Jan 30, 2026
3 min read
Health experts fear a future where measles outbreaks will continue to dominate cities with low vaccination rates.
In this part of the United States, measles is starting to look like an epidemic
Before a year ago, pediatrician Stuart Simko had only seen studies on the history of measles - with its characteristic red rash - once it infected millions of children each year, before a vaccine was invented.
But in the past two months, he has seen six cases, the first time in person.
The children were "very sick," the South Carolina doctor said, with high fevers that were difficult to bring down.
“It is a serious disease that can cause death.And we don't say that to scare people.But people need to know the risks,” said Simcoe, who works at Prisma Health. “It's hard to see a child get sick that you know is preventable.”
Simcoe's six patients, most of them unvaccinated children, were among 789 people infected in South Carolina in the past few months. It is the largest measles outbreak since the US declared the disease eliminated in 2000. The US, with outbreaks in several states, is now on the verge of losing that status - following in the footsteps of the UK and Canada.Two school-aged children died in Texas last year.
Vaccination rates are declining in many U.S.Public health experts worry that outbreaks from measles and other dangerous preventable diseases could become the new normal in cities.
This time, the disease was found in Spartanburg County in southwestern Carolina, which includes several neighboring towns and has a population of about 370,000.
Kate Martin said vaccinated children had measles in their schools, reminiscent of the outbreak.
"It is a lot like Covid where every day it's at another school," she said. Dozens of unvaccinated students at their schools ended up quarantined for 21 days.
Measles vaccination coverage for school-age children is about 90% in Spartanburg County, although some schools have lower rates due to religious exemptions.
The USIt recommends two shots of the measles, mumps, and rubella (MMR) vaccine for children ages one to six, which is 97% effective in protecting against the disease.To achieve herd immunity, which limits its spread and protects those who are not vaccinated, about 95% of the population must be vaccinated.
At local grocery stores and restaurants, members of the Spartanburg community acknowledged the "measles thing" that happened to hundreds of children in the city.Most knew someone who had it, but many said no one wanted to talk about it or seemed to care.
Unlike the Texas measles outbreak, where billboards warning of the disease lined highways and people lined up to get tested, the only measles warning in the county was an urgent care office sign asking people with the disease to wait in their cars.
"It's very bad here," Martin said."But the average person just doesn't think it's a big deal."
A "public health hazard" to the city
For weeks, state Sen.Josh Kimbrel avoids public discussion about measles.A Republican critic of the US government's handling of the pandemic, including the Covid vaccine, Kimbrel said he hoped the situation would "correct itself."
But last December, he got a call from a man whose wife was hospitalized with measles.Kimbrel said the elementary school teacher in her 50s had been vaccinated as a child but contracted the disease from a student, sending her to intensive care for two weeks.
"I think this is pretty much our first death," Kimbrel said.
Kimbrell took to social media with a statement that he hopes to strike a “balance” — supporting “personal choice” — while also emphasizing that the outbreak now requires public health measures, including, he said, limiting where unvaccinated people can go.
He was met with praise — as well as criticism from vaccine-hesitant parents who accused him of violating their rights.But Kimbrel realized he had no other choice.
"I have to go to the funeral of a teacher or a child, it can be prevented," he said."I'm going to be very angry about that."
"We are more concerned about vaccines"
Local officials and doctors say the latest outbreak has mostly affected Russian and Ukrainian immigrants in South Carolina, but others have been infected.The state has taken in hundreds of Ukrainian refugees, while population estimates suggest thousands of Slavic immigrants have moved to the area in recent years.
Slavic churches had many measles epidemics, Kimbrell said, and some took a religious stance against vaccinations.Some schools in the community have vaccination rates as low as 20%.
Kimbrel said misinformation has spread that the MMR vaccine contains fetal cells, a popular conspiracy theory that he tried to combat by emphasizing the safety and mechanisms of the MMR vaccine.
Inna, a member of Spartanburg's Ukrainian immigrant community who declined to share her last name for privacy reasons, has not vaccinated her children against measles.
So the family has avoided the disease, but he knows many who haven't.
Asked if she is worried about her children getting infected, Inna shrugged.
"We're more concerned about what's in the vaccine," she said, adding that she's heard concerns about autism — which have been debunked.
"They had chicken pox and they were fine," she said of her children.Measles carries a higher risk of life-threatening complications than chicken pox.
Some parents are more concerned about the risk of the vaccine than the small risk, said Jennifer Grier, a professor of immunology at the University of South Carolina at Greenville School of Medicine.
"Unfortunately, measles is no longer low risk," she said.
A mile across the country, another flurry of bullets that raced across the Utah-Arizona border sickened hundreds.
Lorna White, a mother of four who lives in the small town of Kennebed, Arizona, decided not to vaccinate her children, saying she was worried it was "too much for a little body."
"Let's say I went and gave my kids the MMR and they got a side effect, I did that to them," he said.
She and her children contracted smallpox at Christmas.
"Either we've all been lucky with mild cases, or measles isn't as bad as it's made out to be," he said in January.
But some may not notice the effects until years later.Measles can lead to long-term complications such as encephalitis and immunodeficiency, which resets the immune system and limits its ability to respond to new infections.
These are the kinds of risks that Simcoe mentions when talking to patients who are hesitant about getting the vaccine.It also tries to recognize that there are small, rare risks with vaccines - but these risks pale in comparison to the risk of measles.
"Some will still choose not to," he added."It's not ideal, but I can't force anyone to do things."
A "real world" test for the unvaccinated
The South Carolina Department of Public Health (DHS) has seen 62 people in mobile clinics since October.Some minor successes have been seen, including the vaccination of 42 adults and 20 children.
But public health experts say the federal government, and particularly Health Secretary Robert F. Kennedy Jr.'s reshaping of U.S. vaccination policy, has hampered efforts.
Under Kennedy's leadership, the US Centers for Disease Control and Prevention reduced the number of recommended childhood vaccines—though not the MMR vaccine.
Kennedy offered conflicting thoughts on the MMR vaccine, sometimes saying it was the best way to protect against the disease while at other times questioning its safety.
His words and skepticism weigh on Spartanburg, residents say.
"He's very well-respected here," Martin said."I think it definitely has something to do with [vaccine hesitancy]."
In recent weeks, Kennedy, a longtime vaccine skeptic, has remained silent on the South Carolina outbreak.In a statement from the US Department of Health and Human Services, it said vaccination is "the most effective way to prevent measles, and the secretary has been clear and consistent on this issue."
Some of Kennedy's allies played down concerns about the cases.Asked last week whether the nation's impending measles outbreak was significant, CDC Deputy Director Ralph Abraham replied: "Not at all."
That same week, Kirk Milhoan, Kennedy's pick to head the Independent Vaccine Advisory Panel, said polio and measles vaccinations should be optional.He speculates that this will allow better data collection on the dangers of measles.
"What we will have in real-life experience when people who are not vaccinated get measles, what is the new incidence of hospitalization? What is the incidence of death?"he told the podcast "Why Should I Trust You?"
This is no secret to medical professionals.
The disease will move through communities with low vaccination rates and infect many before spreading to the next large group of unvaccinated individuals, said Chris Lombardozzi, chief medical officer of Spartanburg Regional Health System's acute care hospitals.
"Finally, I'm worried about all the things we usually vaccinate against," he said, referring to polio, mumps and rubella.
Such experiments, and the defeat of the United States.There.Measles eradication status is likely to have deadly consequences for children in the United States, medical experts said.
"It would be like a public health failure in our country," Greer said.
