kennedy, a known anti-vaccine activist, as the U.S. Secretary of Health and Human Services. Concern grew when Kennedy as emerged as a potential nominee given his history of spreading conspiracy theories related to vaccines and autism.
“I do believe that autism does come from vaccines,” Kennedy said in a 2023 interview with Fox News.
In 1998 a controversial, and since debunked, small study linked the measles vaccine and autism. The medical journal that originally published the study has retracted it, and the doctor accused of falsifying data to make his claim lost his medical license. But the report, and copycat studies, are still heavily cited by anti-vaccination activists.
Dallas Risk Level
The last reported measles case in Dallas County was in 2019, during a national outbreak that started in New York and spread to 1,300 people. The outbreak, the largest in the contiguous United States since the development of the vaccine, put the country’s elimination status at risk.
But Dallas could be at higher risk than before as lowering vaccination rates grow across the nation. In the 2023-2024 school year, 92% of kindergarteners in Dallas County had received the measles vaccine, below the threshold for herd immunity. In the 2019-2020 school year, 97% of Dallas kindergarteners had been vaccinated. According to a recent KXAN report, the number of vaccinated kindergartners in Texas has dropped about 3% from 2020 to 2024.
Dr. Philip Huang, director and health authority for the Dallas County Health and Human Services Department, told the Observer the overall risk of measles in Dallas is low, but pocket communities are still vulnerable. Huang noted that private schools, which tend to report lower-than-average vaccination rates, are especially vulnerable.
“[Dallas is] not in particular risk. But there are certainly pockets of low vaccination that we’re wanting to minimize,” he said. “It’s an easy fix for people to protect themselves with the vaccine.”
Huang credited the lowering vaccination rate with the increased vaccination skepticism that arose during the pandemic.
“We’ve definitely seen politicization of vaccinations and people who are anti-vaxxers because of that,” he said.
Vaccination rates are also lower amongst marginalized communities. During the pandemic, the Texas Tribune reported vaccination disparities between white and Black and Hispanic Texans, with white Texans receiving the vaccine at a much higher rate than communities of color.
“One of the things I know that we’re hearing from our staff on the front lines is that there are groups of people who are afraid to go to the clinics, perhaps because of immigration status,” Huang said. “That’s another thing that we’re hearing about, that there are people that are afraid to go in for things like medical treatment and vaccinations.”
