When Health and Human Services Sec. Robert F. Kennedy Jr. Kennedy answered questions during the first cabinet meeting of the new Trump administration, he incorrectly described the number of people who died in a West Texas measles outbreak and the reason people were hospitalized.
Measles outbreaks are “not unusual,” Kennedy said.
Doctors say that was wrong, too.
“Classifying it as ‘not unusual’ would be inaccurate,” said Dr. Christina Johns, a pediatric emergency physician at PM Pediatrics in Annapolis, Maryland. “Usually [an outbreak] is in the order of a handful, not over 100 people that that we have seen recently with this latest outbreak in West Texas.”
“This is not usual,” said Dr. Philip Huang, director of the Dallas County Health and Human Services Department. “Fortunately, it’s not usual, and it’s been because of the effectiveness of the vaccine.”
“The United States had really gotten to a point where we just didn’t see these kinds of outbreaks happening,” Dr. Lara Johnson, the chief medical officer of Covenant Health Lubbock Service Area, said at a news conference after the first death in the West Texas outbreak, the first measles death in the US in a decade. “Obviously, that has changed over the last 20 something years, and so we do see outbreaks more frequently, but that that is related to how much we’re vaccinating our population.”
Kennedy’s other incorrect claims in the cabinet meeting included that there had been two measles deaths; Texas officials confirmed Wednesday afternoon there has been only one death. The first in this outbreak was a school-aged child who was unvaccinated. New Mexico officials said no measles deaths or hospitalizations have been reported in the state as of Thursday.
Eighteen people have been hospitalized so far in the outbreak, according to the Texas Department of Health Services and Kennedy said Wednesday that they’re “mainly for quarantine.” Quarantine is when exposed individuals separate from others to see if they develop the illness and prevent spread. It’s different from isolation, when people who are actually sick with an illness stay apart from others.
Measles outbreaks in the US
Measles was eliminated in the US in 2000, meaning no outbreaks have persisted for a year or more since then. Experts say some cases are still expected — particularly imported cases associated with international travel — and the US has reported at least a dozen cases each year since reaching elimination status, according to data from the CDC.
But the current measles situation in the US is far from average. A CDC report from last year found that most measles cases reported in the US in recent years were isolated; about two-thirds of all cases reported between January 2020 and March 2024 had no chain of transmission. Less than a quarter of cases reported in that time were associated with outbreaks of three or more cases.
The ongoing outbreak in West Texas, however, accounts for about 90% of all measles cases in the US so far this year — and it’s much larger than outbreaks have been in recent years. According to the CDC report from last year, the average measles outbreak since 2020 has been limited to six cases over an average of 20 days. The West Texas outbreak has nearly doubled the largest outbreak from the last five years over the course of a month.
This is the largest measles outbreak in Texas in 30 years, according to state officials. Since outbreaks of this magnitude occur infrequently, most currently practicing US physicians have never seen a case of measles, according to experts.
“We in pediatrics believe that any death of a child is one death too many, especially when it comes to vaccine preventable illnesses, and so downplaying the gravitas the seriousness of this situation is very concerning,” said Johns.
Declining vaccination rates take a toll
Measles cases have risen in recent years with 285 US cases reported last year alone, the most since 2019 when prolonged outbreaks among undervaccinated communities in New York threatened elimination status, according to the CDC. Declining vaccination rates are driving up the number of cases.
In the decade before the introduction of the MMR vaccine in 1963, there were 400 to 500 US measles deaths per year. Before Wednesday’s death there had not been a measles death in the US since 2015. The country had not seen a measles death in a child since 2003.
Two doses of the measles-mumps-rubella (MMR) vaccine are 97% effective. But MMR vaccine coverage is declining across the country: The US has fallen short of the 95% threshold set by the US Department of Health and Human Services, that’s necessary to help prevent outbreaks of the highly contagious disease for four years in a row.
This outbreak began in a largely unvaccinated rural community.
Coverage of the measles, mumps and rubella (MMR) vaccine is particularly low in Gaines County, the center of the outbreak. Nearly 1 in 5 incoming kindergartners in the county did not get the vaccine in the 2023-24 school year. Some other affected Texas counties also fall below the 95% goal.
“The fact that we’ve allowed it to come roaring back like this in Texas is just unconscionable. It never had to happen, never should have happened,” said Hotez.