Near the again nook of the native library’s car parking zone, largely out of view from the principle 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 instances recognized. Health officers have inspired people who find themselves unvaccinated to get a shot by visiting its cell 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 current press briefing. “We had hoped to see a more robust uptake than that in our mobile health units.”
As South Carolina tries to comprise its measles outbreak, public well being officers throughout the nation are involved that the extremely contagious virus is making a significant 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 lots of of folks have been contaminated and two youngsters died.
For the primary time in additional than 20 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, corresponding to New Mexico, Arizona, and Kansas. But it shows 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, doubtlessly 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 world 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 charge is among the many lowest of South Carolina’s 46 counties. And that was true “even before covid,” mentioned Chris Lombardozzi, a senior vice chairman with the Spartanburg Regional Healthcare System.
Nearly 6,000 youngsters in Spartanburg County faculties final yr — 10% of the full enrollment — both obtained an exemption permitting them to forgo required vaccinations or didn’t meet vaccine necessities, in line with knowledge printed by the state.
Lombardozzi mentioned the county’s low vaccination charge is tied to misinformation not solely printed on social media but in addition 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 instances, 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 weak. “Which is why we’re seeing constant, small brush fires of measles outbreaks,” Michaud mentioned.
In Spartanburg, the general share of college students 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 faculties in South Carolina are required to indicate that they’ve obtained some vaccinations, together with the measles, mumps, and rubella vaccine, however spiritual exemptions are comparatively simple to acquire. The exemption kind should be notarized, however it doesn’t require a physician’s be aware or any disclosure in regards to the household’s spiritual beliefs.
The quantity of college students in South Carolina who’ve been granted spiritual exemptions has elevated dramatically over the previous decade. That’s notably true within the Upstate area, the place spiritual exemptions have elevated sixfold from a decade in the past. During the 2013-14 college yr, 2,044 college students within the Upstate have been granted a spiritual exemption to the vaccine necessities, in line with data published by The Post and Courier. By fall 2024, that quantity had jumped to greater than 13,000.
Some faculties are extra uncovered than others. The starting of the South Carolina outbreak was largely linked to at least one public constitution college, Global Academy of South Carolina, the place solely 17% of the 605 college students enrolled in the course of the 2024-25 college yr supplied documentation displaying that they had obtained their required vaccinations, in line with knowledge printed by the Department of Public Health.
No one from Global Academy responded to interview requests.
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 an identical assertion throughout an interview on “Dr. Phil” later that month.
But these endorsements stand at odds with different statements Kennedy has made that solid doubt on vaccine security and have falsely linked vaccines with autism. The CDC, underneath 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, informed 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 offer assist in the course of the measles outbreaks.
Meanwhile, Kennedy has steadily championed the thought of well being freedom, or freedom of alternative, concerning 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 in regards to the risk 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 obtainable 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 assist 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 essential entrance.
Edward Simmer, interim director of the Department of Public Health, wouldn’t converse to KFF Health News in regards to the measles outbreak. During a legislative listening to in April, Republican state lawmakers voted in opposition to his everlasting affirmation as a result of of his previous assist 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 as a result of of their covid response. In Missouri, the place MMR vaccine rates have declined amongst kindergartners since 2020 and measles instances 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 informed KFF Health News that his Republican colleagues raised legitimate questions on Simmer’s previous assist for covid vaccines.
But, Davis mentioned, it could be “tremendously unfortunate and not beneficial from a public health perspective” if the Republican Party simply took a stance in opposition to vaccines “as a matter of policy.”
The Department of Public Health had administered 44 doses of the MMR vaccine by its cell well being unit from October to mid-November. The final cell vaccine clinic was scheduled for Nov. 24. But well being officers are inspired that sufferers are searching for vaccines elsewhere. The company’s monitoring system shows 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 faculties. 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.