SEMINOLE, Texas — Last Saturday, Zach Holbrooks walked into a mobile measles screening and vaccine clinic he had helped set up.
As the executive director of the South Plains Public Health District, which includes Gaines County, he dropped by to check on how many shots the crew had given out so far that day.
"Has it been busy today?" Holbrooks asked the two staffers in what's normally a livestock show barn on the outskirts of downtown Seminole. "Not so far. We've only given one," they replied.
Holbrooks works and lives in this town, the county seat, which in the last few weeks became the epicenter of the largest measles outbreak in three decades.
As of Tuesday, March 4, one 6-year-old unvaccinated child had died of the measles. There are now 159 confirmed cases and 22 hospitalizations, but local health authorities say the true total is likely much higher.
The Centers for Disease Control and Prevention says outbreaks tend to occur when the vaccination rate in a community dips below 95%. The kindergarten vaccination rate for measles, mumps and rubella on record in Gaines County sits at 82%, according to state health records.
But many children there are homeschooled or attend private primary school, so those rates could be even lower.
Holbrooks has been busy since the outbreak started in late January. He's been setting up mobile testing and vaccination sites; he said this remote part of West Texas has a large immigrant population, many whose immunization records are unknown, so he's been circulating flyers with measles information in different languages.
"We have a mix of people out here, a large German speaking population, Spanish speaking population," which he said makes getting residents the right information about disease control even more complicated.
Authorities still don't know how the measles got to Seminole, but John Belcher, the town's former mayor, said he understands why it's spreading beyond the city limits.
Folks who live out here basically have to drive everywhere, he said. They hop in the car or truck and drive miles to get groceries, go to doctor's appointments, attend church and to get to work.
"I'd say within 200 miles, maybe even farther, if there's a metal building out there, it came from products manufactured in Gaines County," Belcher said. "And the building was probably put together by companies from Gaines County."
People here need to drive about 80 miles to catch a flight at the Lubbock Airport.
Others travel often to nearby communities in Lea County, on the New Mexico side of the state line. That state has reported 10 confirmed measles cases. On Thursday, New Mexico Health officials confirmed that an unvaccinated adult testing positive for the virus has died.
A sense of normalcy
In Seminole, the outbreak has mainly infected children since early January.
Local authorities say the Mennonite community has been hit hard by measles, though they don't have an exact number of confirmed cases.
Grub Shack, a restaurant owned and run by a Mennonite family, seems to be running at full steam. Other businesses in downtown Seminole and people just carry on with their daily lives.
Many Mennonites immigrated here in the late 1970s. There remain thousands of Mennonites in Seminole some 50 years later.
Tina Siemens' father moved his family here from northern Mexico in 1976 when she was 8. She was raised Mennonite and manages the West Texas Living Heritage Museum, which tells the history of this part of West Texas' Native American and Mennonite heritage.
While many Mennonites are not against vaccines in principle, Siemens said, some seek other solutions.
"The Mennonites are very keen on home remedies," Siemens said. "So there may be a family that, nobody knows that they might have all had the measles."
The state's health officials have said there's plenty of vaccine for everyone who needs it, and Holbrooks said he doesn't think it's a lack of access to the vaccine that's spreading measles out here.
At last count, 214 people in Gaines County have been vaccinated for measles since the outbreak. Holbrooks believes that number is not higher because some people fear debunked ideas about its safety.
"I just think there's some vaccine hesitancy, even more so since COVID," Holbrooks said.
According to the CDC, the measles vaccine is safe and two doses prevent infection, not just severe illness, 97% of the time.
Julie Carter has lived in Seminole all her life. Her three kids are adults: 19, 22 and 30 years old. They got the measles vaccine before starting elementary school, but she became a vaccine skeptic when she started researching ways to improve her health.
"I was overweight; I wasn't feeling good," Carter said. "I kind of went on a journey where I got educated. I came across the vaccine thing and wasn't sure how healthy those were."
Health officials say doubts about vaccines continue to hamper vaccination efforts. Plus, this illness has not been a major public health issue. In 2000, the CDC declared the virus eliminated from the United States.
Holbrooks said that for a lot of younger parents, measles is a thing of the past.
"It's not something that people thought a lot about," he said. But he's urging those in the community to do just that because the consequences can be severe. "If it was just a simple rash, a rash won't lead to brain inflammation, intellectual disability, death, pneumonia, deafness, convulsions."
And measles, one of the most contagious known viruses, can spread for days without a person feeling sick.
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