‘Like playing with fire’: Spokane measles vaccine rates too low as Texas outbreak rages

As the measles outbreak in Texas continues to grow, Spokane County’s vaccination rate remains below what is needed to prevent an outbreak.

More than 95% of kindergarten-age children need to have two doses of the measles-mumps-rubella vaccine to prevent a measles outbreak, according to the Centers for Disease Control and Prevention. Among school districts in Spokane County, 86.4% of kindergartners are fully vaccinated against measles.

Spokane Public Schools vaccination rates remain slightly higher than the county as a whole, while some rural districts have lower rates. Over the past five years, vaccination rates have trended slightly downward by approximately 5 percentage points in Spokane and across the state.

Neighboring Idaho has the lowest measles vaccination rate in the country. In the 2023-24 school year, only 79% of Idahoan kindergartners were fully vaccinated against measles.

As of early April, 69% of all Spokane County children are fully vaccinated against the disease, according to the Spokane Regional Health District. Their data comes from the Washington Immunization Information System, which is a registry that collects vaccine information from schools and medical providers.

Spokane Regional Health District immunization program coordinator Kayla Myers warned that data may be an undercount but also said she has “never seen MMR (vaccination) so low” in Spokane County.

Last year there was a measles outbreak in Deer Park, but it was contained to one household and three cases. SRHD epidemiologist Mark Springer said Spokane was “very lucky” to have contained the outbreak, and further spread of the disease could have “very easily overwhelmed” a public health agency like SRHD.

That kind of large-scale outbreak is currently ongoing in the southwestern United States. Beginning in west Texas in January, the outbreak has grown to more than 700 cases in six states. The number of measles cases has nearly tripled what was seen in 2024. Two unvaccinated children and one adult have died from measles so far this year.

Three cases of measles have been reported in Washington this year – all on the state’s West Side. Two cases are connected and result from international travel. As of Sunday, cause of the third case is still under investigation.

University of Michigan Medical School dean Dr. Marschall Runge said the large-scale outbreak is expected to continue in the Southwest for the next nine to 12 months. During that time other areas of the United States remain at higher risk of their own outbreak.

“It is a little bit like playing with fire. Once you have an outbreak, if there’s a population of people that are unvaccinated, they all eventually get measles,” he said.

If more than 95% of the population were vaccinated than a measles outbreak could be easily contained. But that becomes exponentially more difficult if a significant number of individuals are not vaccinated.

“The majority of measles patients don’t die. But death can occur and its not inconsequential,” Runge said. “In children under 5, about 1 in 4 are hospitalized either because of pneumonia or encephalitis. And if you are a patient there’s no perfect way to predict if my child will be the one at higher risk.”

Springer believes parents should especially be on the lookout for signs of measles in their kids during the next year as the Southwest outbreak grows.

“We are all gonna be dealing with this for much of the next year,” he said.

Measles often presents with a high fever, runny nose and a cough. But it is distinguished by a rash that appears three to five days after initial symptoms – starting on the face and then moving down the body.

If a child has these symptoms, a parent may want to call ahead to urgent care before getting treated, Springer said. Because measles is so easily spreadable, other patients at urgent care could be infected.

“Measles is super contagious. It lingers in the air for hours, so we need to be careful,” Runge said.

Vaccination is “by far the foundation for preparedness of measles,” he added.

U.S. Health and Human Services Director Robert F. Kennedy Jr. – a longtime skeptic of vaccinations – said via X on April 6 that the MMR vaccine is the “most effective way to prevent the spread of measles.”