Utah has become the epicenter of a national measles outbreak. The public health crisis has concentrated in the state’s southwest corner, where health officials are struggling to find messaging that resonates in communities with some of the state’s highest rates of unvaccinated residents.

“We’ve seen higher and higher rates of parents exempting their kids from vaccines over the past four or five years,” David Heaton, the public information officer for the Southwest Utah Public Health Department, said. “That’s what’s left us open to have this outbreak come through.”

The Southwest Utah Public Health Department serves Beaver, Garfield, Iron, Kane and Washington counties. There, 260 measles cases have been reported, at a rate of more than 91 in 100,000 people, and with more than 600 cases across the state so far, Utah state epidemiologist Leisha Nolen says she is “very concerned” a Utahn could soon die from the measles.

But many Utahns do not have good information about the disease and the success of vaccines, public health officials warn, and they are struggling with how to address the spread without alienating vaccine skeptics. This has meant the state has taken a somewhat cautious response, asking local health departments to tailor their responses to the regional needs, and is thus far avoiding a COVID-esque vaccination and quarantine effort.

This stands in contrast to South Carolina’s response, which was until recently the center of the measles outbreak. The state’s health department put together weekly news briefings, a mobile health clinic and quarantines for unvaccinated people exposed to the virus, according to the South Carolina Department of Public Health’s website.

And their efforts seem to have been successful: The state saw 997 cases, but no new infections have been reported in about a month, leading health officials there to say the outbreak is now nearing its end.

In Utah, there has been no comparable public briefing schedule or enforcement strategy, and the state’s last press conference on the virus was in early March, where state health officials asked the public to help them stop the spread.

But cases are going down. State data shows that new cases have been trending downward since late March. Of the 638 measles cases in the state, 540 have been among people who have not been vaccinated, while just 63 have been among vaccinated people and 35 among people whose vaccination status is unknown, according to the latest DHHS data.

Vaccine resistance

Since the outbreak began in June 2025, Heaton said clinics in southwest Utah have seen a slight uptick in parents bringing in children for the measles, mumps and rubella vaccine, mostly from hesitant parents now opting to get their kids at least one dose during the outbreak.

He said the department has the capacity to expand response efforts, including pop-up vaccination clinics across its five-county region, but so far there has been little demand, and no direction from the state to do so.

“At some point it falls on personal responsibility,” Heaton said. “Once everyone’s immunized that is going to be immunized, it may just need to run its course over this season, or maybe even a couple of years.”

And although health care providers who diagnose or suspect a patient has measles are required to report that to the state, Nolen said she is “quite confident” there are other cases of people who do not seek care and thus are not reported.

But she is confident about the downward trend, a success the state epidemiologist credits to some communities banding together to get vaccinated and avoid the spread of disease — but messaging about vaccines is tricky in a state with a heavily Republican population that is highly supportive of the “Make America Healthy Again” agenda.

“It is so complex right now,” Nolen said. “The key thing is, everybody wants their kids to be safe. There’s no question about that.”

Many people, she said, are getting misinformation on social media, and don’t know where else to look — and are not inclined to trust state officials.

“There’s no question that the COVID outbreak has affected how people are responding to this outbreak,” she said. “There’s been a lot of trust that’s been broken, and a lot of people that are more suspicious of different public health actions or vaccines, and that makes it even harder to be able to help and control this specific outbreak.”

‘Coordinated autonomy’

This presents a challenge for health officials, who are concerned pushing too hard for vaccines or implementing a top-down approach to the outbreak could backfire. Instead, both Nolen and Utah’s Department of Health and Human Services spokesperson Mike Grass said the state’s current approach is a sort of “coordinated autonomy.”

Grass said state-level officials talk weekly about the outbreak, and that the 13 health departments throughout Utah meet biweekly about the measles with DHHS and talk daily on a WhatsApp group. There has been no standardized statewide response to the outbreak passed down from state officials.

“We’re putting out social content related to recommendations from a statewide perspective,” Grass said, noting the state is encouraging people to talk to their doctors and reminding them that the measles vaccine — known as the MMR vaccine — is proven to be effective.

But, he said, the state relies heavily on the 13 regional health departments to talk to their communities. “Because they know their communities,” Grass said, “so they know what’s going to resonate.”

In southwest Utah, Heaton said the health department has focused on messaging that encourages vaccination and reducing the spread while avoiding “message fatigue.”

To reach residents, he said the department uses weekly radio spots, has put out around three to four press releases and mails a public health magazine that comes out periodically.

One message Heaton said has been effective is asking people who suspect they may have measles to call a health care provider before going to a clinic, a step that has helped reduce the number of medical facilities that become exposure sites.

Nolen also said the state has been working with religious leaders to communicate about the spread of measles.

“They are super trusted and a leader in their community, so to have religious leaders be able to talk to their community about this is really, really valuable,” she said.

The goal, Nolen said, is for measles education to come from people closer to the communities — not a government official in Salt Lake City — who residents are more inclined to trust.

Heaton agreed.

“You say all you can in different ways, but it really comes down to what people are willing to do,” Heaton said. “People aren’t worried.”

Most unvaccinated residents are not newly resistant to vaccination, he said, and are unlikely to change their minds. Instead, he said the health department is focusing on parents who are hesitant or simply behind on routine vaccinations.

COVID 2.0?

And while it’s easy to draw parallels between the measles and the COVID pandemic, Nolen said they are not really equivalent public health crises, and that some of the statewide approaches to COVID would not be applicable for addressing the current spread of measles.

For one, most Utahns have already been vaccinated against measles.

According to DHHS data, about 90% of the state population has had the MMR vaccine. The other 10%, however, is not solely a population that does not have access to the vaccine. About half of unvaccinated Utahns, Nolen said, are unvaccinated by choice, meaning pop-up vaccine clinics like those popular during the COVID pandemic are unlikely to be effective.

“We could put up as many vans out there as you want with the measles vaccine on it, and those people are not going to go to them,” Nolen said. “They could even knock on their door and they’re not going to take that vaccine, so that kind of action really isn’t going to work in this situation.”

Instead, she said, the focus has to be on education about the risks and protective measures. Public health is, among other things, about responding to the desires of the public, Nolen added.

“And certainly we can’t do things that the public is not interested in,” she said.

Note to readers• This story has been updated with new state measles data from May 5.