Measles Outbreak Reaches Over 800 Confirmed Cases in the US
Building trust with patients through fact-based information could help boost vaccination rates to the desirable coverage.
As of May 15, 2025, a total of 1024 confirmed measles cases have been reported in 31 jurisdictions. There have been 14 total outbreaks, which are defined as 3 or more related cases, and 92% of cases are associated with an outbreak. Of these cases, 96% were reported in patients who were unvaccinated or had unknown vaccination status. The CDC data reported that individual jurisdictions may report probable cases of measles, but the agency’s data only reflect confirmed cases. For comparison, in 2024, there were 16 outbreaks, with 198 of 285 cases being outbreak associated.1
Building trust with patients through fact-based information could help boost vaccination rates to the desirable coverage. | Image Credit: tashatuvango - stock.adobe.com
Texas reported the most cases (722 cases) as of May 20, 2025, but other cases have been seen in Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Indiana, Kansas, Kentucky, Maryland, Michigan, Minnesota, New Jersey, New Mexico, New York City, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Vermont, and Washington.1,2
“I think it’s important to think about this in the context of prevaccine vs what we’re currently experiencing,” Crystal Hodge, PharmD, associate professor of pharmacotherapy at The University of North Texas Health Science Center at Fort Worth, said in an interview.3 “We had about 500,000 cases of measles per year that led to about 500 deaths from measles per year, roughly 50,000 hospitalizations, and about 1000 people every year who ended up with permanent brain damage from encephalitis, which is a potential complication for measles.”
In 1912, measles became a nationally notifiable disease in the United States, meaning health care providers and laboratories had to report all cases they encountered. The mandatory reporting resulted in an average of 6000 measles-related deaths each year for the first decade. After the vaccine became available in 1963, the CDC tried to eliminate measles in the US by 1982. Although the goal was not met, measles cases fell by 80% in 1981 compared with 1980. The CDC declared measles eliminated from the US in 2000.4
Hodge added that between 2000 and 2024, there were only approximately 63 cases of measles per year and approximately 4 outbreaks. The largest outbreak still remains in Texas, with the largest number of cases reported in Gaines County (406), followed by Terry (60) and Lubbock (53) counties. There were 213 cases reported in patients aged 0 to 4 years, 272 in patients aged 5 to 17 years, and 233 in patients 18 years or older. Further, 688 patients were either unvaccinated or had unknown vaccination status, with only 15 and 19 patients who had 1 dose or 2 doses of the vaccine, respectively.2,3
“One of the biggest concerns in Texas is that the reason why it was able to become such an outbreak is because of the low vaccination rates in that particular community where it was reported, and unfortunately, I think one of the things that the COVID-19 pandemic highlighted is that there tends to be a lack of trust and goodwill in health care,” Hodge said.3 “There is concern that there are going to be growing numbers of larger communities that are unvaccinated or [are] below the threshold of vaccination needed for herd immunity, and that’s going to potentially leave people vulnerable to ongoing outbreaks and one of the reasons why it’s been difficult to get this current outbreak under control."
"Trust is something that, in most cases, needs to be earned, and if that trust is lost, it is a very difficult hill to overcome to regain that trust." — Lauren Angelo, PharmD
Herd immunity is important to keep outbreaks contained, according to Hodge. She stated that the vaccination rate to stop the spread of measles is 95% or greater, but in Texas, some community vaccination rates were as low as 50%. Additionally, not everyone is eligible to be vaccinated, so herd immunity can help protect more vulnerable patients who cannot receive the vaccine. When there is no vaccination, 1 measles case is expected to cause 12 to 18 other cases, according to Hodge, and measles is considered the most infectious disease. For every person with chickenpox, another 10 to 12 people will contract the virus, and for every person with smallpox, another 5 to 7 people will be infected.3
In results from a poll released by HealthDay Harris Poll, at least half of US adults reported that recent disease outbreaks and media coverage contributed to why they changed their views on vaccines. It also showed that 44% of respondents said their views on vaccines have changed in the past 5 years, with 25% of those respondents being more supportive of vaccines and 19% being less supportive. Further, 90% of individuals reported that they seek out their health care provider for vaccine information and 34% rely on political and religious beliefs.5
“Trust is something that, in most cases, needs to be earned, and if that trust is lost, it is a very difficult hill to overcome to regain that trust,” Lauren Angelo, PharmD, associate dean for academic affairs at Rosalind Franklin University in North Chicago, Illinois, said in an interview.6 “I think to build that trust and rapport, we need to be present and we need to be seen as a resource within our community. So if we’re able to step outside of the pharmacy and offer clinics or educational sessions that are offsite and during extended hours so patients can attend, that will go a long way in building that trust and rapport and working at that individual level with specific patients.”
Angelo added that health care providers are good at sharing information and data within their own circles, but when talking to patients, it might be more difficult for them to understand the data. The way pharmacists learn—through continuing education, podcasts,and webinars—is geared to the health care professional. She stated that learning how to build patient-friendly messages, teaming up with community leads, conducting focus groups, and developing information that is fact based but resonates with patients could go a long way in building trust.6
“As we continue to have these conversations, it’s important to take a step back [to] see what’s working and what’s not working, and how do we change that?” Angelo said.6 “If we’re going to see a difference in hesitancy and improve vaccine uptake, something does need to change, and havingmore patient-friendly messaging and marketing materials is probably one of the first steps that we need to make sure we take.”
To read these stories and more, download the PDF of the Drug Topics May/June issue here.
Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.
REFERENCES
1. Measles cases and outbreaks. CDC. April 18, 2025. Accessed April 22, 2025. https://www.cdc.gov/measles/data-research/index.html
2. Measles outbreak – April 18, 2025. Texas Health and Human Services. April 18, 2025. Accessed April 22, 2025. https://www.dshs.texas.gov/news-alerts/measles-outbreak-2025
3. Gallagher A, Hodge C. Expert: for every 1 measles case, there are expected to be 12 to 18 more. Drug Topics. April 18, 2025. Accessed April 22, 2025. https://www.drugtopics.com/view/expert-for-every-1-measles-case-there-are-expected-to-be-12-to-18-more
4. History of measles. CDC. May 9, 2024. Accessed April 22, 2025. https://www.cdc.gov/measles/about/history.html
5. HealthDay Harris Poll exclusive vaccine attitudes survey + interview w/ Dr. Peter Hotez (March 28, 1 PM ET). HealthDay News. March 28, 2025. Accessed April 22, 2025. https://www.newswise.com/articles/healthday-harris-poll-exclusive-vaccine-attitudes-survey-interview-w-dr-peter-hotez-march-28-1-pm-et
6. Gallagher A, Angelo L. Q&A: pharmacists can overcome vaccine hesitancy through trust and communication APhA 2025. Drug Topics. April 1, 2025. Accessed April 22, 2025. https://www.drugtopics.com/view/q-a-pharmacists-can-overcome-vaccine-hesitancy-through-trust-and-communication-apha-2025
