Since the West Texas measles outbreak began in late January, Dr. Ana Montanez, a pediatrician in Lubbock, has had some difficult conversations with families.
There was the worried phone call with the mother of an unvaccinated toddler in Gaines County, the epicenter of the outbreak, who had developed a high fever and persistent cough.
And there have been some tense talks with families about questionable remedies like cod liver oil and vitamin A, both of which have been touted by Robert F. Kennedy Jr., the newly minted health and human services secretary.
“The families that I touch base with in Gaines County — they are fearful and concerned,” said Dr. Montanez, who practices at Texas Tech University Health Science Center. The county has had low childhood vaccination rates for years.
But the “toughest” conversations she has had are with parents of babies under 6 months old, who are too young to be vaccinated against the highly contagious disease, Dr. Montanez said. Aside from urging parents of unvaccinated babies to make sure anyone who spends time with their children is vaccinated, there is only so much comfort she can offer — particularly to those who need to work and send their children to day care.
“I’ll say, ‘If we can’t vaccinate them, I wouldn’t recommend day care,’ ” she said. “‘But I completely understand that you have to work.’ ”
Recently, one of her patients made the financially risky decision not to return to her job in order to stay home and keep her baby safe.
An Easily Transmitted Virus
Measles is one of the most contagious viruses in the world, and can live on surfaces or suspended in the air for two hours. Public health recommendations call for children to receive their first shot to protect against it between 12 months and 15 months old, and a second round between the ages of 4 and 6.
Children living near an outbreak can receive their dose of the measles, mumps, and rubella (MMR) vaccine early — as young as 6 months. Mothers who have been vaccinated or have had the measles pass some antibodies to their newborns that help protect them after birth, though in recent years research has suggested that protection may not be as robust as doctors and researchers once thought.
All of which leaves parents of young babies living in and around the current outbreaks in West Texas and New Mexico — which experts believe are related — in an agonizing situation. As many as one out of every 20 children infected with measles gets pneumonia, according to the Centers for Disease Control and Prevention, and about one out of every 1,000 develops brain swelling.
Nine out of 10 unvaccinated people will become infected with measles if they come into contact with an infected individual, according to the C.D.C., and babies and young children whose immune systems are still developing are at higher risk of serious complications. So a baby who simply breathes in the same air that an infected person has coughed or sneezed in may become sick.
Avoiding Public Places
Jenna Sullivan, a postpartum doula in Lubbock, said she felt awful for her clients who were grappling with added stress on top of what is already such a “vulnerable” time for new parents.
“We’ve had a pretty rough flu season,” Ms. Sullivan said. “And RSV has been making its rounds. Adding measles to that has caused fear for some of my families.”
She has encouraged parents to avoid public spaces as much as possible — there have been exposures at Walmart and Target, for instance — but acknowledged that doing so isn’t always possible. Babies require frequent checkups, and mothers may need to see a doctor or a lactation specialist, she said, though recently she has been helping clients arrange house calls rather than going to an office or clinic.
Dr. Montanez and other local pediatricians said they were returning to Covid-era strategies to protect babies and offer parents a sense of comfort — reserving early morning visits for families with young babies, and allowing patients to be seen in their cars to avoid exposures in the waiting room. Still, on Thursday, she said, there was an exposure in the newborn nursery, which she and her colleagues are now warning families about.
Pediatricians also said they were administering more MMR vaccinations than usual. At Leaps & Bounds, a private pediatric practice in Lubbock (a county that so far has had three reported measles cases during the outbreak), providers typically give about 20 MMR vaccinations a month. Since the outbreak, they have given more than 160.
“Obviously, parents are very concerned at this point,” said Dr. Todd Brodbeck, a pediatrician with West Texas Pediatrics, also in Lubbock. “We get a lot of phone calls, a lot of questions about: Are my kids protected? Have we had these vaccines?”
Feeling Vulnerable and Uncertain
Britta Anderson, a 38-year-old first-time mother from Lubbock, felt overwhelming relief when her 13-month-old daughter was vaccinated against measles last month, she said, just as cases in nearby Gaines County began to explode.
“We worked really hard, for a long time, to have her,” Ms. Anderson said, adding: “With the measles, it impacts my awareness of how vulnerable life is. I never, for a second, take her health or her being here for granted.”
She feels reassured about the level of protection her daughter has now (one dose of the MMR vaccine is 93 percent effective against measles), though she plans to ask her daughter’s pediatrician about getting a second dose early. According to the C.D.C., children can receive a second dose of the vaccine before they otherwise normally would — between age 4 and 6 — as long as 28 days have passed since the first dose.
But on a WhatsApp group chat that Ms. Anderson shares with several friends who are mothers, the frustration is palpable. “Definitely there’s a sense of fear and uncertainty — just a sense of not having a lot of power or control,” she said.
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