A measles outbreak continues to spread in Texas. More than 200 people have been infected. One child has died. And health experts are now concerned that low vaccination rates will make it harder to contain.Teddy Rosenbluth, a health reporter at The New York Times, explains the rapid outbreak — and asks whether the government’s response will signal a turning point in how America views public heath.Guest: Teddy Rosenbluth, a health reporter at The New York Times.Background reading: The Texas measles outbreak shows signs of a riskier future for children.Here’s where measles is spreading in the United States.Robert F. Kennedy Jr. linked the outbreak to poor diet and health, citing fringe theories.For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday. Photo: Desiree Rios for The New York Times Unlock full access to New York Times podcasts and explore everything from politics to pop culture. Subscribe today at nytimes.com/podcasts or on Apple Podcasts and Spotify.
Chapter 1: What is the current status of the measles outbreak in Texas?
From The New York Times, this is The Daily. I'm Kim Severson. A measles outbreak continues to spread in Texas, where more than 200 people have been infected, one child has died, and health experts are now concerned that low vaccination rates will make it harder to contain.
Today, my colleague Teddy Rosenbluth takes us into the epicenter of the outbreak and explains whether its rapid spread and the government's response to it signals a turning point in how America views public health. It's Wednesday, March 12th. Teddy, welcome. Thank you. Like most people, I don't really think about measles being much of a threat.
You may hear about an outbreak, but it gets contained. We all move on. This outbreak doesn't seem to be going away. Can you lay out for me why it's different?
Chapter 2: Why is this measles outbreak different from previous ones?
Yes. So part of the reason that you probably don't think very much about measles, even though it's an incredibly contagious virus, is because it's vaccine-preventable. It's been eliminated in the United States since 2000, which means there'll be cases here and there, but it's not continuously spreading. And so we've seen these other outbreaks. You know, we saw one in New York.
We saw one in Washington. But experts are looking at this outbreak a little bit differently. And that's because, one, a child has died. And two, because childhood vaccination rates have been falling for some time. And that fall really accelerated during the pandemic and just hasn't rebounded.
And so in some pockets of the United States, what we're seeing is that vaccination rates for the measles, mumps, rubella vaccine, the MMR shot, have fallen far below where experts would want them to be. And those pockets have multiplied and gotten bigger, really raising concerns that these once-isolated outbreaks are going to travel further and infect more people.
And that's what's happening in Texas specifically, right? Right. So walk me through this. When did it start and where are we now?
Chapter 3: How did the measles outbreak start in Texas?
So the first couple cases started popping up at the end of January. And they were these kids who belonged to a very large Mennonite population that settled in West Texas in the 1970s. In this population, there is no religious doctrine that says that they cannot be vaccinated.
But historically, they have had low vaccine uptake just because they don't interact with the medical system as often as the broader community.
Right. And as I understand, they're much more reliant on natural remedies.
Yes, a long tradition of holistic medicine, that sort of thing. Okay. But the lack of vaccination uptake in that area sort of gives measles the oxygen that it needs to spread rapidly through the community. And so by the end of February, we saw more than 120 cases, right? And then two months later, we're now up to more than 200 cases.
And now we're also seeing a separate but likely related outbreak in New Mexico, in a county that borders where this outbreak has been happening in Texas. And unfortunately, we've seen two deaths related to these outbreaks. So I was really interested in seeing what an outbreak of measles looks like. This is a virus that many people have never seen in their lifetimes.
So I started to call some doctors, call some public health officials, and ultimately decided to travel down there myself.
Okay, so you land in West Texas. Take me through how your trip started.
Sure. So maybe just at the scene a little bit, what West Texas is known for is, you know, four things. Cotton, peanuts, oil, and this big Mennonite community.
What is it? It's a 35-year-old.
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Chapter 4: What are the symptoms and risks of measles?
And for most kids and adults, these symptoms will resolve within a few weeks. But for some kids, measles can be really dangerous. About one in 20 kids develop pneumonia, which makes it really difficult to get oxygen into the lungs. You know, some kids have to be hospitalized, maybe even put on a ventilator.
One in a thousand kids get encephalitis, you know, swelling of the brain, which can cause permanent damage, blindness, deafness, intellectual disability. And then, of course, in rare cases, children can die.
Teddy, you spoke with the mother of the girl, the unvaccinated girl who didn't flinch when she got the shot, right? Yes. Well, what was going through her mind?
So this is a woman who had vaccinated three of her children.
But she felt as though, you know, after her third child got the vaccine, it turned him angry. Yeah. Yeah. Right.
And after that, you know, combined with things that she had heard from the community about the risks of the vaccine, she decided that she wasn't going to vaccinate any more of her children. And as a result, several of her children fell ill with measles during this outbreak, and she was just exhausted.
How old is the little one? Okay.
That must be awful. But I asked her whether this changed anything for her, whether she regretted not getting her younger kids vaccinated. Like, did you think about maybe I should get the vaccine for measles? No, no. And she basically said no. So I really wanted to go deeper to understand more fully how people are making these decisions.
What's wrong?
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Chapter 5: How are personal beliefs affecting vaccination decisions?
A woman named Ansley Klassen.
Can you put your shoes on, please?
I met her at a park just a few blocks away from the hospital. And, you know, this is a mom who is really scared of her kids getting measles. You know, she's pregnant herself. She understands the risks to pregnant women, to young kids.
If there's an outbreak, I know that there are people that are not going to, you know, quarantined like they need to. And that's really scary because I don't want to catch it and I don't want my children in the hospital for it.
And are her kids vaccinated? She has vaccinated one of her kids up to one year.
Okay.
But around that time is when the COVID-19 pandemic started. And that is when a lot of misinformation around vaccines, around the medical system started swirling around on social media. And she decided not to get any of her other kids vaccinated.
There is just so much fear and so much just people like you need to vaccinate, like just kind of being a little pushy on the topic. I didn't like that.
And when this outbreak first started, she considered getting the MMR vaccine for her kids. Like I said, she knows that it's a serious disease.
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Chapter 6: What impact did the COVID-19 pandemic have on vaccination rates?
Right. Many parents think of measles as just a common nuisance. But physicians today know that measles is more than a nuisance.
They had to launch these massive campaigns to get the vaccination rate as high as possible.
Supplies of the vaccine are ready for shipment to doctors throughout the country.
They poured funding into making vaccines available and accessible. They made the vaccines a requirement for public schools. The goal was to get as many people as possible vaccinated to starve this virus of oxygen.
As increasing numbers of children are vaccinated, We will be well on the way to eradicating a disease that down through the centuries has killed millions of children and left others impaired mentally and physically.
And this is that phrase, herd immunity, right? Right. Can you explain it to me a little bit better?
So for a virus as contagious as measles... And it's really contagious, right? The most contagious. One person infected with measles can spread it to 18 other people. Oof. Yes. So the idea is you get as many people as possible protected against measles so that if one person in the community becomes infected, it has nowhere to go. You've starved it of oxygen, essentially, until it simmers down.
And that's what the United States was able to do, right? It got the vaccination rate high enough, took away the oxygen, and the disease couldn't spread.
Exactly. So the result of this big public campaign to get people vaccinated, the requirements, the funding investment, was essentially that by 2000, vaccination rates were above 95%. And as a country, the U.S. had eliminated this disease. It went from something that pretty much everyone gets as a child to something unheard of. That is until vaccination rates started coming down.
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