The ongoing measles outbreak in the Southwestern U.S. that began in late January in Gaines County, Texas, that grew to over 800 cases across 4 states and dozens of counties, is slowing. Health officials are "cautiously optimistic", as additional cases are slowing across the outbreak area. Between May 23 and 27, there were only 2 additional cases reported (one in El Paso County, TX and one in Lea County, NM). Wastewater analyses for the measles virus have also been decreasing in both Lubbock and El Paso, which is another positive sign that the worst may be over.
However, in other parts of Texas, as well as states across the county, cases are continuing to rise.
The recent vaccine promotions are working, as more and more families are vaccinating their children, including the recommendations of early vaccination for children under a year, slowing the spread of one of the world's most infectious diseases.
Standard vaccination recommendations for children are a first dose between 12 and 15 months old and a second dose between 4 and 6 years old. However, for those living in or traveling to locations where there is ongoing measles outbreaks (including traveling internationally), the CDC recommends that babies aged 6 to 11 months should receive one MMR dose immediately, and then two additional doses at the recommended intervals (12 to 15 months and 4 to 6 years). For unvaccinated children and adults, one dose should be given immediately, followed by a second dose at least 28 days later.
According to Truveta, a health care and analytics company, approximately 10% of 10-month-old babies in Texas have received at least one measles vaccine during April 2025 (10.4x higher than the average between January 2024 and January 2025); while 8.7% of 6-month old babies received a measles vaccine in April 2025 (a 31.7x increase compared to 0.3% of 6-month-olds between January 2024 and January 2025).
"It does show that parents really are scared, and that parents don't want to wait," Nina Masters, a senior applied research scientist at Truveta, told the Texas Tribune. "They don't want to wait 12 months to get their child vaccinated. They want to wait six months and one day, and they want to do it as soon as they can."
Pediatricians and local health departments are to thank, for encouraging their patients to heed public health recommendations for early vaccination.
Even though the ongoing outbreak linked to West Texas has slowed, additional outbreaks have broken out across the midwest in May, including 3 separate outbreaks in North Dakota, an outbreak in Arkansas, and the continuing outbreak in Kansas (which has a genetic link but no identified source link to the West Texas outbreak). As of May 29th, there have been 19 outbreaks across 14 states in 2025. There have also been an increase in cases nationally, with cases in new states in recent weeks, including Nebraska, Iowa, and Idaho.
With vaccination rates below the herd immunity threshold in many locations, the risk of further large-scale outbreaks is high.
According to a 2024 MMWR report on vaccination rates and exemptions of U.S. Kindergarteners, during the 2023–24 school year, coverage declined to <93% for all reported vaccines (range = 92.3% [tDap] to 92.7% [MMR]), well below the Healthy People 2030 target of 95% MMR vaccination rate, for the 4th consecutive year. Even as recently as the 2019-2020 school year, coverage was above 95%, however coverage of all 4 major vaccines decreased in 80% of jurisdictions.
The jurisdictions with Kindergarten MMR vaccination (2 doses) below 90% were:
The exemption rate for at least 1 vaccine increase from 3.0% in 2022-23 to 3.3% in 2023-24, with exemption rate increases in 41 jurisdictions, including 14 jurisdictions with exemption rates exceeding 5%. The highest exemption rate was Idaho with 14.3% of Kindergarteners (13.9% non-medical exemptions).
The jurisdictions with Kindergarten exemption rates exceeding 5% were:
The community immunity threshold (CIT) for measles is 92-94%, meaning at least 92-94% of the population in the community needs to be immune to measles - either through vaccination (2 doses MMR) or previous infection. The AAP Vaccination Across America Map is updated weekly with locations experiencing outbreaks and current case numbers. The maps also displays immunization rates by state and the Community Immunity Threshold (CIT)s.
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