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When Pastor Landon Schott attended a school board meeting for Mercy Culture Preparatory Academy last week, he found the room filled with balloons and T-shirts.

The celebratory shirts read: #1 school in Texas for least amount of vaccinations.

Schott, who has more than 48,000 followers on Instagram, posted a video to congratulate all the families at the school who have chosen to “embrace freedom of health and they are not allowing government or science projects to affect how you live and lead your life.”

State Rep. Nate Schatzline also shared the news with his over 17,000 followers on X. His video says that the school is in his district and that his children attend there.

“Why haven’t we celebrated this sooner?” the Republican asked.

The Fort Worth-area school has the lowest measles vaccination rate in Texas: Just 14% of incoming kindergartners had measles-mumps-rubella (MMR) coverage last school year, according to data from the state health department.

But low vaccination rates across Texas are leaving many communities vulnerable amid a measles outbreak centered in the western part of the state, one of the largest the United States has seen since the disease was declared eliminated in the country in 2000.

In efforts to prevent even broader spread, public health officials in Texas, New Mexico and Oklahoma are working around the clock to raise vaccination rates and otherwise help protect vulnerable communities – work that is challenged by the spread of disinformation.

“They are stressed and stretched beyond belief,” Terri Burke, executive director of the Immunization Partnership, a nonprofit focused on improving vaccination coverage in Texas, said at a briefing Thursday. “The biggest thing I’m hearing is the need for more resources.”

One public health director in a county that has been hit by the outbreak told Burke she had been working more than a month straight without a day off.

“We spoke at six o’clock at night, and she told me she had started at 4:30 that morning,” she said.

Overall, the MMR vaccination rate among kindergartners in Texas was 94.3% for the 2023-24 school year, just below the 95% target that federal agencies have set to prevent epidemics. But about half of all school districts in the state have coverage that falls below this threshold, including nearly a quarter that have a vaccination rate of less than 90%. And Mercy Culture Preparatory Academy is one of more than a dozen schools where coverage was less than 50%.

The school did not immediately respond to ’s request for comment on its vaccination coverage.

Tarrant County, home to Mercy Culture Preparatory, has not reported any measles cases this year, but local health officials there and in many parts of the state are preparing for what seems inevitable.

“We’re kind of a more high-risk area, if you will,” Russ Jones, chief epidemiologist with the Tarrant County Public Health Department, said at a county commissioners’ meeting Tuesday, referencing the county’s vaccination rate of 91.5%. “At this level, we’ll have some cases.”

He also noted that there are pockets of the county where even larger shares are unvaccinated, including children at Mercy Culture Preparatory.

“Those would be particularly vulnerable if that network of cases crosses with our unvaccinated population,” he said. “If it doesn’t happen, there won’t be a problem. If it does, then we could have many cases, depending on the population it crosses with.”

To prepare, the county health department is communicating directly with schools and day cares and coordinating with hospitals and other local health care providers. Vaccines are available at community clinics, too.

“There is a heightened vigilance across our state because of this outbreak,” Burke said.

As public health experts work to curb the spread, there’s concern about the ways anti-vaccine messaging can hinder their efforts.

“There has been a lot of misinformation [and] disinformation on social media,” said Dr. Philip Huang, director of the Dallas County Health and Human Services Department. “On social media, you can put some of that info out there without any fact checks, and incorrect information is just as readily available as correct information.”

He also attributed decreasing vaccination rates to a distrust in government and politicization over vaccinations in general.

“There are these pockets of communities that are anti-vax, and so you can get a lot of people together that aren’t vaccinated, and that’s the biggest … dangerous situation,” Huang said.

As in Tarrant County, Huang’s department has hosted informational sessions with school nurses, physicians and hospitals to make sure everyone is up to speed on measles. He has sent letters to public and private school officials who are in districts with low vaccination rates and offered to provide vaccines.

Across the state line in New Mexico, which has also seen dozens of measles cases, officials are providing vaccines through free clinics. Jimmy Masters, the Southeast regional director with the New Mexico Department of Public Health, says the driving message is “to be proactive.”

His region has set up clinics not only in Lea and Eddy counties, where there are current cases, but in neighboring Chaves County. Residents are encouraged to check their vaccination status if they are unsure whether they ever received a dose of the MMR vaccine.

New Mexico has administered nearly twice as many MMR vaccines as last year. In the past six weeks, there have been nearly 10,000 doses given, compared with about 5,300 in the same time frame last year.

Primary care physicians can also play a key role in getting ahead of the measles outbreak by addressing questions and concerns directly with patients and families.

“We have a number of parents today who have concerns about all the vaccines their children receive. We’d recommend they talk to their primary care physician,” Tarrant County’s Jones said.

Some pediatricians – both in counties that have reported cases and in those that haven’t – are reaching out to families directly to raise their awareness of the ongoing outbreak and encourage them to get their children vaccinated.

“I think it’s very important for all of us – and especially on an individual level – to continue to be the voice of truth, if you will, but also the voice of strength and endurance and commitment to our families and our children in Texas,” Dr. Ana Montanez, a pediatrician in Lubbock, said at the briefing Thursday.

Learning about how many vaccinations had been administered in New Mexico bolstered her determination to continue the work she’s been doing to keep her patients and their families safe.

“That extra effort is being made, and there is a difference that is coming out from that, although it may be small and tied up in little experiences,” she said. “But it is making a difference.”

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