LANDRUM, South Carolina — When John Otwell learned about measles exposure warnings at his local Costco, concern for his infant son Arthur and an expected new baby in June made routine errands feel risky.
“We go to the Costco that was kind of a hotbed,” said John Otwell, who knew about the state health department’s warnings of public exposures at the store. “A lot of people just don’t get it; they think it’s just a cold. It’s not.”
Arthur received his MMR vaccination at nine months instead of the standard 12 to 15 months due to South Carolina’s massive outbreak, which became the nation’s largest in over three decades. However, the family’s upcoming newborn must wait until at least six months for protection — a reality causing anxiety for parents nationwide as measles continues spreading.
Infants who haven’t reached vaccination age face the greatest danger during measles outbreaks. The illness can devastate their developing immune systems, causing severe dehydration when babies refuse food and fluids. Complications include pneumonia, brain inflammation, and in some cases, death.
These vulnerable babies rely completely on community-wide immunity — requiring at least 95% vaccination coverage to prevent outbreaks. However, declining immunization rates have weakened this protection throughout South Carolina and nationally. Spartanburg County, where the outbreak centered, shows vaccination rates below 90% among students.
“Babies become sitting ducks,” said Dr. Deborah Greenhouse, a Columbia pediatrician. “The burden is on all of us to protect all of us.”
Political leaders increasingly frame vaccination as personal liberty rather than community health responsibility. Health Secretary Robert F. Kennedy Jr., known for opposing vaccines, has pursued policy changes and overseen significant public health budget reductions. Despite temporary legal obstacles slowing his efforts, numerous state proposals threaten to reduce vaccination requirements further.
South Carolina’s outbreak, reaching approximately 1,000 cases, has begun declining. Nevertheless, measles continues expanding across multiple states, with 17 outbreaks recorded this year following 48 last year. The United States risks losing its measles elimination status.
Dr. Jessica Early never anticipated treating measles patients, but feared for her young patients and her own infant when cases appeared in Greer. She began administering approved MMR doses to babies as young as six months and providing second doses earlier than recommended ages of four to six years.
Health officials frustrate medical professionals by withholding detailed case breakdowns. State authorities reveal only that 253 of 997 cases involved children four and younger, citing privacy concerns for refusing more specific data. Hospital admission numbers remain unknown since facilities aren’t mandated to report measles hospitalizations.
Medical practices fielded numerous inquiries about infant safety in waiting areas and childcare facilities. Thomas Compton, who oversees Miss Tammy’s Little Learning Center locations throughout the affected region, reported 18 families withdrawing children despite no confirmed cases at his facilities. Some families forfeited deposits days before enrollment, forcing staff reductions.
While licensed daycare centers must enforce vaccination requirements, families easily obtain religious exemptions. Approximately one-fifth of Miss Tammy’s 300 enrolled children have vaccination waivers.
“A lot of parents were really stressed out,” Compton said. “Anytime that we had a little sickness going on or something, they were like, ‘Do you think it’s the measles?’”
Investigation revealed Trump administration officials encouraged activists to promote anti-science legislation in state capitals. Nationally, approximately 350 anti-vaccine proposals were introduced through late October, including eight in South Carolina.
Current state legislation would eliminate vaccination requirements for children under two years old.
“In other words, it would get rid of those requirements in the day cares,” pediatrician Greenhouse said. “And for people like me, that is a gut punch that is terrifying.”
Republican State Senator Carlisle Kennedy defended his proposal as protecting parental rights during subcommittee discussions. His August-born baby, facing kidney problems, received customized vaccination scheduling through medical consultation.
“We didn’t want to put vaccines in his body before his body was able to survive them,” he said.
Critics argued that community immunity protects children in such medical situations. The Senate subcommittee approved the legislation, concerning Greenhouse about its potential passage.
“In the climate that we are currently living in, I think any bill potentially could have legs,” she said. “It is our job to do our absolute best to make sure that those legs don’t go anywhere.”
Medical professionals warn that such legislation increases vaccine hesitancy and public confusion, regardless of final outcomes. Some parents tell Greenhouse they believe government recommendations have changed, despite consistent American Academy of Pediatrics guidance.
“They don’t actually know who they can trust,” she said.
Dr. Martha Edwards, leading South Carolina’s American Academy of Pediatrics chapter, noted the state has simplified non-medical exemption processes. Religious exemptions doubled since 2020 in the outbreak’s center, with 4% of students statewide holding such waivers for 2025-26.
“Parental choice is a big buzzword in a lot of the Southern states,” Edwards said. But the choice not to vaccinate, she said, impacts other parents’ rights to keep their children safe.
Medical experts anticipate worsening conditions ahead. The first quarter of 2026 recorded 1,671 measles cases — representing 73% of 2025’s total, the worst year in over thirty years. International health officials will assess America’s measles elimination status this November.
National MMR vaccination rates dropped from 95.2% in 2019-20 to 92.5% among kindergartners in 2024-25, masking dramatically lower rates in specific communities. One Spartanburg County school shows only 21% of students receiving all required immunizations.
Healthcare providers worry about returning to pre-vaccine era disease threats.
“The whole concept of immunization is one of the best things that has ever happened to medicine,” Greenhouse said. “To see that we are actually going backwards is just confounding.”
Helen Kaiser, residing in the outbreak area, vaccinated her twin two-year-old boys ahead of schedule to protect them and their community.
“I would never forgive myself,” she said, “if I knew that my son had gotten another baby very sick and it was something I could have prevented.”
