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In early November, the South Carolina Department of Public Health opened a pop-up mobile vaccine clinic in a library parking lot in Boiling Springs. Dozens of people in South Carolina\u2019s Upstate region have been diagnosed with measles this fall. (Photo by Lauren Sausser\/KFF Health News)<\/p>\n
This article<\/a> first appeared on KFF Health News<\/a>.<\/em><\/p>\n BOILING SPRINGS, S.C. \u2014 Near the back corner of the local library\u2019s parking lot, largely out of view from the main road, the South Carolina Department of Public Health opened a pop-up clinic in early November, offering free measles vaccines to adults and children.<\/p>\n Spartanburg County, in South Carolina\u2019s Upstate region, has been fighting a measles outbreak since early October, with more than 50 cases identified. Health officials have encouraged people who are unvaccinated to get a shot by visiting its mobile vaccine clinic at any of its several stops throughout the county.<\/p>\n But on a Monday afternoon in Boiling Springs, only one person showed up.<\/p>\n \u201cIt\u2019s progress. That progress is slow,\u201d Linda Bell, the state epidemiologist with the Department of Public Health, said during a recent press briefing. \u201cWe had hoped to see a more robust uptake than that in our mobile health units.\u201d<\/p>\n As South Carolina tries to contain its measles outbreak, public health officials across the nation are concerned that the highly contagious virus is making a major comeback. The federal Centers for Disease Control and Prevention has tallied more than 1,700 measles cases<\/a> and 45 outbreaks in 2025. The largest started in Texas<\/a>, where hundreds of people were infected and two children died.<\/p>\n For the first time in more than two decades, the United States is poised to lose its measles elimination status<\/a>, a designation indicating that outbreaks are rare and rapidly contained.<\/p>\n South Carolina\u2019s measles outbreak isn\u2019t yet as large as those in other states, such as New Mexico<\/a>,\u00a0Arizona<\/a>\u00a0and\u00a0Kansas<\/a>. But it shows how a confluence of larger national trends \u2014 including historically low vaccination rates, skepticism fueled by the pandemic, misinformation and \u201chealth freedom\u201d ideologies promoted by conservative politicians \u2014 have put some communities at risk for the reemergence of a preventable, potentially deadly virus.<\/p>\n \u201cEveryone talks about it being the canary in the coal mine because it\u2019s the most contagious infectious disease out there,\u201d said Josh Michaud, associate director for global and public health policy at KFF, a health information nonprofit that includes KFF Health News. \u201cThe logic is indisputable that we\u2019re likely to see more outbreaks.\u201d<\/p>\n Spartanburg\u2019s vaccination rate is among the lowest of South Carolina\u2019s 46 counties. And that was true \u201ceven before COVID,\u201d said Chris Lombardozzi, a senior vice president with the Spartanburg Regional Healthcare System.<\/p>\n Nearly 6,000 children in Spartanburg County schools last year \u2014 10% of the total enrollment \u2014 either received an exemption allowing them to forgo required vaccinations or did not meet vaccine requirements, according to data published by the state.<\/p>\n Lombardozzi said the county\u2019s low vaccination rate is tied to misinformation not only published on social media but also spread by \u201ca variety of nonmedical leaders over the years.\u201d<\/p>\n The pandemic made things worse. Michaud said that fear and misinformation surrounding COVID-19 vaccines \u201cthrew gasoline on the fire of people\u2019s vaccine skepticism.\u201d In some cases, that skepticism transferred to childhood vaccines, which historically have been less controversial, he said.<\/p>\n This made communities like Spartanburg County with low vaccination rates more vulnerable. \u201cWhich is why we\u2019re seeing constant, small brush fires of measles outbreaks,\u201d Michaud said.<\/p>\n In Spartanburg, the overall percentage of students with required immunizations fell from 95.1% to 90% between the 2020-21 and 2024-25 academic years. Public health officials say a minimum of 95% is required to prevent significant spread of measles.<\/p>\n Children who attend public and private schools in South Carolina are required to show that they\u2019ve received some vaccinations, including the measles, mumps and rubella vaccine, but religious exemptions are relatively easy to obtain. The exemption form must be notarized, but it does not require a doctor\u2019s note or any disclosure about the family\u2019s religious beliefs.<\/p>\n The number of students in South Carolina who have been granted religious exemptions has increased dramatically over the past decade. That\u2019s particularly true in the Upstate region, where religious exemptions have increased sixfold from a decade ago. During the 2013-14 school year, 2,044 students in the Upstate were granted a religious exemption to the vaccine requirements, according to data published by The Post and Courier<\/a>. By fall 2024, that number had jumped to more than 13,000.<\/p>\n Some schools are more exposed than others. The beginning of the South Carolina outbreak was largely linked to one public charter school, Global Academy of South Carolina, where only 17% of the 605 students enrolled during the 2024-25 school year provided documentation showing they had received their required vaccinations, according to data published by the Department of Public Health.<\/p>\n No one from Global Academy responded to interview requests.<\/p>\n In April, after visiting a Texas family whose daughter had died from measles, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. wrote on social media that the \u201cmost effective way to prevent the spread of measles is the MMR vaccine.\u201d He made a similar statement during an interview on \u201cDr. Phil\u201d later that month.<\/p>\n But these endorsements stand at odds with other statements Kennedy has made that cast doubt on vaccine safety and have falsely linked vaccines with autism. The CDC, under his authority, now claims such links \u201chave been ignored by health authorities<\/a>.\u201d<\/p>\n \u201cWhat would I do if I could go back in time and I could avoid giving my children the vaccines that I gave them?\u201d he said on a podcast in 2020. \u201cI would do anything for that. I would pay anything to be able to do that.\u201d<\/p>\n Throughout 2025, he has made other misleading or unsupported statements<\/a>. During a congressional hearing in September, Kennedy defended his past claims that he was not anti-vaccine but affirmed his stated position that no vaccines are safe or effective.<\/p>\n Emily Hilliard, a spokesperson for the Department of Health and Human Services, told KFF Health News that Kennedy is \u201cpro-safety, pro-transparency and pro-accountability.\u201d Hilliard said HHS is working with \u201cstate and local partners in South Carolina\u201d and in other states to provide support during the measles outbreaks.<\/p>\n Meanwhile, Kennedy has frequently championed the idea of health freedom, or freedom of choice, regarding vaccines, a talking point that has taken root among Republicans.<\/p>\n That has had a \u201cchilling effect all the way down through state and local lawmakers,\u201d Michaud said, making some leaders hesitant to talk about the threat that the ongoing measles outbreaks poses or the effectiveness and safety of the MMR vaccine.<\/p>\n Brandon Charochak, a spokesperson for South Carolina Gov. Henry McMaster, said the governor was not available to be interviewed for this article but referenced McMaster\u2019s comment from October that measles \u201cis a dangerous disease, but in terms of diseases, it\u2019s not one that we should panic about.\u201d<\/p>\n On a separate occasion that month, the Republican governor said he does not support vaccine mandates. \u201cWe\u2019re not going to have mandates,\u201d he said, \u201cand I think we are responding properly.\u201d<\/p>\n Even though the South Carolina Department of Public Health has repeatedly encouraged measles vaccines, the push has been notably quieter than the agency\u2019s COVID-19 vaccine outreach efforts.<\/p>\n In 2021, for example, the agency partnered with breweries throughout the state for a campaign called \u201cShot and a Chaser,\u201d which rewarded people who got a COVID-19 vaccine with a free beer or soda. By contrast, the pop-up measles vaccine clinic at the Boiling Springs Library featured no flashy signage, no freebies, and wasn\u2019t visible from the library\u2019s main entrance.<\/p>\n Edward Simmer, interim director of the Department of Public Health, would not speak to KFF Health News about the measles outbreak. During a legislative hearing in April, Republican state lawmakers voted against his permanent confirmation because of his past support for COVID-19 vaccines and masking. One lawmaker specifically criticized the agency during that hearing for the Shot and a Chaser campaign.<\/p>\n Public health officials in other states also have been blocked from new roles because of their COVID-19 response. In Missouri, where MMR vaccine rates have declined<\/a> among kindergartners since 2020 and measles cases have been reported this year, Republican lawmakers rejected a public health director<\/a> in 2022 after vaccine opponents protested his appointment.<\/p>\n In South Carolina, Simmer, lacking lawmakers\u2019 confirmation, leads the public health agency in an interim capacity.<\/p>\n South Carolina Sen. Tom Davis of Beaufort was the only Republican on the Senate Medical Affairs Committee who voted to confirm Simmer in April. He told KFF Health News that his Republican colleagues raised valid questions about Simmer\u2019s past support for COVID-19 vaccines.<\/p>\n But, Davis said, it would be \u201ctremendously unfortunate and not beneficial from a public health perspective\u201d if the Republican Party just took a stance against vaccines \u201cas a matter of policy.\u201d<\/p>\n The Department of Public Health had administered 44 doses of the MMR vaccine through its mobile health unit from October to mid-November. The last mobile vaccine clinic was scheduled for Nov. 24. But health officials are encouraged that patients are seeking vaccines elsewhere. The agency\u2019s tracking system shows that providers across Spartanburg County administered more than twice as many measles vaccines in October as they did a year ago.<\/p>\n As of mid-November, more than 130 people remained in quarantine, most of them students at local elementary and middle schools. Cases have also been linked to a church and Greenville-Spartanburg International Airport.<\/p>\n \u201cWe\u2019re reminding people that travel for the upcoming holidays increases the risk of exposures greatly,\u201d said Bell, the state epidemiologist. \u201cDue to that risk, we\u2019re encouraging people to consider getting vaccinated now.\u201d<\/p>\n KFF Health News correspondent Amy Maxmen contributed to this report. KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF \u2014 an independent source of health policy research, polling and journalism. Learn more about KFF<\/a>.<\/em><\/p>\nSchools and \u2018small brush fires\u2019<\/h4>\n
\u2018Health freedom\u2019<\/h4>\n