An Arizona town is at the center of a budding measles outbreak

Mohave County health officials are warning people in the northern Arizona town of Colorado City and its surrounding communities about a growing measles outbreak. Nine cases of the highly contagious disease have been confirmed in the county.

Colorado City, which is situated on the Arizona-Utah border, had a population of about 3,300 people as of the 2020 census. A large portion of its residents are members of the offshoot Fundamentalist Church of Jesus Christ of Latter-day Saints, or FLDS, which has a known vaccine hesitancy.

“We urge residents to become acquainted with the signs, symptoms and available vaccination options,” Mohave County health department spokesperson Danielle Lanaga wrote in an email to Phoenix New Times. “Public health officials are actively identifying exposure locations and notifying individuals who may be at risk.”

Earlier this month, the Mohave County health department reported one positive measles case along the Arizona-Utah border. According to a health department press release, the individual was unvaccinated and had no significant travel history. Other community members were potentially exposed between Aug. 2 and 7 in both Arizona and Utah.

A week after that measles case was reported, the Arizona Department of Health Services, which tests potential measles cases for county health departments, announced that eight additional positive measles cases were identified in Mohave County. In addition to the four reported cases in Navajo County earlier this year, this week’s cases brought Arizona’s total measles cases this year to 13.

Measles is rare, but highly contagious. If one person has it, up to nine out of 10 unvaccinated people nearby will be infected, according to the Centers for Disease Control and Prevention. Serious complications from the illness, such as pneumonia and encephalitis, can lead to death, especially among babies and young children.

The widespread adoption of the measles, mumps and rubella vaccine — or MMR vaccine — effectively eliminated measles in the U.S. in 2000. The MMR vaccine is 97% effective against measles after two doses. Despite that, positive measles cases have been on the rise throughout the country this year as vaccine rates have slipped and vaccine misinformation has increased. Nearly 1,400 cases have been confirmed across 41 states. Per the CDC, 35 outbreaks have been reported and 87% of cases are outbreak-associated.

Mohave County is particularly vulnerable to a measles outbreak. Only 78% of the county’s kindergarten students are vaccinated for measles, which is well below the 95% rate required to achieve herd immunity.

Right now, the county health department is “all hands on deck,” Arizona Public Health Association Director Will Humble told New Times. The county health department team is working, with support from the state health department, to contact-trace to find exposed people and either vaccinate them before the incubation period expires or quarantine them. The Arizona State Public Health Laboratory is “processing the samples” of potential positive measles cases “coming from the county,” ADHS spokesperson Magda Rodriguez wrote to New Times.

About Colorado City

Colorado City is a small town with a median age of only 20, according to the U.S. Census Bureau. For more than a decade, the residents of the former fundamentalist Mormon stronghold had no access to health care for dozens of miles. In December 2019, the Creek Valley Health Clinic opened, bringing modern medicine to the rural area.

During the last few weeks, the clinic has “definitely seen an increase in the MMR vaccine,” clinic CEO Hunter Adams wrote in an email to New Times. The clinic has also seen an increase in community members requesting information about measles symptoms and testing. Since the county health department made the announcement to the community, the clinic has had more than 150 local residents request or receive the MMR vaccine, Adams wrote.

Yet, anti-vaccination sentiments are deeply rooted in the community, which was magnified during COVID-19 over fear of governmental intrusion, according to reporting by the University of Utah Health. Some in the community won’t go to the clinic for religious reasons.

This has resulted in abysmal rates of immunization among the community’s children. According to immunization data schools provided to ADHS, only 7.7% of kindergarten students at Colorado City’s small Cottonwood Elementary have the MMR vaccine. At Masada Charter School, only 40% of kindergarten students are vaccinated against measles. These schools serve only 39 and 50 students, respectively.

While details on the specific positive cases are sparse, at least one confirmed measles case is an eighth-grader at Colorado City’s El Capitan High School, according to a Facebook post by Cottonwood Elementary. The student and his two family members are being quarantined at home, according to the post, but schools remain open and “parents are welcome to send their students understanding that they accept the risk of exposure.”

“These schools are a bad place for cases to be,” Humble told New Times. “There are so many susceptible kids all in the same place.”

Students with “visible signs of illness” will be sent home for three to 21 days if they are positive, according to the post. Remote instruction is also available. The Colorado City Unified School District Governing Board, which has a blog post warning residents about measles on its homepage, will meet on Monday to discuss closing the schools.

However, students attending public or charter schools only represent a small part of the picture. Children are overwhelmingly homeschooled in Colorado City, and according to reporting by 12News, nearly 61% of the town’s homes get money from the state’s Empowerment Scholarship Account program. In fact, there are 476 ESA recipients in 783 homes in Colorado City’s ZIP code. This leaves the rest of the town’s vaccination status relatively unknown.

A large percentage of children being homeschooled could be a good thing in this case, Humble said, as “there’s a good chance these kids weren’t in school at all.” Children who aren’t surrounded by other unvaccinated kids should have a smaller chance of being exposed to measles.

Still, given Mohave County’s poor vaccination rate and the already eight-fold increase in cases week over week, the outbreak in the county may be just getting started.