Antivax paranoia has supercharged a deadly measles outbreak in Texas
When a girl was brought to the hospital with a rash and fever, Leila Myrick recognised the symptoms only from her textbooks at medical school. Like most doctors at the hospital in Seminole, in this remote part of west Texas, she had never seen a measles patient before.
It had been 20 years since the last case was diagnosed in the area. Following a nationwide vaccination campaign, measles was declared eliminated from the United States in 2000, though there have been outbreaks in some parts of the country since then.
“We didn’t even bother learning about measles because it was eradicated,” Myrick told me last week in her office, as a crowd of patients waited outside. “We never saw it.”
Five weeks on from the first patient, one child has died in the west Texas measles outbreak — the first death from the disease in the US for a decade. Now, the virus that once decimated the Native American population in this region is spreading unchecked through under-vaccinated communities.
It is hitting children, who are most likely not to have been immunised, the hardest.
Robert F Kennedy Jr, the US health secretary, has responded not by forcefully calling for vaccinations, but by spreading vague assurances that vitamin A and a good diet will prevent measles — ideas criticised by doctors as dangerous and misleading.
Myrick, who like most of her colleagues has not had a day off since the outbreak started, summed it up: “It’s spiralled out of control.”
Leila Myrick had never seen a case of measles outside of her textbooks, until a little girl came to her hospital in Texas with the disease
MARK FELIX FOR THE SUNDAY TIMES
Thirty-five years ago, doctors said, this outbreak would not have happened. Vaccination rates were so high that the population here had herd immunity. Yet in recent decades, immunisation figures have been steadily falling as false information about the dangers of vaccines take root. Around Seminole, deep out in the flat, dry expanses of oil country, about 15 per cent of people aren’t inoculated against measles — one of the highest vaccine resistance rates in the region.
Doctors had long warned that all it would take was one case for the touch paper to be lit and the virus to spread. So when Myrick looked at the livid red rash blossoming from head to toe on her young patient, who a blood test showed had not been vaccinated, she knew something was changing. She told the family to isolate, while the girl was taken to hospital with respiratory issues.
Soon, more cases were being reported. “It just kept growing from there,” she said, adding that she had heard reports of people holding “measles parties” in the area to infect their children.
• How measles spread among unvaccinated Texans and killed a child
Since that first case at the end of January, 198 people in Texas have been diagnosed with measles. This year in Gaines County, the epicentre of the outbreak there have been 107 cases, mostly children, since adults tend to be vaccinated. Officials say the true numbers are likely far higher, since many don’t report to the hospital for testing.
At least 22 people, including Myrick’s patient, have so far been taken to hospital. Last month, a schoolgirl died after contracting the virus. She had no underlying conditions, the health department said, and like the overwhelming majority of the other cases she had not been vaccinated.
The anti-vaccine sentiment in her community runs so deep that rumours are already circulating that she did not die of complications from measles even though doctors confirmed this.
Like many of the first patients to catch the virus here, the girl was a Mennonite, part of a Christian church whose members first settled in the Americas in the 17th century.
“It was tough, but was it really, actually measles?” said Tina, a church custodian in Seminole, who did not give her last name. “It’s all in the air. It’ll get warmer and it won’t be so bad. If you’re sick, just stay home.”
Many of the patients in the outbreak have been children
MARK FELIX FOR THE SUNDAY TIMES
Amid the rising tensions over the outbreak, Republican politicians have blamed illegal immigrants for bringing the virus into the country from Mexico. Officials say there is no evidence for this: though it is unclear exactly how the virus was brought into the Mennonite areas, there was no trail of infection leading from the border to Gaines County.
Like others in the community, Tina said that she felt that Mennonites had been unfairly blamed for the current outbreak. “It’s not coming from the Mennonites,” she said. “We are not a disease.”
Eva, a pregnant mother of three in her twenties, who was pushing her children around the local supermarket in a trolley, said she wasn’t worried about measles. “I guess if God wants us to have it, we’ll have it,” she said, adding that she wasn’t sure if her children had been vaccinated.
At the Community Church of Seminole — which offers sermons in Low German, the language spoken by the Mennonites — David Klassen, the pastor, said he had heard that the girl who died had done so because she had been given the MMR (measles, mumps and rubella) vaccine when she was sick.
“Most of our wives are very well educated,” the pastor said. “They do a lot of reading, they do a lot of studying. Simply because they want to know what’s the right thing, and don’t necessarily trust the medical field.” Doctors, while declining to comment on specific cases, said that it was extraordinarily unlikely that an MMR vaccine could cause death.
David Klassen, a pastor at the Community Church of Seminole, said members “don’t necessarily trust the medical field”
MARK FELIX FOR THE SUNDAY TIMES
Though there is no religious obligation not to vaccinate, many Mennonites choose not to inoculate their children. They are not alone. Outside the Mennonite community, the number of antivaxers has grown in recent decades. Following a now-retracted study in The Lancet in the late 1990s that linked the MMR jab with autism, vaccine hesitancy began to rise in the US.
By 2019, the MMR vaccination rate for preschoolers (aged three to five) in the US had dropped to 92 per cent, below the 95 per cent required for herd immunity. That year, an outbreak that began to spread in New York infected more than 1,200 people across 30 states.
Dr Tammy Camp, a paediatrician at Texas Tech University Health Sciences Centre in Lubbock, 75 miles from Gaines County and the nearest big city to the outbreak’s epicentre, said that this trend had increased “dramatically” since the Covid-19 pandemic.
“Because no one had seen measles in so long, fear of the vaccine is greater than the fear of the disease,” said Camp, who oversees the doctors working on the outbreak. “I think as a community they viewed it as, well, it’s a mild disease … that just tells me that we haven’t done a good a job of communicating that as we need to, to say that the risk of harm with the vaccine is almost nonexistent.”
Inside the Community Church of Seminole, where the Mennonite community gathers
JULIO CORTEZ/AP
The death of the unvaccinated schoolgirl last month, she said, was both heartbreaking and entirely preventable. “I just feel horrible for a family who has to go home and not have their child at the dinner table any more,” she said.
The introduction and wide adoption of the measles vaccine had been one of the great American public health success stories. Before the measles vaccine was introduced in 1963, the US would have between three to four million cases a year, with about 50,000 hospital admissions and about 500 people dying of measles each year. After mass inoculations began, cases and deaths dropped until, by 2000, the disease was declared eradicated.
Yet many today say they believe that by not vaccinating their child, they are raising them in a more “natural” way. At a Mardi Gras fundraiser for Lubbock Meals on Wheels last week, Cheri Hernandez, 39, was standing by the face painting station holding Ezekiel, her youngest, in her arms while her five-year-old twins played on the bouncy castle.
None of the children were vaccinated. Hernandez, a primary school teacher, had obtained exemptions for them — a simple process that doesn’t require parents to provide a medical reason for refusing the inoculation. She said that she thought public health officials had been “scaremongering” with their warnings about measles.
Cheri Hernandez, 39, an elementary school teacher, with her youngest son Ezekiel
MARK FELIX FOR THE SUNDAY TIMES
“We don’t believe in vaccines, as part of the research I’ve done,” she said. “It’s your choice.” Like many of her friends, and other “natural moms” she spoke to online, Hernandez said that she had been giving her children Vitamin A supplements in the belief that it would protect them from the measles.
Health workers in West Texas told me that Kennedy, the nation’s top health official, had been pushing for the supplement to be shipped to areas in need since the outbreak began, rather than calling for people to take the vaccine. “It’s crazy,” said one, who did not want to be named.
“This is completely insane. We have a vaccine that is incredibly safe and works. And he’s spouting this completely crazy pseudo-science.”
Paul Offit, a professor of paediatrics and director of the vaccine education centre at the Children’s Hospital of Philadelphia, said that though there was strong evidence that vitamin A had helped malnourished children in the developing world strengthen their defence against measles, this did not generally apply for otherwise healthy patients in the US.
While the vitamin is at times administered to measles patients who are being treated in hospital, it is poisonous if given in large doses. Public health officials in Lubbock said they feared that parents who had read online about Vitamin A would give their children an overdose of the supplement, with potentially damaging consequences.
Robert F Kennedy Jr, a vaccine sceptic, was made secretary of health and human services by Donald Trump
ANDREW HARNIK/GETTY
In an article for Fox News last week, Kennedy called for vaccines to be made “readily accessible for all those who want them” and said that “all parents should consult with their healthcare providers to understand their options to get the MMR vaccine”. A team from the Centers for Disease Control and Prevention were due to arrive in Lubbock last week to help overwhelmed local health officials with the response.
Yet Kennedy has stopped short of calling for parents to vaccinate their children. And despite the proven efficacy of the MMR inoculation, he claimed that before its introduction, improvements in sanitation and nutrition had eliminated 98 per cent of measles deaths.
“Good nutrition remains a best defence against most chronic and infectious illnesses,” he wrote.
Offit, the professor of paediatrics, said this was untrue. “The reason measles declined in the 1940s was the availability of antibiotics. Measles is immunosuppressive so you would see bacterial infections on top of measles,” he said. “That’s why the rates of death dropped.”
Katherine Wells, director of public health in Lubbock, said the outbreak had been entirely preventable — and she feared it would get much worse if the virus made it into daycare centres with children who were not yet old enough to be vaccinated.
“The reason why we haven’t seen measles in our community in 20 years is because of high vaccination rates, and when those vaccination rates are lower, [the] introduction of just one person that’s contagious with measles can start spreading like wildfire,” she said.
Since the outbreak began, the public health department has been offering a free daily clinic with walk-in vaccinations. On Thursday morning, Lisa Nunez, 43, was at the clinic to get her two-year-old grandson Silas his first dose of the MMR vaccine. She had little time for parents who chose not to get their children inoculated.
“I think they’re crazy,” she said. “It’s here to stop kids getting sick and dying. If they don’t get it, it’s putting other kids at risk too.”
