As the 2024-25 school year begins, public health experts are raising concerns about declining MMR vaccination rates among kindergartners across Texas. According to data from the Texas Department of State Health Services, analyzed by NBC News in collaboration with Stanford University researchers, more than half have dropped below the recommended immunization threshold needed to prevent outbreaks of measles, mumps, and rubella – 139 of 254 counties.
The Centers for Disease Control and Prevention (CDC) recommends that at least 95% of a population be immunized with the MMR (measles, mumps, rubella) vaccine to maintain herd immunity. However, Texas has seen a significant decline in vaccination coverage, especially over the past decade. In 2014 and 2015, only 42 counties fell below that benchmark. Now, that number has more than tripled.
Under Texas law, the MMR vaccine is required for all students attending public and private schools. However, families can request exemptions for medical or “reasons of conscience,” including religious beliefs. The rise in such exemptions has contributed to the declining coverage.
Some counties stand out for their particularly low vaccination rates. Irion County, located west of San Angelo, recorded the lowest MMR coverage among kindergartners this school year, with only about two-thirds fully vaccinated.
Gaines County — where nearly 20% of kindergartners had nonmedical exemptions — a severe measles outbreak earlier this year led to over 760 reported cases, 99 hospitalizations, and two children deaths. Nearly half the total cases occurred in Gaines County alone.
Vaccination rates have dropped even in Texas’ largest population centers. In Harris County, the rate has declined from 96.6% to 91% over the past ten years. Similar declines have been observed in Dallas County (down to 90.2%) and Travis County, which now stands at just 86.7%.
Blanco County, within the Austin metropolitan area, has also experienced a steady decline. The coverage rate there dropped to 86.1% this year. On the other hand, Caldwell County has remained relatively stable, maintaining a rate above 95% for most of the past decade.
Counties like Bastrop, Hays, and Caldwell continue to report MMR coverage rates that meet or exceed CDC recommendations.
Dr. Peter Hotez, dean of the National School of Tropical Medicine, points to increased anti-vaccine activism — particularly since the COVID-19 pandemic — as a key factor behind the decline. In comments to KXAN, Hotez noted that in Austin, vaccine resistance has become prominent.
“We’ve had one of our worst years for measles in Texas this year,” Hotez said. “Other diseases will follow, like whooping cough, pertussis. Hopefully, we won’t see it spill over to polio.”
Texas Health and Human Services also requires the polio and Tdap vaccines (which protect against tetanus, diphtheria, and pertussis), but MMR coverage is a particularly urgent concern due to its impact on community immunity and the recent rise in outbreaks. Hotez warns that more robust public health education is essential.
