Measles Outbreak in West Texas: A Public Health Challenge

In early 2025, as measles started to spread in West Texas, Katherine Wells realized she was in dire need of funding.

Although the outbreak was primarily in Gaines County, which is about an hour away, Wells, the director of Lubbock’s public health department, faced a pressing need for more staff to deal with numerous exposures in pediatric offices, urgent care facilities, restaurants, and daycares.

“We were really depending on non-hourly staff, and, you know, I can push them to work extra if necessary, but it’s not ideal,” Wells explained. In meetings with the Texas Department of State Health Services, she requested about $100,000 to hire temporary workers to alleviate the burden on her already strained team.

“I just wanted some funds to pay a retired school nurse we’ve previously worked with if I needed a few extra hours of help,” she said.

Unfortunately, the answer was always “no.” While the state did send a few travel nurses from different regions, no additional funding was provided.

To contain the measles outbreak before it spiraled out of control, public health officials must swiftly reach out to those exposed, check their vaccination status, and encourage them to either get vaccinated or quarantine for three weeks.

Wells ended up reassigning at least half of her team to focus on the outbreak while juggling their regular responsibilities.

The Economic Impact of a Measles Outbreak

Wells couldn’t say how much it cost the Lubbock Health Department to control the virus during the outbreak that kicked off in late January of the previous year within a largely unvaccinated Mennonite community.

Since 2019, an investigative report found that over two-thirds of counties have seen significant declines in vaccination rates. More than half of the counties tracking MMR rates are below the threshold needed to prevent a measles outbreak.

A recent report highlights that if these vaccination rates keep dropping just 1% annually over the next five years, the U.S. could face costs soaring up to $1.5 billion per year, according to an analysis from the Yale School of Public Health.

Using existing data on county-level vaccination coverage, Yale researchers modeled projected increases in measles cases, hospitalizations, and the associated economic toll.

Their findings indicated that approximately $41.1 million annually would cover basic medical needs for patients, while $947 million would be needed for public health efforts like surveillance and contact tracing. Moreover, productivity losses could reach around $510.4 million each year.

Dr. Dave Chokshi, chair of Common Health Coalition, emphasized that measles outbreaks have far-reaching effects on the entire health system.

“The consequences of measles outbreaks aren’t just about health,” remarked Chokshi, who once served as New York City’s health commissioner. “There are economic ramifications too, like employees losing work and health systems being overwhelmed.”

Measles had been declared eliminated in the U.S. back in 2000. Since then, isolated outbreaks have generally been contained quickly. However, declining vaccination rates are raising concerns about the increased potential for larger outbreaks, now jeopardizing the nation’s elimination status.

As the measles cases began to rise in West Texas in late January 2025, coinciding with President Donald Trump’s second inauguration, the administration had not strongly promoted vaccines to counter such outbreaks.

The focus instead shifted toward discussing “personal choice” over public health needs regarding childhood vaccinations.

In the early months of 2026, more than 1,000 confirmed measles cases emerged, nearly half of the total cases from the previous year, with 94% of those affected being unvaccinated.

A study from Johns Hopkins Bloomberg School of Public Health found that the initial cost to communities from a measles outbreak averages around $244,480. This includes expenses related to vaccine clinics and staffing until the outbreak is resolved, as noted by Bryan Patenaude, a health economics associate professor.

“We understand the factors involved in managing a measles outbreak, from how many cases turn severe needing care to accurate tracking of each case,” Patenaude commented.

The report, published online in October, examined outbreaks across 18 states since 2004, excluding the recent incidents in Texas, Utah, and Arizona.

The additional costs associated with each measles case average $16,000, accounting for contact tracing, medical bills, and monitoring during quarantine. A few cases could quickly add up—five cases nearing $324,480 and an outbreak of 50 potentially costing $1 million.

Clark County, Washington, faced a measles outbreak in 2019 that involved 72 cases, leading health officials to dedicate time ensuring that individuals followed quarantine protocols.

“We even brought in staff from the CDC and other states to assist with case investigations and tracing contacts,” said Dr. Alan Melnick, public health director of Clark County. The team diligently checked in with quarantined individuals daily. Ultimately, the majority of subsequent cases arose among those who had been quarantined, Melnick noted.

A report found that productivity losses from this relatively modest outbreak in Clark County exceeded a million dollars.

Notably, the measles vaccine is available for free in the U.S.

“People should recognize how valuable vaccines are,” Melnick stated, “considering they not only save lives but also save a lot of money.”

Former California legislator and pediatrician Dr. Richard Pan, who bolstered state vaccine legislation after a 2015 Disneyland outbreak, remarked, “The costs of these outbreaks are significant, and American families ultimately bear that burden.”

Meanwhile, South Carolina is grappling with the largest outbreak in decades. Spartanburg County is on high alert, with at least 1,000 cases reported and potential exposures traced back to fast food restaurants, medical offices, and even government buildings.

The South Carolina Department of Public Health has been reticent about revealing the costs associated with their contact tracing and increased staffing efforts.

However, an official confirmed that the CDC had authorized a request to reallocate hundreds of thousands of dollars intended for emergencies.

Additionally, South Carolina received $100,000 from the CDC for its response to vaccine-preventable diseases, according to Louis Eubank, deputy incident commander for the state health department. Both entities continue to communicate about additional resource needs.

At the federal level, a senior official indicated that the CDC had allocated $8.5 million to seven regions experiencing measles outbreaks in the past year but declined to specify where those funds were directed.

Funding decisions were informed by requests from state or local health departments and the availability of CDC resources.

As the outbreak spilled over into North Carolina, Dr. David Wohl, a specialist in global health and infectious diseases at the University of North Carolina at Chapel Hill, faced challenges in managing a potential surge beyond the 23 confirmed cases already recorded.

“So many people are involved in addressing this within my healthcare system,” Wohl noted. “I can’t even begin to count the hours and calls—everyone is really stretched.”

Intangible and Indirect Costs

While the economic burden of measles outbreaks can be numerically assessed, the personal costs for families with unvaccinated children are significantly more challenging to quantify.

Throughout the past year, many individuals—over 10% of those infected, according to the CDC—have been hospitalized due to serious complications like high fever and pneumonia.

Parents have likely spent countless, distressing hours tending to their ill children. Most recover, but some are left with severe long-term effects such as encephalitis, which can result in seizures, vision or hearing loss, and cognitive challenges.

In rare cases, measles can lay dormant for years before re-emerging, severely affecting the brain and nervous system, a condition known as subacute sclerosing panencephalitis, which is nearly always fatal.

In Texas, two young girls, aged 6 and 8, tragically succumbed to measles weeks after their diagnoses.

Though the economic implications of such outbreaks are significant, the human toll cannot be overlooked, as Chokshi aptly pointed out. “Every statistic represents a child grappling with a devastating illness or a family confronting an unexpected hospitalization, or in dire cases, a tragedy from what is, fundamentally, a preventable disease.”