Lauren Sausser
BOILING SPRINGS, S.C. — Near the again nook of the native library’s parking zone, largely out of view from the primary street, the South Carolina Department of Public Health opened a pop-up clinic in early November, providing free measles vaccines to adults and youngsters.
Spartanburg County, in South Carolina’s Upstate area, has been combating a measles outbreak since early October, with greater than 50 circumstances recognized. Health officers have inspired people who find themselves unvaccinated to get a shot by visiting its cellular vaccine clinic at any of its a number of stops all through the county.
But on a Monday afternoon in Boiling Springs, just one particular person confirmed up.
“It’s progress. That progress is slow,” Linda Bell, the state epidemiologist with the Department of Public Health, mentioned throughout a latest press briefing. “We had hoped to see a more robust uptake than that in our mobile health units.”
As South Carolina tries to include its measles outbreak, public well being officers throughout the nation are involved that the extremely contagious virus is making a serious comeback. The Centers for Disease Control and Prevention has tallied more than 1,700 measles cases and 45 outbreaks in 2025. The largest began in Texas, the place tons of of individuals have been contaminated and two kids died.
For the primary time in additional than twenty years, the United States is poised to lose its measles elimination status, a designation indicating that outbreaks are uncommon and quickly contained.
South Carolina’s measles outbreak isn’t but as massive as these in different states, similar to New Mexico, Arizona, and Kansas. But it reveals how a confluence of bigger nationwide developments — together with traditionally low vaccination charges, skepticism fueled by the pandemic, misinformation, and “health freedom” ideologies proliferated by conservative politicians — have put some communities in danger for the reemergence of a preventable, probably lethal virus.
“Everyone talks about it being the canary in the coal mine because it’s the most contagious infectious disease out there,” mentioned Josh Michaud, affiliate director for international and public well being coverage at KFF, a well being info nonprofit that features KFF Health News. “The logic is indisputable that we’re likely to see more outbreaks.”
Schools and ‘Small Brush Fires’
Spartanburg’s vaccination price is among the many lowest of South Carolina’s 46 counties. And that was true “even before covid,” mentioned Chris Lombardozzi, a senior vp with the Spartanburg Regional Healthcare System.
Nearly 6,000 kids in Spartanburg County colleges final yr — 10% of the entire enrollment — both obtained an exemption permitting them to forgo required vaccinations or didn’t meet vaccine necessities, based on knowledge revealed by the state.
Lombardozzi mentioned the county’s low vaccination price is tied to misinformation not solely revealed on social media but additionally unfold by “a variety of nonmedical leaders over the years.”
The pandemic made issues worse. Michaud mentioned that concern and misinformation surrounding covid vaccines “threw gasoline on the fire of people’s vaccine skepticism.” In some circumstances, that skepticism transferred to childhood vaccines, which traditionally have been much less controversial, he mentioned.
This made communities like Spartanburg County with low vaccination charges extra susceptible. “Which is why we’re seeing constant, small brush fires of measles outbreaks,” Michaud mentioned.
In Spartanburg, the general share of scholars with required immunizations fell from 95.1% to 90% between the 2020-21 and 2024-25 educational years. Public well being officers say a minimal of 95% is required to stop vital unfold of measles.
Children who attend private and non-private colleges in South Carolina are required to indicate that they’ve obtained some vaccinations, together with the measles, mumps, and rubella vaccine, however non secular exemptions are comparatively straightforward to acquire. The exemption kind should be notarized, but it surely doesn’t require a physician’s word or any disclosure concerning the household’s non secular beliefs.
The variety of college students in South Carolina who’ve been granted non secular exemptions has elevated dramatically over the previous decade. That’s significantly true within the Upstate area, the place non secular exemptions have elevated sixfold from a decade in the past. During the 2013-14 faculty yr, 2,044 college students within the Upstate have been granted a spiritual exemption to the vaccine necessities, based on data published by The Post and Courier. By fall 2024, that quantity had jumped to greater than 13,000.
Some colleges are extra uncovered than others. The starting of the South Carolina outbreak was largely linked to at least one public constitution faculty, Global Academy of South Carolina, the place solely 17% of the 605 college students enrolled in the course of the 2024-25 faculty yr supplied documentation displaying they’d obtained their required vaccinations, based on knowledge revealed by the Department of Public Health.
No one from Global Academy responded to interview requests.
‘Health Freedom’
In April, after visiting a Texas household whose daughter had died from measles, Health and Human Services Secretary Robert F. Kennedy Jr. wrote on social media that the “most effective way to prevent the spread of measles is the MMR vaccine.” He made the same assertion throughout an interview on “Dr. Phil” later that month.
But these endorsements stand at odds with different statements Kennedy has made that forged doubt on vaccine security and have falsely linked vaccines with autism. The CDC, beneath his authority, now claims such hyperlinks “have been ignored by health authorities.”
“What would I do if I could go back in time and I could avoid giving my children the vaccines that I gave them?” he mentioned on a podcast in 2020. “I would do anything for that. I would pay anything to be able to do that.”
Throughout 2025, he has made different misleading or unsupported statements. During a congressional listening to in September, Kennedy defended his previous claims that he was not anti-vaccine however affirmed his acknowledged place that no vaccines are secure or efficient.
Emily Hilliard, a spokesperson for the Department of Health and Human Services, instructed KFF Health News that Kennedy is “pro-safety, pro-transparency, and pro-accountability.” Hilliard mentioned HHS is working with “state and local partners in South Carolina” and in different states to supply help in the course of the measles outbreaks.
Meanwhile, Kennedy has incessantly championed the concept of well being freedom, or freedom of selection, relating to vaccines, a speaking level that has taken root amongst Republicans.
That has had a “chilling effect all the way down through state and local lawmakers,” Michaud mentioned, making some leaders hesitant to speak concerning the menace that the continuing measles outbreaks poses or the effectiveness and security of the MMR vaccine.
Brandon Charochak, a spokesperson for South Carolina Gov. Henry McMaster, mentioned the governor was not accessible to be interviewed for this text however referenced McMaster’s remark from October that measles “is a dangerous disease, but in terms of diseases, it’s not one that we should panic about.”
On a separate event that month, the Republican governor mentioned he doesn’t help vaccine mandates. “We’re not going to have mandates,” he mentioned, “and I think we are responding properly.”
Even although the South Carolina Department of Public Health has repeatedly inspired measles vaccines, the push has been notably quieter than the company’s covid vaccine outreach efforts.
In 2021, for instance, the company partnered with breweries all through the state for a marketing campaign referred to as “Shot and a Chaser,” which rewarded individuals who obtained a covid vaccine with a free beer or soda. By distinction, the pop-up measles vaccine clinic on the Boiling Springs Library featured no flashy signage, no freebies, and wasn’t seen from the library’s most important entrance.
Edward Simmer, interim director of the Department of Public Health, wouldn’t communicate to KFF Health News concerning the measles outbreak. During a legislative listening to in April, Republican state lawmakers voted towards his everlasting affirmation due to his previous help for covid vaccines and masking. One lawmaker particularly criticized the company throughout that listening to for the Shot and a Chaser marketing campaign.
Public well being officers in different states even have been blocked from new roles due to their covid response. In Missouri, the place MMR vaccine rates have declined amongst kindergartners since 2020 and measles circumstances have been reported this yr, Republican lawmakers rejected a public health director in 2022 after vaccine opponents protested his appointment.
In South Carolina, Simmer, missing lawmakers’ affirmation, leads the general public well being company in an interim capability.
South Carolina Sen. Tom Davis of Beaufort was the one Republican on the Senate Medical Affairs Committee who voted to verify Simmer in April. He instructed KFF Health News that his Republican colleagues raised legitimate questions on Simmer’s previous help for covid vaccines.
But, Davis mentioned, it will be “tremendously unfortunate and not beneficial from a public health perspective” if the Republican Party simply took a stance towards vaccines “as a matter of policy.”
The Department of Public Health had administered 44 doses of the MMR vaccine by means of its cellular well being unit from October to mid-November. The final cellular vaccine clinic was scheduled for Nov. 24. But well being officers are inspired that sufferers are looking for vaccines elsewhere. The company’s monitoring system reveals that suppliers throughout Spartanburg County administered greater than twice as many measles vaccines in October as they did a yr in the past.
As of mid-November, greater than 130 folks remained in quarantine, most of them college students at native elementary and center colleges. Cases have additionally been linked to a church and Greenville-Spartanburg International Airport.
“We’re reminding people that travel for the upcoming holidays increases the risk of exposures greatly,” mentioned Bell, the state epidemiologist. “Due to that risk, we’re encouraging people to consider getting vaccinated now.”
KFF Health News correspondent Amy Maxmen contributed to this report.
