No measles reported yet in Nevada, but state’s vaccination rate slipping

Measles, a highly contagious disease considered to have been eradicated since the turn of the century, is making a comeback. Nevada has no reported cases as of Thursday morning, but public health officials worry the state may be vulnerable as vaccination rates have slipped in recent years. 

The New York Times and other media outlets have tracked more than 270 cases of measles in 12 states. That includes 223 cases confirmed by the Texas Department of State Health Services as of March 11 and 33 cases confirmed by the New Mexico Department of Health as of Wednesday. Two cases were confirmed among travelers at Los Angeles International Airport last week, the Los Angeles Times reports.

The Centers for Disease Control and Prevention, which previously updated case counts daily on its website, last month announced it will only update weekly. As of March 7, it was reporting 222 cases nationally.

In 2024, the CDC reported 285 cases in 32 states and the District of Columbia. None of them were fatal. Nevada did not report any cases.

So far this year, an unvaccinated child in West Texas and an adult in New Mexico have died from measles, according to health officials. 

Measles, a highly contagious virus, usually begins with a fever, cough, runny nose and pink eye. Two to four days later a distinctive rash generally appears. Infected individuals are contagious for four days before and after the appearance of a rash. Complications include pneumonia, encephalitis, and death. 

The virus is transmitted by direct contact or by inhaling infectious droplets. Measles virus can remain on surfaces and in the air for up to 2 hours.

Signs of illness usually occur a week to 10 days following exposure. 

Herd immunity at risk?

The measles vaccine became available in 1963. Anyone born before 1958 is assumed to have had measles, says Dr. Brian Labus of UNLV’s Department of Epidemiology and Biostatistics. 

“For this group, getting vaccinated was unnecessary because their natural infection provided lifelong protection,” Labus said via email. “Thanks to widespread vaccination, measles was no longer a common childhood illness by the late 1960s.”

Lately, amid debunked rumors of connections between vaccinations and autism, as well as opposition to the COVID-19 vaccine, the ranks of the vaccinated are slipping. 

The CDC estimates that in the 2018/19 school year, 95% of kindergarten students in Nevada were vaccinated against measles. By 2023/24, the vaccination rate had fallen to 91.8%.

Nationally, the vaccination rate during that time period dropped from 94.7% to 92.7%. 

Those drops in vaccination rates correspond with an increase in the number of parents filing religious exemptions. In 2018/19, an estimated 3.2% of Nevada kindergarteners had a religious exemption. By the 2023/24 school year, 5.6% did. Nationally, 3.1% of kindergarten students had a religious exemption.

The percentage of children with medical exemptions has remained steady at .2% in Nevada and nationally.

The measles, mumps, and rubella (MMR) vaccination rates in Nevada vary by county, from 83% in White Pine County to 95.8% in Storey County. In Clark County, the largest county in the state, 91.5% of students were vaccinated, while 94.8% in Washoe County were. 

In Gaines County, Texas, which has the majority of cases in the West Texas outbreak, the MMR vaccination rate is 82%, well below the 95% threshold to prevent outbreaks, the Associated Press reports.

“Measles elimination hinges on vaccination coverage remaining above 95% to retain sufficient community protection,” the National Institutes of Health wrote in 2022, noting “recent declines in routine measles vaccinations due to the COVID-19 pandemic… are a cause for concern.”

“We encourage all parents to follow established vaccination guidelines to help protect their children and the community,” says SNHD, adding it will reach out to unvaccinated individuals “to encourage post exposure vaccination if they have been potentially exposed.”

The wildcard in the current outbreak is the role, influence, and administrative skills of U.S. Secretary of Health and Human Services Robert Kennedy Jr., who has asserted a link between autism and childhood vaccinations, and has been criticized for a lack of leadership during the recent measles outbreaks.

In a message on the HHS website, Kennedy said the “decision to vaccinate is a personal one.” 

“It is not a scientific article,” said Labus of Kennedy’s statement. “It is an opinion piece.”

The New York Times reports Kennedy, in an interview posted on Fox News last week, blamed the measles vaccination for harming children in West Texas, the site of several outbreaks, asserted it is difficult for measles to kill a healthy person, and blamed the West Texas cases on malnutrition. 

The measles vaccination is administered in two doses – the first between 12 and 15 months of age, and the second between 4 and 6 years old, and is 97% effective, according to experts.  

“Higher vaccination rates provide greater protection for everyone- children and adults alike,” the Southern Nevada Health District said via email, adding it takes “proactive steps to protect public health” during a measles outbreak.

That response includes “public education focused on vaccinations, enhanced surveillance, pre-established outbreak response plans, and close collaboration with community, state, and federal partners.”

The Health District recommends anyone with symptoms contact a health care provider before visiting a health care facility to guard against spreading the illness.

Exemptions from vaccination are available if a child can’t be immunized because of a medical condition or vaccination is contrary to parents’ or guardians’ religious beliefs.

Conditional enrollment of unvaccinated children is allowed under some circumstances, according to the state. 

If the State Board of Health determines a dangerous or contagious disease is present at a school and there is at least one student who is not vaccinated, the unvaccinated child must be immunized or “be excluded from school,” according to a state website, for a period of time determined by the State Board of Health.

“When we do exclude a child, it serves multiple purposes,” says Labus. “First and foremost, it protects the child. We don’t want them attending a school during an outbreak because they are at high risk of disease and they would likely be exposed and get sick.”

Excluding an unvaccinated child “also helps prevent ongoing transmission within the school and helps to stop the outbreak. If the outbreak spreads to the teachers and staff, it may be difficult to continue to operate until the outbreak is over.” 

“Measles vaccination doesn’t just protect children—it safeguards our entire community,” Nancy Diao, ScD, Division Director of Epidemiology and Public Health Preparedness at Northern Nevada Public Health said in a news release. “Pregnant individuals, immunocompromised people, and other high-risk groups may face severe complications from measles, and vaccination is the most effective way to prevent outbreaks and protect those who cannot be vaccinated themselves.”

State health officials declined to provide specifics about any preparations in light of measles cases in other states.

“The Division of Public and Behavioral Health creates response plans for a wide range of public health threats. That includes diseases like measles,” the division said in an email.