Dr. Andrew Carroll, a family physician in Chandler, Arizona, a suburb outside of Phoenix, first arrived there in 2000, the same year the United States declared measles had been eradicated. Now, 25 years later, an outbreak is accelerating a couple hours away from his practice — only the latest in a number of troubling outbreaks across the United States this year as vaccination rates tumble.
In 2025, more than 1,900 cases have been diagnosed — the most in more than 30 years. More than 200 Americans, the vast majority of them young children, were hospitalized and three people have died — the first measles deaths in the US in more than a decade. A massive outbreak that began in an insular religious community in west Texas set the tone for the year: As cases grew over the spring, US Health Secretary Robert F. Kennedy Jr. waffled on the value of vaccines while touting unproven treatments like cod liver oil. The Arizona outbreak was likewise seeded in a fundamentalist Mormon community with a history of low vaccination rates.
When I spoke with Carroll shortly before the holidays, he thought back to his training in the 1990s, during the height of the AIDS epidemic. “I watched a lot of people die slowly and agonizingly,” he said. But we’ve made so much progress in both research and public health: today, people can live for decades with HIV and have safe sexual relationships with partners who were not infected.
“That’s science,” he said — the very same rigorous, empirical process that eradicated another deadly disease, measles, which before widespread vaccinations started in 1963 was killing hundreds of children every year. The same process has eliminated diseases like polio and smallpox.
“It only takes one generation to forget the progress we’ve made on certain things — and one of those is measles,” Carroll told me. “Twenty-five years ago, we were a measles-free nation. Now we’re back one generation later because we forgot how terrible it was.”
There are many reasons why measles is spreading in the US again — the decline in trust in the measles vaccination, political polarization, social media algorithms, and the Covid-19 backlash.
But in speaking with five doctors practicing in or near some of this year’s hot spots, something else stood out to me: Americans have lost their fear of measles.
And the measles virus is fearsome: It is still one of the most contagious infections known to humanity. It can put healthy children in the hospital; a small number of infected people will die from it. Even if a patient survives measles, it can cause a person’s immune system to lose its protection against a wide variety of pathogens — a phenomenon known as immunity amnesia.
That’s why the measles vaccine was such a scientific miracle. It was highly effective — preventing infections in 97 percent of cases — and, after a concerted public health campaign to educate people on the value of getting vaccinated, upward of 90 percent of Americans had received their measles shot at the turn of the 21st century and nearly every American agreed on the importance of childhood vaccinations.
“We’ve done too good of a job,” said Dr. Emily Briggs, a family physician in New Braunfels, Texas, outside San Antonio. She’s joking — mostly. But Carroll told me that the patients in his practice who are most concerned about the outbreak a few hours away are the grandparents — the only remaining generation that saw the impacts of measles up close.
Not only have Americans grown complacent about measles, but our current political landscape has contributed to a slide in vaccination rates across the board.
Fewer people are getting the annual flu shot and Covid-19 booster rates are pitifully low. Vaccination rates have been dropping not only for measles but for whooping cough, another deadly disease that is seeing a resurgence. Trust in experts and scientists is near an all-time low.
And it hasn’t helped that America’s top health official, Kennedy, has minimized how dangerous the disease really was: “When you and I were kids, everybody got measles,” he said in March on Fox News, touting the lifetime protection that infection incurred and ignoring the several hundred annual deaths that still occurred in the mid-20th century.
And so the measles virus has had an opportunity to reconquer areas where it had long been absent. Fewer than half of kids in a Mennonite community in west Texas, where that state’s outbreak began, were vaccinated. At the South Carolina charter school that is the epicenter of that state’s currently accelerating outbreak, less than 20 percent were.
Dr. Ada Stewart, a family physician in Columbia, South Carolina, told me she was bracing for another surge in cases after the holiday season. She said her patients were approaching the end of year with trepidation, too:
“I have people coming to me: ‘Can I go visit Grandma up there in Greenville? Is it safe? Should I take my baby?’” Stewart said. “People are scared.”
Doctors are bearing the burden of our public health crisis
The doctors I spoke to for this story told me that they are exhausted and frustrated. Many of them described patients who have become more dubious of medicine, who have their own sources of information — frequently inaccurate — and now public health authorities under Kennedy are validating some of the more outlandish ideas they find on social media and YouTube. It’s harder to gain their patients’ trust.
“There’s some resistance by many people to take lessons from history. They don’t want to be encumbered by those lessons and give up their autonomy and their agency to choose for themselves what they want to do,” Dr. Jason Terk, a pediatrician in north Texas, told me. “Of course, they don’t understand that what they choose to do isn’t just for them. It’s for everybody else when it comes to public health.”
And that’s an additional burden on already overworked and underpaid doctors. America doesn’t have enough primary care physicians or pediatricians as it is. They are already among the lower-paying specialties, which has driven more and more young doctors to pursue more lucrative positions as orthopedic surgeons and to work in higher-paying metro areas.
I’ve written stories about the twilight of the family doctor and America’s doctor deserts, communities that already struggle to find primary care doctors and pediatricians who will come and practice there. Now, these doctors are tasked with combating misinformation not only from social media but from the federal government — often with even fewer resources than before.
“Our burnout is so significantly higher now because: Why is it on us to have to reiterate the exact same accurate information when that’s why we have public health officials? That’s why we have a federal government,” Briggs said. “Yet it’s falling to us as individual physicians to have to reiterate evidence-based medicine each and every visit.”
The medical consensus that had held for as long as some of these doctors have been practicing — upward of 30 years in some cases — has been shattered. “It’s been a little bit insane,” Briggs said.
Now that vaccine hesitancy has gone mainstream, Terk, the Texas pediatrician, told me he tries to walk through the science, the risks and benefits, and make them clear to his patients. But he also wants them to understand that while a vaccination may be a personal decision, if they choose to ignore his advice, they take responsibility for the consequences.
Those are the difficult conversations physicians find themselves having in our new era of measles. If there is any potential bright side to this year’s outbreaks, they say, it’s that new experiences with this deadly disease may convince people once again of the value of a measles shot.
“We’re going through a cycle, and there will be casualties. There will be needless deaths and illnesses,” Terk told me. “I think that the only generation that is going to learn from this will be maybe the next one.”