Experts warn that the actual number of measles cases in the U.S. could be much higher than reported, despite some claims from government officials.
During a Cabinet meeting last week, U.S. Health Secretary Robert F. Kennedy Jr. downplayed the current measles outbreak, calling it “plateaued.” However, recent data from his own department contradicts this.
In Texas, the epicenter of the outbreak, the health department reported 234 new cases in the past three weeks—an increase of 39% compared to the previous period. Outbreaks have also spread to Indiana and Ohio. In total, at least 760 measles cases have been reported in 24 states this year.
Despite these numbers, many experts believe the true count could be in the thousands. Dr. Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security, stated that it is impossible to declare that the outbreak is “plateauing” without full knowledge of the total number of cases.
Some believe that the number of deaths related to measles suggests that cases are underreported. Measles usually kills about three people per 1,000 cases, and three deaths have already been recorded in this outbreak. These include two children in Texas and one adult in New Mexico. The official case count for Texas, New Mexico, Oklahoma, and possibly Kansas stands at 668 cases.
Due to Various Factors
Dr. Nina Masters, a senior research scientist at Truveta, explained that the underreporting of cases could be due to people not seeking medical care or avoiding hospitals. Some communities, like the Mennonite population in Texas, rely on home remedies and avoid going to doctors, making it harder to track the outbreak accurately.
The underreporting issue has been compounded by cuts in federal funding for public health. The CDC has reduced grants by more than $11 billion since the Covid-19 pandemic, affecting the ability of state and local health departments to respond effectively.
Vaccination Could Help Control the Outbreak
The majority of people affected by the outbreak have either not been vaccinated or have an unknown vaccination status. The measles-mumps-rubella (MMR) vaccine is highly effective at preventing measles, especially when administered quickly. Public health experts agree that rapid mass vaccination can help stop outbreaks.
In a study of a previous outbreak at a migrant shelter in Chicago, Dr. Masters found that timely vaccination significantly reduced the number of cases. If vaccination had been delayed by a week, the number of cases would have been much higher.
Declining Vaccination Rates
The U.S. once led the world in controlling measles through high vaccination rates. However, vaccination coverage has dropped since the Covid-19 pandemic. In 2024, only 68.5% of children received their first MMR dose by 15 months, a decline from 77% in 2020. This is well below the 95% threshold needed to prevent outbreaks.
In counties like Gaines County, Texas, nearly 20% of children entering kindergarten in the 2023-24 school year had not received the MMR vaccine. Other areas with low vaccination rates are also experiencing high measles case counts.
Frustration Among Experts
Public health experts, including Dr. Mark S. Roberts from the University of Pittsburgh, are frustrated by the preventable deaths and the lack of legislative action. Despite predictions of a measles outbreak in Texas, lawmakers did not pass any new laws to improve vaccination rates.
Dr. Roberts believes the current outbreak could have been avoided, calling it “predictable and totally avoidable.” He expressed concern over the lack of effective vaccination policies and public health resources.
The Path Forward
The current measles outbreak highlights the need for better data collection and targeted vaccination efforts. Dr. Masters emphasized the importance of vaccination, not only for individual protection but for community safety. “Not vaccinating your child doesn’t just put your child at risk, it puts other children at risk,” she said.
Despite challenges, experts believe the outbreak can be controlled with stronger vaccination efforts and public health measures.
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