Measles was declared eliminated in the United States in 2000, a historic achievement in the world of public health.
Now, it's back. And the second Donald Trump administration is making it harder to fight the outbreak, which does not bode well for the next four years.
Since January, Texas has reported 100 cases of the highly contagious viral infection as outbreaks have spread in under-vaccinated communities, with 16 that required hospitalization. Eighty percent of these cases involve people who did not receive the measles vaccine, which is typically given to young children as part of the MMR vaccine, or measles, mumps and rubella.
The vaccine doesn't just work on individuals; it also protects the community, including those who cannot get vaccinated for health reasons. Ideally, herd immunity would take effect when at least 95% of people in an area are vaccinated. But in Gaines County, for example, childhood immunization rates hover near 70%.
In a normal presidency, this would be a time for action, with federal support for local public health programs or maybe the president using the bully pulpit to encourage people to get their children a safe and effective vaccine that prevents a brutal disease that can cause deafness, intellectual disabilities or even death.
The Trump administration is making things worse, in part by reducing the number of public health workers haphazardly.
But the Trump administration is instead making things worse, in part by reducing the number of public health workers haphazardly in its zeal to cut the federal workforce.
Recent federal health agency staffing reductions have hampered containment efforts. This year, the Centers for Disease Control and Prevention lost 1,300 employees — around 10% of its workforce — including 50 specialists from its Epidemic Intelligence Service program tasked with outbreak investigations. These cuts coincide with delayed case reporting and reduced data-sharing with local health departments, complicating real-time response coordination.
Trump's personal vaccine skepticism and his efforts to undercut the similarly safe and effective coronavirus vaccine by reinstating military service members who were dismissed for refusing it may also be to blame.
Vaccination rates continue to decline nationally, with exemptions reaching record highs in 12 states. While most measles cases involve children, the CDC warns that adults vaccinated before 1968 may need booster shots—a recommendation struggling to gain traction due to strained public health outreach capacities.
The current Texas outbreak mirrors 2019’s surge in New York, where 1,274 cases nearly cost the U.S. its designation as a country that had eliminated the disease. Health experts stress that measles’ 90% transmission rate demands rapid, well-resourced responses. With hospitalizations rising and containment protocols delayed, the window to preserve this public health milestone is narrowing. Investment in immunization programs and disease surveillance remains critical to preventing measles from regaining endemic status.
Unfortunately, we will not get the kind of response we need from the Trump administration soon.
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