Maps reveal the deadly outbreak that will hit US if vaccinations continue to decline

The deadly measles outbreak that plagued Texas this year could have been drastically less severe, a new study claims, but only if more people were vaccinated.  

Researchers from at the University of Texas, in Austin, found there would have been about half as many measles cases in the state if just five percent more people had received the MMR vaccine. 

And hospitalizations would have also dropped by about half. 

The outbreak ripped through Texas and surrounding states earlier this year, sickening 762 people and hospitalizing 99, mostly children. Two young girls died.

The state’s measles vaccination rate had slipped to 94.3 percent of kindergarteners, down from 98.5 percent in 2013. In Gaines County, the epicenter of the outbreak, coverage was even lower at 82 percent.

But now researchers have modeled how the crisis might have unfolded under different immunization rates. The projections did not provide death data. 

Based on the current measles vaccine uptake, the model said that in Gaines County alone, about 400 people would have been infected and approximately 80 would have been hospitalized.

In one scenario, which looked at measles cases and hospitalizations if vaccine rates were five percent lower, the study estimated there would have been approximately 500 cases in Gaines County, about 100 more than under the current levels of vaccination.

It also estimated there would have been nearly 100 hospitalizations, compared to the 80 estimated under current rates.

Pictured above is Peter Hildebrand with his wife Eva and two of his children. They met with RFK Jr, health secretary, after the death of their daughter from the measles 

The above graphs from the model show estimates for the total number of cases and hospitalizations from measles that would be recorded in Gaines County under different vaccination rates

But, if vaccine rates were five percent higher in the county, the model estimated that cases would have dropped to 200 and hospitalizations to 40.

Across Texas, the model estimated that at current vaccination levels the outbreak would have caused six counties to record an infection rate above 12 measles cases per 1,000 people.

But, if the vaccination rate was five percent higher, estimates suggested that no county would have recorded an infection rate above this. 

 Writing in their study, the scientists warned: ‘Findings of this study highlight the critical role of improving MMR vaccination coverage to prevent large-scale measles outbreaks, particularly in regions with declining immunization rates.

‘The [outbreak] underscores the challenges in maintaining community immunity in the setting of vaccine hesitancy and disruption of routine vaccination programs.’

The study comes amid proposals from Robert F Kennedy’s team to tweak recommendations for the measles vaccine in the US.

An estimated 92.5 percent of kindergarteners are now vaccinated against measles nationwide, data suggests, compared to the peak of 95.2 percent in 2019 to 2020. 

The CDC recommends 95 percent vaccination for herd immunity. 

For the study, published as a letter in JAMA, researchers constructed a computer model of Texas and then tracked how a measles outbreak might unfold under different vaccination rates.

They tracked three scenarios: One with measles vaccination rates matching current levels, a second with a five percent higher vaccination rate, and a third with a five percent lower vaccination rate.

In each scenario, the first measles case was detected in Gaines County on January 20, 2025, in line with the recent outbreak. The simulation was run until June 10, 2025, about two months before the official end of the outbreak.

The above map shows the model’s estimate for measles cases and hospitalizations across Texas under current vaccination levels

The above shows its estimates if five percent fewer people were vaccinated than current levels

And this map shows the estimates for measles cases and hospitalizations if vaccination rates rose by five percent

Overall estimates were not provided for the total number of cases or hospitalizations detected in the entire state of Texas, or for deaths in either Texas or Gaines County.

Vaccination rates are dropping nationwide amid growing distrust of public health recommendations, with a recent KFF Poll finding that fewer than half of Americans now say they have confidence in the FDA and CDC.

Vaccination rates are particularly low in Gaines County in part because it is home to a large religious community of Mennonite Christians.

Measles used to be a major scourge in the US, with 3 to 4million people infected every year, while 48,000 were hospitalized and 400 to 500 died from the disease.

But amid the rollout of the vaccination, the disease almost disappeared, with the US achieving measles elimination status in 2000.

A sign reading ‘measles testing’ is seen in Gaines County, Texas, that was the epicenter of a major measles outbreak this year

But amid falling vaccination rates, it now appears to be returning, with the 1,491 measles cases recorded this year being the most since the disease was declared eradicated.

Measles is the most infectious disease in the world, and is spread via droplets expelled when someone sneezes, coughs or exhales. One patient is likely to infect nine out of ten unvaccinated people they come into contact with.

Early warning signs of the disease include a fever, cough, runny nose and red, watery eyes, that appear within a few days of infection.

But within a week patients can break out in a nasty reddish-brown rash that covers the face and then spreads downward over the body, including the limbs and feet.

Measles is particularly dangerous to older adults, young children and pregnant women because they have weakened immune systems.

About one in five unvaccinated people infected with the disease are hospitalized, while one in 20 unvaccinated children infected develop pneumonia and one in 1,000 suffer from encephalitis, or swelling on the brain.

The CDC estimates that nearly one to three out of every 1,000 unvaccinated children who are infected with the disease will die from respiratory or neurological complications.