South Carolina’s measles outbreak shows chilling effect of vaccine misinformation – CNN

Report on Measles Outbreak in South Carolina and Implications for Sustainable Development Goals

Executive Summary

An ongoing measles outbreak in Spartanburg County, South Carolina, presents a significant challenge to public health and undermines progress toward several United Nations Sustainable Development Goals (SDGs). This report analyzes the outbreak’s root causes, including low vaccination rates, public skepticism, and political polarization, through the lens of SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), and SDG 16 (Peace, Justice, and Strong Institutions). The low public uptake of free vaccination services, despite a growing public health crisis, highlights a critical disconnect between health infrastructure and community engagement, threatening to reverse decades of progress in disease prevention.

Challenges to SDG 3: Good Health and Well-being

The resurgence of measles directly contravenes SDG Target 3.3, which aims to end epidemics of communicable diseases by 2030. The situation in South Carolina and across the United States illustrates a regression in public health outcomes.

1. Insufficient Vaccination Coverage: Spartanburg County’s immunization rate has fallen to 90%, below the 95% threshold required for community protection (herd immunity). This failure to ensure widespread vaccine access and acceptance is a direct barrier to achieving universal health coverage as outlined in SDG Target 3.8.
2. Low Uptake of Public Health Interventions: A mobile clinic established by the South Carolina Department of Public Health to provide free vaccines reported extremely low attendance, with only one person showing up on a particular day. This indicates that availability alone is insufficient to guarantee public health security.
3. National Public Health Threat: The United States has documented over 1,700 measles cases and 45 outbreaks in 2025. This trend jeopardizes the nation’s measles elimination status, a critical public health achievement aligned with global goals to eradicate preventable diseases.

Impact on SDG 4: Quality Education

The outbreak is intrinsically linked to the educational system, compromising the goal of providing safe and inclusive learning environments for all children (SDG Target 4.a).

• Vulnerability within Schools: Approximately 10% of students in Spartanburg County schools, totaling nearly 6,000 children, are not compliant with required vaccinations. This creates a high-risk environment for disease transmission within educational facilities.
• Escalating Exemption Rates: The number of religious exemptions from vaccination requirements in South Carolina’s Upstate region has increased sixfold in the last decade, rising from 2,044 to over 13,000. This trend undermines policies designed to protect the collective health of the student population.
• Concentrated Outbreak Epicenter: The outbreak was largely traced to a public charter school where only 17% of students had documentation of required vaccinations, demonstrating a critical failure in ensuring a safe school environment and highlighting inequalities in health protection among student bodies.

Erosion of Trust and its Effect on SDG 16: Peace, Justice, and Strong Institutions

The effectiveness of public health initiatives relies on public trust and strong, accountable institutions (SDG Target 16.6). The current environment of skepticism and political interference weakens these foundations.

1. Pervasive Misinformation: Skepticism toward historically accepted childhood vaccines has been exacerbated by misinformation surrounding COVID-19 vaccines and ideologies promoted by nonmedical and political leaders. This erodes public trust in scientific institutions.
2. Politicization of Public Health: The concept of “health freedom” has been adopted as a political talking point, creating a “chilling effect” that discourages robust public health advocacy from state and local leaders. This politicization hinders the ability of institutions to implement effective, evidence-based policies.
3. Weakening of Health Agencies: Public health leaders, such as South Carolina’s interim public health director, have faced political opposition for their support of established public health measures. This undermines the authority and stability of the very institutions tasked with protecting community well-being.

Analysis of SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: This is the primary SDG addressed. The article focuses on a measles outbreak, a preventable communicable disease. It discusses vaccination rates, public health responses, the spread of the virus, and the health risks involved, including deaths. The core theme is the challenge of ensuring healthy lives and promoting well-being for all ages in the face of declining immunization coverage.
• SDG 16: Peace, Justice and Strong Institutions: The article highlights challenges related to public institutions. It describes how political ideologies (“health freedom”), misinformation spread by political figures, and political pressure are weakening the effectiveness of public health agencies. The failure to confirm the public health director in South Carolina and the hesitancy of leaders to promote vaccines are examples of institutional challenges that impact public health outcomes.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being
   • Target 3.3: “By 2030, end the epidemics of… communicable diseases.” The article is entirely about the failure to contain a measles outbreak, which is a communicable disease. It states that “public health officials across the nation are concerned that the highly contagious virus is making a major comeback” and that the U.S. “is poised to lose its measles elimination status,” directly addressing the challenge of ending epidemics.
   • Target 3.8: “Achieve universal health coverage, including… access to… effective… and affordable essential… vaccines for all.” The article mentions efforts to provide access to vaccines through a “pop-up clinic… offering free measles vaccines to adults and children.” However, it also highlights the failure in uptake (“only one person showed up”), indicating that mere access is insufficient to achieve the goal when other factors like misinformation are at play.
   • Target 3.d: “Strengthen the capacity of all countries… for early warning, risk reduction and management of national and global health risks.” The article details the public health response to the measles outbreak in Spartanburg County, including the use of mobile vaccine clinics and quarantine measures (“more than 130 people remained in quarantine”). This demonstrates the management of a national health risk, although the effectiveness of this response is questioned due to low vaccine uptake and political interference.
2. SDG 16: Peace, Justice and Strong Institutions
   • Target 16.6: “Develop effective, accountable and transparent institutions at all levels.” The article provides evidence of public health institutions being rendered less effective. The South Carolina Department of Public Health’s push for measles vaccines is described as “notably quieter than the agency’s covid vaccine outreach efforts.” Furthermore, its director, Edward Simmer, was not permanently confirmed by lawmakers “because of his past support for covid vaccines and masking,” which directly impacts the institution’s leadership and stability.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions several quantitative and qualitative indicators that can be used to measure progress.

• Incidence of communicable disease (related to Target 3.3): The article provides specific numbers on the scale of the outbreak.
  • “more than 50 cases identified” in Spartanburg County.
  • “more than 1,700 measles cases and 45 outbreaks in 2025” nationally.
  • “two children died” in the Texas outbreak.
• Vaccination coverage (related to Target 3.8): The article provides detailed data on vaccination rates, which is a direct measure of access to and uptake of essential vaccines.
  • The overall percentage of students with required immunizations in Spartanburg fell from 95.1% to 90%.
  • The public health minimum threshold for preventing spread is 95%.
  • At one specific charter school, only 17% of students had their required vaccinations.
  • The number of religious exemptions in the Upstate region increased sixfold over a decade, from 2,044 to over 13,000.
• Effectiveness of public health interventions (related to Target 3.d): The article provides data on the public health response.
  • The Department of Public Health administered only “44 doses of the MMR vaccine through its mobile health unit from October to mid-November.”
  • However, providers across the county administered “more than twice as many measles vaccines in October as they did a year ago,” suggesting some response from the public through other channels.
• Strength and independence of public institutions (related to Target 16.6): While not a formal UN indicator, the article provides qualitative evidence of institutional weakening.
  • The public health director leads the agency “in an interim capacity” after lawmakers “voted against his permanent confirmation.” This indicates political interference affecting the stability and effectiveness of a key public health institution.

4. Table of SDGs, Targets, and Indicators

Source: cnn.com