The largest U.S. measles outbreak in over 30 years has placed Texas at the center of a growing national health crisis, highlighting both the persistent risks of low vaccination coverage and the complexities of public health outreach in vaccine-hesitant communities. As of late July, health officials have confirmed more than 1,300 measles cases nationwide, with at least 762 of them in Texas alone, according to state and federal data. Two children have died from the disease, and dozens more have been hospitalized with severe complications.

• Texas

The epicenter of the outbreak is Gaines County, a rural area in West Texas with a sizable Mennonite population. Officials believe the virus began circulating there earlier this year before spreading to neighboring counties and beyond. Lubbock County, located to the east, was one of the first regions outside the initial cluster to report cases. Local officials there say the disease has now been contained, with no new reports in over seven weeks.

• Gaines County
• Mennonites
• Lubbock County

Katherine Wells, director of public health in Lubbock, explained that the response effort had to be restructured to meet cultural and logistical realities on the ground. “We tried the traditional vaccine clinic model, but it didn’t match community expectations,” she said. “We found more success when we embedded treatment clinics into churches and worked with local faith leaders.” Wells also pointed out that access to care, language barriers, and a scarcity of public health personnel made containment particularly difficult in rural settings. “We needed more boots on the ground,” she added, noting that simply getting people hydration supplies and oxygen monitors proved challenging.

Nationwide, the demographics of the outbreak skew heavily toward children and adolescents. The Centers for Disease Control and Prevention (CDC) reports that approximately one-third of current U.S. measles infections are in children under the age of five. Another 42 percent are in patients between the ages of five and nineteen. Hospitalization rates have climbed sharply, with about 14 percent of all cases requiring inpatient care. In children under five, that figure rises to one in four.

• Centers for Disease Control and Prevention

Crucially, almost all patients so far—97 percent—have been unvaccinated. Public health experts warn that the situation exposes a dangerous erosion of herd immunity in parts of the country where vaccine skepticism remains widespread. Measles is among the most contagious viruses known to science, capable of spreading to as many as 18 others from a single infected person in an unvaccinated population. The CDC estimates that a 95 percent community immunization rate is needed to avoid outbreaks. Some counties hit hardest by this year’s surge fall well below that threshold.

• Herd immunity
• Measles

The federal response to the outbreak has unfolded during a politically sensitive period, given ongoing national debates over vaccine policy and individual rights. Robert F. Kennedy Jr., a longtime critic of vaccine mandates, has urged Americans to get the measles vaccine during the crisis. In public appearances, he has emphasized voluntary immunization, while continuing to express opposition to government-enforced mandates. When asked about the issue earlier this month, Kennedy stated, “People should be free to make informed choices, but we strongly encourage everyone to protect themselves and their communities through vaccination.”

• Robert F. Kennedy Jr.

Some critics have drawn attention to a separate decision by the Department of Justice to drop charges against plastic surgeon Kirk Moore, an associate of Kennedy’s who had been accused of issuing fraudulent COVID-19 vaccination cards. The DOJ cited evidentiary concerns in discontinuing the case. Kennedy, through an HHS spokesperson, declined to comment on the matter.

• Department of Justice
• Kirk Moore

Back in Lubbock County, the focus has shifted from crisis response to immunization outreach, particularly among groups that remain wary of medical institutions. Zach Holbrooks, who has worked with the local health department on faith-based engagement, said trust-building remains a long-term project. “It’s not just about telling people to get vaccinated,” he said. “It’s about listening, showing up, and responding to what the community actually needs.”

With schools set to reopen soon and summer travel still underway, public health officials across the country are bracing for the possibility of new clusters. The hope, they say, is that this outbreak will serve as a reminder of the virus’s risks—and the protective power of a widely available, decades-old vaccine.