The Daily - The Growing Danger of Measles

Episode Date: March 12, 2025

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.

From the New York Times, this is The Daily. I'm Kim Seberson. 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 Rosenblum 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. of U's 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? 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 will be cases here and there, but it's not continuously spreading. And so we've seen these other outbreaks, 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? 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.

Right, okay. But the lack of vaccination uptake in that area Yes, a long tradition of holistic medicine, that sort of thing. 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... So I spent time at the hospital that serves this community, Seminole Memorial Hospital in Gaines County, Texas, which is the epicenter of this big measles outbreak. Causing the estation tube to fog up. Is this Dr. Parkey? I was shadowing Dr. Wendell Parkey, the director of the family clinic there.

The kid may have headache or ear aches because of the sinus is being swirled. And at the clinic, they have divided their day into two. In the morning, they do all the wellness visits. They see the pregnant women, they do checks to make sure infants are healthy. And then at 1pm. sort of everything shifts. Everyone puts on N95 masks and that's when they start seeing the measles cases. And Dr. Parkey who has worked in the area for almost three decades, he has not seen a measles case before this year. He'd only seen them in medical textbooks. Wow. But he has become very good at spotting these

cases. And it's not because of the rash, which you might think. Literally, even if you didn't see the rash, you can look across the room and go, oh, man, they don't look all frisky. It's because all of these kids come in with this very distinctive look. It looks like they're staring, you know, 100 miles away. Very vacant expression. These kids are sick. And so I got to see this for myself with one patient, this eight-year-old girl in the room with her mom.

And this little girl did not speak any English. She spoke Low German, which is a regional dialect that many Mennonites speak. So she had the rash like Wednesday or something? Yes, it was Wednesday, Thursday, and Friday. She was unvaccinated and recovering from a really nasty case of measles and she had that thousand yard stare. What is she usually like? Is she usually energetic?

Oh yeah. This is a little kid that you would expect to be bouncing around the room and bothering her mother and she was really not feeling well and not responding. Can you lay down? Thank you. At one point they go and give her this injection in her thigh, which Dr. Parkey prescribed to help manage some of her symptoms. And I'm looking at this needle and you know it's like two or three inches long.

Right here. She didn't even cry. No she's crying. You're good. You're done. She didn't even cry. No, she's crying. You're good. You're done. I want to put her binding. She just stares straight ahead. It doesn't even flinch as that needle goes into her leg. Oh my goodness. I have never seen a child who didn't react when they got a shot.

I know. That poor kid must have been very sick. Very. Thank you. Bitter. Bitter, son. You're welcome. So what's her trajectory? What happens to a child who gets measles? So the first symptoms that they'll probably experience, so runny nose, a cough, a fever,

they get these crusty eyes that look a little red and irritated. And then you start to develop that iconic measles rash, which is these flat red spots that start at the top of your body and spread downwards to cover your arms, your neck, your entire trunk. 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, TETTY, 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. There are so many vaccines that you have to get now. Yeah. And in the early years, there wasn't that much. So I think it's not good anymore.

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. The little one is crying all day.

How old is the little one? Two, three. Okay. That must be awful. Yes, that's really hard. 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 or? No. And she basically said no. So I really wanted to go deeper to understand more fully how people are making these decisions. So I connected with this mom of four in Seminole, a woman named Ansley Klassen. I met her at a park just a few blocks away from the hospital. And this is a mom who is really scared of her kids getting

measles. She's pregnant herself. She understands the risks to pregnant women, to young kids. There's an outbreak. I know that there are people that are not going to quarantine 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. — But there was 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. And there's just, like I said, so much uncertainty. And there are stories that you can read that people, like multiple hours after they got the vaccine, they have had effects. But she had seen these scary stories on her mom groups, on social media, on TikTok, of

kids suddenly dying after getting shots, which is not something that happens or is common at all. Ultimately, she and her husband preyed on it and decided not to get her kids vaccinated. So Teddy, it sounds like during COVID, when there was so much division over vaccines, and that moment when everybody seemed to be in a panic over who they could trust, it was in that moment that Ansley herself lost trust with the broader public health system, which, of course, we know is meant to protect everyone in a community. Right.

And, you know, there are lots of vulnerable people in the community that are impacted by a virus as contagious as measles. You know, there are babies who are too young to get the vaccine. There are pregnant people who aren't eligible to get the shot. And people who are immunocompromised, who can't build up that immunity themselves. I saw a patient of Dr. Parky's, a teacher, who had gotten the MMR vaccine, but she was immunocompromised. So she ended up getting just this really nasty case of measles. The rash was covering her torso. It had spread under her hair.

Her scalp was really sore. She was bedridden for a week. And this is sort of the point of public health, is to protect everyone. And when you're talking about a disease as contagious as measles, this is what can happen. It can spread beyond the people who just choose for themselves not to get vaccinated. We'll be right back.

Teddy, how do we eliminate measles in this country in the first place? And I'm asking because these cases are increasing and I want to understand how and I guess if we can stop them at this point. Yeah, so I think what a lot of people don't appreciate when it comes to the elimination of measles is just how widespread it was before the vaccine. So before it became available in the early 1960s, almost all children got measles by the time they were 15. And about 500 people died every year.

So this is everywhere. Eliminating measles was a really hard fought victory that took about four decades. The end product of medicine's long match with measles, the live attenuated virus measles vaccine. And when you think of the COVID vaccine, that's something that was developed really quickly. But that's not what normally happens. Ah. Ooh.

They had isolated the measles virus in 1954. They had started doing trials to check the efficacy, the side effects, and they didn't have a usable vaccine until 1963. And then they had to get people to take the vaccine. 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.

So if you look at the graphs of rates of vaccination nationally, it's gone from 95 to 93 percent, which doesn't sound like a big deal, but you have to think that this isn't evenly distributed. You know, you have some pockets like in Gaines County where you're closer to 80%, which is a real danger zone. And you know, the more of these pockets that you get, the more likely these outbreaks are going to hop from group to group. And those falling rates go hand in hand with the mistrust in the system that we talked about.

You know, it was always there to some extent, but really ramped up during COVID. Right. And of course, there's this other thing that's changed. Trump won, and he appointed Robert F. Kennedy Jr. as health secretary. Kennedy's been a huge promoter of vaccine skepticism, and now by virtue of his position as the secretary, is in charge of the CDC, which is the leading agency responding to this outbreak. So how is RFK Jr.'s CDC doing so far? So, for the most part, during outbreaks like this,

state and local officials are managing the on-the-ground response. And what the CDC typically does is they are out front encouraging everyone to get vaccinated. But several experts I spoke to thought that the reaction from federal health officials this time around has been really muted. The CDC only posted their first significant notice about the outbreak almost a month after the first cases

in Texas started popping up. One epidemiologist I spoke to said they've been, quote, shouting with a whisper. — There's a measles outbreak in Texas at the moment in which a child is reported to have died. Do you have concerns about that? — And then there was this cabinet meeting at the White House in February where RFK Jr. was asked about the outbreak by reporters.

Bobby, do you want to speak on that? We are following the measles epidemic every day. I think there's 120. And he seemed to minimize it. There have been four measles outbreaks this year in this country. Last year there were 16. He said it wasn't unusual. And there are about 20 people hospitalized, mainly for quarantine. He falsely claimed that many of the people hospitalized from this outbreak were there for quarantine, which is not true. They were there because they were sick. And you know, after he faced pushback from these comments, he changed his tune a little bit.

I've spoken to the parents of the child who died. It was a very, very emotional and long conversation with them. So he went on Fox News and he did this long interview. He said he spoke to the Mennonite community. He talked to the family of the child who died. At this point, we are recommending that people in those communities get vaccines. And he actually comes out and says that, you know, health officials recommend the vaccine

for people in Gaines County. But almost moments later. The CDC in the past has not done a good job at quantifying the risk of vaccines. He starts talking about some of the risks of getting vaccinated. He says that there are people in the Mennonite community who are quote unquote vaccine injured. You know, again, the risks of getting the MMR vaccine are very low.

He even goes so far as to say at one point, we're going to return to the Hippocratic oath. Where doctors are treating patients based upon what's best for that patient rather than you know what's best theoretically for the entire community. That's the only way that you know medicine should be focused on individual health versus you know what he says is theoretically good for the community. And as I said, we are recommending that people in Gaines County get vaccines, or we are also respectful of their personal choices. And so ultimately, he's making a pretty weak recommendation for vaccines and emphasizing

this idea of personal choice. So how do career public health officials view this? What are they thinking about the outbreaks? So I think a lot of experts are really looking at what's happening in Gaines County as a warning sign. If vaccines rates dip any lower, we are at serious risk of these outbreaks sort of igniting on a national scale. And it might not happen with this outbreak, but it might happen next year.

And they're not just worried about this one virus. You can think about measles sort of like a canary in the coal mine. When you see an outbreak of measles, it's likely that other vaccine-preventable infections are not so far behind. Teddy, I wonder if we're going to look back on this outbreak and see it as something of a turning point. The idea for a long time in this country was that public health meant something needs to be done

for the greater good, even if it's distasteful or uncomfortable for the individual. But we're living through a moment where actually individual rights are in the forefront, right? We have an administration that's embraced that very idea. And it's to the point where even the Secretary of Health won't directly encourage people to get vaccinated. You know, I think we might be at a turning point.

Even on the ground at the heart of this outbreak, I talked to a public health official in Seminole who said he recognizes that measles is an awful virus and he wants people to get the vaccine because he knows it can prevent so many of these cases and hospitalizations. But he also said, you know, this is Texas and people have the right to do what they want with their bodies. And so if people continue to make that choice and stay unvaccinated, we know what happens. This is an incredibly contagious virus. And we know what viruses do when they have enough oxygen.

Teddy, thank you. Thanks for having me. We'll be right back. Here's what else you need to know today. Today we made an offer that the Ukrainians have accepted, which is to enter into a ceasefire. On Tuesday, the Trump administration announced Ukraine had agreed to a U.S. proposal for a 30-day ceasefire with Russia following talks between the two countries in Saudi Arabia. American officials also said the U.S. would immediately resume

military assistance to Ukraine. It was a major breakthrough after a disastrous meeting in the Oval Office in February between President Trump and Ukrainian President Volodymyr Zelensky. We'll take this off for now to the Russians. And we hope that they'll say yes, that they'll say yes to peace. The ball is now in their court. Secretary of State Marco Rubio said that the proposed And we hope that they'll say yes, that they'll say yes to peace. The ball is now in their court.

Secretary of State Marco Rubio said that the proposed ceasefire agreement now puts the pressure on Russia to end the war. Russian officials did not comment on the U.S. proposal, which was announced just hours after Ukrainian drones had targeted Moscow. Also on Tuesday, the Trump administration continued its dismantling of the Department of Education, announcing that more than 1,300 employees will be laid off. The department will now be about half the size as it was when Trump started his second term.

The president has long promised to eliminate the department, but it's a movie can't make without the approval of Congress. Today's episode was produced by Will Reed and Alex Stern with help from Muge Zadie. It was edited by Lexi Diao and Paige Cowitt with help from Mark George. Contains original music by Marian Lozano, Diane Wong, and Dan Powell. It was engineered by Alyssa Moxley. Our theme music is by Jim Brumberg

and Ben Landsberg of Wonderly. That's it for the daily. I'm Kim Seberson. See you tomorrow.