Lower vaccination rates, less funding could hinder Nebraska’s measles response as number of national cases grows

Nebraska’s public health districts are trying to increase awareness of vaccination benefits, especially those of the MMR vaccine, which help protect people from measles, mumps and rubella – potentially serious diseases caused by viruses.

The Panhandle Public Health District, which announced the state’s first, and so far the only, known case of measles in 2025, has been holding more vaccination clinics in an effort to boost MMR vaccination rates. Health Director Jessica Davies said her district’s partnerships with local hospitals and clinics was a lifeline following the measles case in Sheridan County in late May. Davies said the “appropriately vaccinated” child, who didn’t have any recent travel history at the time, contracted a mild case and has since fully recovered.

“We had been preparing for measles for a while, because as we saw it coming to the states, and then to Kansas, and then Colorado, we continued to increase our communications on it,” Davis said. “And I felt like we responded to the best of our ability.”

Though there were several areas of potential exposure in Sheridan County, including at a Family Dollar store, no related measles cases have been reported, Davies said. But her district is keeping a close eye on more cases continuing to pop up in surrounding states.

“Now, we’re seeing more cases in South Dakota, and there’s a lot of travel to our area too,” Davies said. “We want people to really heed the warning, making sure that they are vaccinated, their families are vaccinated. And especially for the kiddos that are too young to be vaccinated, that we build that wall of immunity around them.”

Since the start of this year, health officials have confirmed cases in every state surrounding Nebraska, including 83 cases in Kansas, 16 in Colorado, seven in Missouri, six in Iowa, four in South Dakota and one in Wyoming.

Only halfway into 2025, the U.S. already just recorded a record number of measles cases since the disease was declared eradicated in 2000. At least 1,277 cases have been reported to health officials this year, according to the U.S. Centers for Disease Control and Prevention (CDC). The previous high was recorded in 2019, when health officials confirmed 1,274 measles cases in the U.S. Three people, including two children, have died this year from measles, according to the CDC.

Davies is concerned there will be more cases reported in Nebraska, since the state’s MMR vaccination rates have continued to trend downward.

“We really need 95% [of the population vaccinated against measles] for herd immunity, and we’re below that,” Davies said. “The concern is that, if this continues to be a trend, how much this can really wear on the response effort.”

The United Health Foundation has Nebraska listed 47th in percentage of childhood immunizations in its “America’s Health Rankings.” A measles case-tracking map from the Johns Hopkins Center for Outbreak Response Innovation shows immunizations vary in Nebraska, with the panhandle having vaccination rates lower than 90%. Northern Nebraska counties appear to have vaccination rates ranging between 90% and 94%. Many of the state’s southern counties show vaccination rates hitting the 95% threshold. Davies worries if Nebraska doesn’t improve its vaccination rates, more cases could get through the vaccination barrier.

“I think that’s what we’re preparing ourselves now for – continuous phases, and what that looks like for balancing staff response and overall response,” Davies said. “We are a small staff, and we really wear a lot of hats.”

Federal and state changes could hinder outbreak responses

The measles outbreak comes at a precarious time with recent federal and state decisions that will affect health education, vaccination programs and financial resources. State senators cut $3.5 million in funding for Nebraska’s 19 public health districts in the budget passed in May. Following the bill’s passage, several public health directors said the cuts will force them to cut back early childhood immunizations, service hours or even staffing.

The back-and-forth grant pauses and terminations on the federal level have affected the number of financial options for health departments, as well. Robert F. Kennedy Jr., the new U.S. Secretary of Health and Human Services under President Trump, has brought a wave of policy changes and staff appointments. RFK Jr. removed all 17 members of the CDC’s Advisory Committee on Immunization Practices, or ACIP, a national advisory panel that helps shape vaccine recommendations and policy for the CDC. Some public health advocates said RFK Jr.’s new appointments to the panel lack “strong, current expertise in vaccines.”

Justin Frederick, the deputy public health director for the Douglas County Health Department, said the future of the ACIP committee could directly impact immunization responses in Nebraska.

“Those decisions on which vaccines were recommended also have a financial component there, as well,” Frederick said. “If they were recommended by the ACIP and signed off by the director of the CDC, the way the laws are written [states] insurance companies have to pay for those. Fifty percent of children in the United States actually get their vaccines through the Vaccines for Children program. That’s all driven by the ACIP committee, so there’s huge potential there for the loss of access to vaccines for kids across this country.”

Frederick said state and federal resources are critical ahead and in the aftermath of measles outbreaks. He said handling one case of measles could easily cost thousands of dollars in case investigation, contact tracing and public notification.

He remembers weathering several measles exposures in Omaha in 2010, when health officials confirmed several cases between four siblings who weren’t vaccinated against measles. There were at least four known periods of public exposure, including at the Omaha’s Henry Doorly Zoo on the grand opening of the Madagascar Exhibit and at a morning mass service on Mother’s Day. The exposure at the zoo included notifying several neighboring states from where kids had traveled.

Frederick pointed to strong vaccination rates at the time for why no more cases were reported in connection to the exposures.

“We may be healthy and not have a large concern for ongoing complications. It’s really hard to know if you’re going to have pneumonia or encephalitis or seizures or be hospitalized due to measles,” Frederick said. “With a lot of these vaccine-preventable diseases, the reason that we may want to get vaccinated is to help our community. We can look at this, not only just from an individual perspective, but from a perspective of, ‘I’m doing my part to keep my community safe.’”

Both public health department representatives, Frederick and Davies, recommended anyone contact their local public health department to verify that they’re updated on their vaccinations. And they encourage anyone with questions on vaccinations to consult their health care provider.

“It’s really important that parents feel confident when they are moving forward with immunizing their children,” Frederick said. “Talk to your pediatrician. Ask those questions. Go prepared. Write questions down, so that you’re confident in the decision that you’re making. It’s really important.”