In 2000, measles was declared eliminated in the United States after 12 months of no reported spread. Thanks to a comprehensive vaccine program and the development of a two-dose measles, mumps and rubella vaccine, it seemed that measles would disappear, similar to the polio virus.
Fast forward to 2025, and there is a significant measles outbreak in Texas, which has reported more than 540 cases. As of April 11, the Centers for Disease Control and Prevention, or CDC, has reported 712 cases nationwide and three measles-related deaths; 97% of the individuals infected with measles are unvaccinated.
Washington has reported two measles cases in King and Snohomish counties. In February 2024, Spokane Regional Health District, or SRHD, reported a measles case in Deer Park, but there have been no new local cases since then.
Mark Springer, the communicable disease investigation and prevention manager at SRHD, says measles is a highly contagious respiratory illness that can spread through the air, potentially leading to hospitalization and death.
According to the CDC, a common symptom of measles is a blotchy red rash on the face, which then spreads down the body.
Springer says there is no real treatment for the illness, with medical advice offering only "supportive care" including rest, isolation and addressing fever symptoms.
He says measles can have long-term complications, such as wiping out "memory cells" and creating a condition known as immune amnesia. Memory cells are immune cells that recognize past infections and quickly respond to pathogens.
"This is a killer in developing countries," Springer says. "It brings your immune system back to [that of] a newborn under 5 years old."
Kayla Myers, the immunization program coordinator at SRHD, says that to prevent an outbreak like we're seeing in other parts of the country, the general population's vaccination rates need to be at 95% or higher. She says that in Spokane County, 86% of children 19 months to 35 months old have received their first dose of MMR vaccine, while 69% of children ages 4 to 6 years old have received the second dose.
Myers acknowledges that some parents worry about the many vaccines their children have to take, but she emphasizes that it's important not to play "Russian roulette" by opting out and risking the chance of getting the virus.
Some parents are concerned that the MMR vaccine contains live versions of the virus. However, Myers says it's an attenuated vaccine, meaning it contains a weakened, harmless version of the measles virus that doesn't cause the disease, but allows the immune system to learn to recognize and protect against it.
Myers says that getting one MMR dose will provide 93% protection against measles, and a second dose provides 97% protection. She says reaching out to your medical provider about concerns is the best way to decipher misinformation if you're hesitant about vaccines.
The CDC offers no recommendation about catching up on a second dose of the MMR vaccine for adults born before 1989, but recommends two-dose vaccination for people who do not have evidence of immunity and are in college, traveling internationally, working in health care, or who are members of other sensitive groups. The CDC also advises re-vaccination for the 5% of adults who received the inactivated measles vaccine between 1963 and 1967.
Dr. Noreen Womack is the chair of the Idaho chapter of the American Academy of Pediatrics and practices in Meridian, Idaho. She says that eradicating vaccine-preventable diseases has changed people's mindset about the risks and benefits of vaccinations.
"I think vaccination rates are lower because they've been too successful, and they're a victim of their own success," Womack says. "People forget they need to weigh risk benefits, and when you truly do that, it is my belief, and the belief of 99.9% of medical providers, that the benefits of vaccines outweigh the risks."
Womack says for the first 25 years of her career as a medical professional, measles was essentially a theoretical illness in the U.S., but now vaccine hesitancy and misinformation are contributing to its resurgence.
The current U.S. secretary of Health and Human Services, Robert F. Kennedy Jr., has wrongly suggested vitamin A as a cure for measles. In March, the New York Times reported that some parents in the Texas outbreak provided their kids with large doses of vitamin A, which caused liver damage in some cases.
Womack says research has shown children with vitamin A deficiency in developing countries tend to have the worst measles outcomes, but vitamin A is not a prevention tool.
"The studies show that it doesn't prevent measles, but if you are vitamin A deficient, you tend to have a worse outcome," Womack says.
The CDC's most up-to-date reporting from the 2023-24 school year states that Idaho's kindergarten student population has a 79.6% measles vaccination rate; meanwhile 94.3% of Texas kindergarteners were vaccinated for measles.
Womack says Idaho's low vaccination rates are due to loose regulations. Laws like the recently signed Idaho Medical Freedom Act, which bans medical mandates in Idaho including vaccine requirements to attend schools, may worsen Idaho's vaccination rates.
Panhandle Health District spokesperson Kate Hoyer tells the Inlander via email that anyone with questions about communicable diseases should speak to their medical provider.
"There are no measles cases in North Idaho or the state of Idaho currently," Hoyer writes. "We continue to monitor the situation and will communicate updates to our community if anything changes."
The consequences for not vaccinating can be tragic, as seen in Texas with the death of two children in this measles outbreak, Womack says.
"I've seen other vaccine-preventable diseases that don't have treatments, and you just watch the kids suffer, and it's heartbreaking," Womack says. "Once you've seen an unnecessary death, you don't want to see another one." ♦
