Is RFK Jr right about the US measles outbreak being 'not unusual'?

The United States is facing a surge in measles cases, with an outbreak in West Texas leading to the country’s first measles-related death in a decade.

US Health Secretary Robert F Kennedy Jr, in a recent meeting with President Donald Trump and his cabinet, described the situation as “not unusual.”

Kennedy asserted that measles outbreaks occur annually and pointed out that there had already been four outbreaks in the US this year, compared to 16 in 2024.

However, public health experts caution that while cases do arise each year, the scale of the current outbreak is cause for concern.

How serious is the current Measles situation in the US?

The outbreak, which began in late January, has been particularly severe in Gaines County, Texas , where 80 cases have been reported.

The virus has also spread to eight other counties and into New Mexico, with additional cases recorded in Georgia, Alaska, New Jersey, and California.

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The US Centers for Disease Control and Prevention (CDC) confirmed that as of February 20, 2025, there were 93 measles cases across eight jurisdictions, with more recent Texas data placing the total at 124 cases.

Unlike typical small-scale outbreaks of previous years, this year’s outbreak has already resulted in one death, the first in the country since 2015.

Measles is a highly contagious virus, capable of lingering in the air and on surfaces for hours. Symptoms typically include fever, cough, runny nose, watery eyes, and a distinctive rash.

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In severe cases, the infection can lead to pneumonia, brain inflammation, and, in rare instances, death. The CDC estimates that one to three out of every 1,000 infected children will die from the disease.

Before the first measles vaccine was licensed in 1963, the virus infected between three and four million people annually in the US, leading to nearly 50,000 hospitalisations and 400-500 deaths each year.

So far in 2025, at least 18 people have been hospitalised due to the current outbreak. The majority of cases have occurred in younger individuals between the ages of five and 17 years old.

The deceased child, who was school-aged and unvaccinated, was hospitalised in Lubbock before succumbing to the disease . Kennedy initially stated that two people had died from the outbreak, but the Associated Press later confirmed that this was a misstatement and only one death had been reported.

Are measles outbreaks becoming more common?

Measles was declared eliminated in the US in 2000, thanks to widespread vaccination efforts. In the years that followed, cases were sporadic and often linked to individuals who had travelled abroad and brought the virus back. However, in recent years, declining vaccination rates have contributed to a rise in large outbreaks.

Comparative data suggests that the current outbreak is progressing at a faster rate than in previous years. For instance, the CDC’s weekly case reports show that 92 measles cases had already been recorded in early 2025 — more than double the number recorded in the same period in 2024.

Only three cases were reported in the same time frame in 2023. While the outbreak has not yet reached the scale of the 2019 outbreak, which saw 1,274 confirmed cases across 31 states, the current outbreak has already resulted in one fatality, unlike the 2019 outbreak.

Past outbreaks, such as the Disneyland-linked surge in Southern California in 2014-15 and the New York outbreak in 2018-19, demonstrate how gaps in vaccination coverage allow measles to spread rapidly.

In the 2023-24 school year, 39 states reported measles vaccination rates below the 95 per cent threshold required for herd immunity, compared to 28 states in 2019-20.

Public health officials stress that each outbreak signals a lapse in public health defences. “Each outbreak signifies a lapse in our public health defences and poses serious risks, especially to children,” The New York Times quoted Dr Jerome Adams, who served as US Surgeon General during the first Trump administration.

What is the role of vaccination in preventing measles?

The measles vaccine, administered as part of the measles, mumps, and rubella (MMR) immunisation, remains highly effective in preventing infection. A single dose provides 93 per cent protection, while the recommended two-dose regimen is 97 per cent effective.

Despite this, the national MMR vaccination rate among kindergartners has declined from 95 per cent in 2019 to 92.7 per cent in 2025, with some states reporting rates as low as 79.6 per cent.

Texas, the epicentre of the current outbreak, has seen significant declines in vaccination rates. In Gaines County, where most of the cases have been reported, the vaccination rate among kindergarteners is 82 per cent, significantly below the herd immunity threshold.

New Mexico, which has recorded nine cases of measles this year, has reported no direct links between its cases and the Texas outbreak, indicating that multiple transmission chains may be at play.

In other states, New Jersey health authorities recently reported two measles cases in Bergen County, linked to a child who had travelled abroad. Los Angeles County health officials also confirmed a measles case in an infant who was exposed while travelling through Los Angeles International Airport.

Georgia has reported three cases, all within an unvaccinated family in metro Atlanta, while Alaska confirmed one case in January in an unvaccinated adult who had travelled overseas.

Why is RFK Jr a dubious figure when it comes to vaccines?

Robert F. Kennedy Jr. has long been a controversial figure in the vaccine debate. He has expressed scepticism regarding the safety of vaccines and has previously questioned immunisation efforts.

His past involvement in vaccine-related controversies includes a visit to Samoa in 2019, where he met with anti-vaccine activists shortly before a measles outbreak killed 83 people, reported Newsweek. Kennedy later wrote to the Samoan prime minister, questioning whether the outbreak was due to low vaccine coverage or a “defective vaccine.”

Now serving as the head of the US Department of Health and Human Services (HHS), Kennedy has promised not to use his position to advance anti-vaccine rhetoric.

However, he has already signalled his intent to review the US childhood vaccine schedule , which protects against diseases like measles, polio, and whooping cough.

Public health officials worry that such efforts could undermine confidence in immunisation programmes at a time when vaccination rates are already declining.

While Kennedy is correct that measles cases occur in the US every year, public health experts state that the current outbreak stands out due to its size, spread, and the first measles-related death in a decade.

The decline in vaccination rates has made such outbreaks more frequent and severe. Health officials continue to urge residents, particularly those in affected areas, to check their vaccination records and get the MMR vaccine if they have not already done so.

Given the highly contagious nature of measles and its potential complications, maintaining high vaccination rates remains the most effective defence against future outbreaks.

With inputs from agencies