Opinion: How long, in the current environment, can Minnesota hold measles back?

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Minnesota has so far dodged becoming mired in the ongoing measles outbreak, which began in Texas this past January and has since spread across a swath of the southwest U.S., exacting a toll of more than 1,000 infections and three deaths. New cases continue to be tallied daily and experts believe the situation could roll on for a year before it is fully contained. But we fear our state’s luck is unlikely to hold owing to the current context surrounding this unfolding public health emergency.

Although Minnesota in 2025 should be a place where vaccine-preventable diseases are distant memories from the last century, instead the state has become a place where we see outbreaks of anachronistic illnesses. This is due to several forces coming together, including efforts by U.S. Health Secretary Robert F. Kennedy Jr. to discredit the benefits of vaccines while peddling ineffective treatments and the throttling of federal funds that is gutting our state’s world-class health department’s ability to provide real access to vaccines.

Amid the largest measles outbreak in 30 years, Kennedy is de-emphasizing vaccination even though it is the most effective way to prevent all harms caused by measles. Meanwhile, he has falsely asserted that measles can be treated with cod liver oil and other means. These messages, which he had been propagating even prior to his leadership appointment at Health and Human Services, are a force shattering confidence in vaccines.

Unfortunately, we can observe that these lies, proffered by both Kennedy and others, are taking hold in the public’s imagination. A recent Kaiser Family Foundation poll revealed that 25% of parents said the risks of the MMR (measles, mumps and rubella) vaccine outweighed the benefits, an increase from two years prior, when 17% of parents agreed with this statement. Further, nearly a quarter of respondents indicated they believed the false claim that MMR causes autism was likely true.

MMR refusal has left Minnesota far from being measles-proof. In order to achieve herd (or “community”) immunity, which would be a buffer to uncontrolled spread even if a case entered the community, an estimated 95% of the population must be fully vaccinated (receive two MMR shots). Acknowledging this, Minnesota requires that students be fully vaccinated by the time they begin kindergarten. However, only 87% of our kindergartners met this standard in the last school year.

Compounding the problem of dwindling vaccine coverage is its unevenness. The level of vaccine coverage within a community will determine that community’s risk. However, there are multiple Minnesota schools that have high concentrations of kids hailing from vaccine-hesitant families, resulting in coverage lower than 40%. The introduction of a single case into such a poorly protected community will lead to rapid spread, as we saw in Texas.

Our recent study painted a grim picture of not just the shortfall in overall measles vaccine coverage but also stark vaccine inequities in our state. Measles vaccine uptake in Minnesota varies substantially by demographic category. While it is recommended that children in the U.S. get their first dose between 12 and 15 months of age, only about 30% of children born in Minnesota to Somali parents had received the first dose of vaccine by age 24 months. This will leave them highly vulnerable to measles infection as they begin their toddler years and their social contacts increase. Indeed, Minnesota has seen several notable measles outbreaks, particularly affecting the East African communities, since 2010.

Our prior research delved into the wariness about the MMR vaccine, which has persisted for over a decade since Minnesota’s Somali community was aggressively targeted by misinformation about the roundly proven-false claim that the vaccine caused autism. We can see in the numbers how devastating this misinformation was, given that before 2010 (just before the misinformation campaign arrived), Somali-Minnesotan children were more likely than the general Minnesotan population to be up to date on MMR.

Further, families’ vaccine doubt, even when it begins with misinformation about a particular vaccine, appears to bleed to having hesitancy about other vaccinations, as we have observed drops in coverage in the East African populations for other, non-MMR vaccines. However, we know that these communities can be reached when vaccines are accessible and when outreach and education on the value of vaccines comes from trusted sources that represent the communities in need. In our own research, East African women told us that when making decisions about vaccines for their families, they valued direct and clear communication about their concerns in culturally appropriate ways.

This is why we are so appalled at the blindsiding cuts to the Minnesota Department of Health that were triggered by Trump administration slashes in federal funding to states. This resulted in the jettisoning of large numbers of staff who were steadfastly working to monitor vaccination and infectious disease outbreaks, and to develop approaches to protect all of our Minnesota communities. Vaccine clinics that were reaching people in underserved communities were cut, making coverage across all communities seem to be an insurmountable challenge at the moment.

Unfortunately, these issues are not isolated to MMR. We believe access to all vaccines is threatened. Last week it was reported that the Food and Drug Administration (FDA) is poised to enact a policy that will ban many children and adults from getting COVID-19 vaccines. This action is being taken despite these vaccines offering protection against severe disease and having been established as safe to receive.

While there will always be challenges that our communities face, the uncontrolled spread of vaccine-preventable disease should not be one that Minnesota deals with at present. Vaccines are indispensable; it is critically important for our state to get back on track with supporting protecting everyone with vaccination.

Rachel Widome, Inari Mohammed and Kelly Searle are epidemiologists at the University of Minnesota’s School of Public Health.