There were 285 cases reported in the US last year, the most since 2019, according to the US Centers for Disease Control and Prevention. And cases have already emerged in 2025: Two cases of measles were detected in metro Atlanta last week; this week, one case was confirmed in New Mexico, and an outbreak in West Texas is growing, with 24 cases, according to the state health department. Cases have also been identified in Alaska, Rhode Island and New York City.

Measles is a highly contagious airborne illness that can cause rash, fever, red eyes and cough. Severe cases can result in blindness, pneumonia or encephalitis, swelling of the brain according to the World Health Organization. In some cases, the illness can be fatal.

Prior to the introduction of the measles vaccine in 1963, the virus would claim an estimated 2.6 million lives each year worldwide. In 2023, WHO estimated that there were 107,500 measles deaths, largely in countries with low vaccination.

“We’ve eliminated the memory of measles. I don’t think people remember how sick that can make you,” said Dr. Paul Offit, director of the Vaccine Education Program at the Children’s Hospital of Philadelphia.

Experts say it’s a good time for everyone to be thinking about their immunity to measles.

Vaccination is the best protection

The best way to stay protected against measles is to get vaccinated, according to experts. The measles, mumps and rubella (MMR) vaccine is 93% effective against measles after one dose and 97% effective against measles after two, according to the CDC.

Officials’ guidance says children should get two doses of the MMR vaccine: the first dose between 12 and 15 months and the second around age 4, before starting school.

“When people consider their choice about vaccinating their child, it isn’t just about their own individual child, but this is a public health issue. … If we just stop thinking about the health of the population, we are going to see more and more vaccine-preventable illness, outbreaks occur,” said Dr. Christina Johns, a pediatric emergency physician at PM Pediatrics.

Older children or adults can also get vaccinated if they didn’t get the vaccine as a child, she says. However, people born before 1957 are likely to have been naturally infected and thus already have immunity, according to the CDC.

CDC guidance also indicates that if someone is exposed to measles, getting the MMR vaccine within 72 hours could induce some protection or result in less serious illness.

Across the country, cases are rising now in large part due to declining vaccination rates, which Johns said stems from “the misinformation and disinformation campaigns that have gone wild and run rampant.”

A record share of US kindergartners had an exemption for required vaccinations last school year, leaving more than 125,000 new schoolchildren without coverage for at least one state-mandated vaccine, according to data published by the CDC in October.

The US Department of Health and Human Services has set a goal that at least 95% of children in kindergarten will have gotten two doses of the MMR vaccine, a threshold necessary to help prevent outbreaks of the highly contagious disease. The US has now fallen short of that threshold for four years in a row.

Should you check your immunity?

Titer tests at a primary-care office can be used to check for immunity against measles. Some doctors say that this is not necessary, though, if you have gotten both recommended doses of the MMR vaccine or have had the measles itself.

Titer tests can detect the presence of antibodies – infection fighting proteins produced by immune cells in response to a specific foreign pathogen – at high concentrations. When you have an infection or you get vaccinated, your immune cells learn how to produce antibodies against the virus and can stay in your system for years, helping fight repeat or future infections.

In the case of measles, a virus with a longer incubation period, the body has longer to prepare to fight the infection, including more time to produce antibodies. So even if the titer tests don’t show high levels of antibodies, your immune memory cells may still be able to respond to the virus quickly, according to Offit.

“All you need is memory,” he said. “It’s not likely tested in a commercial laboratory.”

The commercial laboratory tests or titer tests are most useful for people who don’t know their vaccination status, experts say.

This happens “particularly if they don’t have access to their own vaccination records, which is so often the case because people move, pediatric practices go – the pediatrician passes away or retires and you can’t contact the office anymore,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center.

Doctors may also want to test people who have weakened immune systems to see how much immunity they have to measles. In this case, immunosuppressed patients may not be eligible for the vaccine, which uses live but weakened form of the virus, but they may want information about their immunity status and to discuss further with providers.

Do adults need booster shots?

If you were vaccinated with the first version of the measles vaccine – a killed-virus vaccine used between 1963 and 1968 – or don’t know which type of vaccine you received, the CDC recommends getting at least one dose of MMR.

Experts say that those who received two doses of the current MMR vaccine will probably have measles immunity for their entire life.

“Less than 1% of people who are fully vaccinated will have waning immunity to measles to the point where they are susceptible to infection,” Johns said. “As we age, all types of immunity have the potential to wane, but fully vaccinated folks are generally considered protected from infection for their lifetime.”

During mumps outbreaks, it is possible that local authorities may recommend additional MMR doses for those who are at risk of heavy exposure, according to the CDC.

For measles, Schaffner says some people may find that they have low titers of antibodies after testing and, “in conjunction with their physicians, decide to get another dose of the vaccine booster. And I’d say there’s no harm to that as far as we know, but the benefit is uncertain.”

An Oklahoma bill is being proposed which will allow medications such as Ivermectin to be purchased over the counter in the Sooner State.

The Bill is SB426 and is authored by Oklahoma Freedom Caucus Chairman Shane Jett (R-Shawnee).

The bill requires pharmacies in the state to make chloroquine, hydroxychloroquine and ivermectin over the counter drugs.

Ivermectin became world-wide known seemingly overnight during the COVID pandemic.

If a pharmacy or pharmacist does not make those drugs over the counter medicine, then the State Board of Pharmacy is to revoke their license immediately.

The bill has yet to be heard by a committee.

Scientists have identified a probiotic in dairy fermentation that may help alleviate and reverse some autism symptoms.

Currently patients can only use antipsychotics, antidepressants, stimulants and anti-anxiety medications for treatments, but the new study suggests a natural method could just as effective.

The discovery was made using genetically modified mice that were prone to autism-like symptoms.

When modified, the mice exhibited symptoms of the disorder like a reduced interest in social interactions and an imbalance in the key neurotransmitters crucial for functions like learning, memory and cognitive processes.

Researchers gave the animals a daily dose of the probiotic Lactobacillus murinus (a type of bacteria commonly found in dairy products like cheese and yogurt) for one month.

Following the experiment, the mice’s brains became more flexible and adaptable, which helped them learn and remember things better.

The treatment also led to recovery of the intestines and other genes that are impacted by the disorder.

Around one in 36 children has been diagnosed with autism spectrum disorder (ASD) in the US, according to the CDC’s most recent estimate.

What causes the disorder is unknown. Research has pointed to growing pollution and chemical contamination in food and water may allow toxins to infiltrate the bloodstream of pregnant mothers and travel to the brain of the developing fetus, causing inflammation that impairs nerve signals that lead to autism.

Most children cannot be diagnosed until at least four years old and the current treatments include behavioral and speech therapies.

But the Chinese scientists may have uncovered a treatment in common foods that could complement behavioral interventions with minimal side effects, they said.

The study used 34 mice that had 13 pairs from their CHD8 gene removed, which disrupted protein production, South China Morning Post reported.

The mice then began to show autism-like behaviors, including anxiety, problems with socializing and memory.

Other research has found that gut bacteria can impact brain functions through the gut-brain axis, the complex network of communication between the gastrointestinal tract and the central nervous system.

That led the team to test if Lactobacillus murinus could be a treatment for autism.

The probiotic is known for its anti‐inflammatory and antibacterial actions. It has also been found to ease depression.

The mice were given Lactobacillus murinus over the course of 30 days, allowing researchers to monitor their behavior and internal progress.

Not only did their social behaviors reverse, but the intestine started to return to normal.

A 2022 study conducted at China’s Zhujiang Hospital found underdeveloped intestines could be a significant factor in driving autism-related gut microbiota and behavioral issues.

The new research also found the excitatory/inhibitory (E/I) balance in the brain’s cortex showed a trend toward recovery.

This balance of neural activity in the brain involves excitation and inhibition and is a key factor in how the brain processes information and generates oscillatory activity.

Individuals with autism often have lower levels of dopamine D2 receptors, a protein that helps regulate movement, learning, memory, reward and attention.

But following the probiotic treatment, researchers observed a burst in levels that suggested the cells were recovering.

Several brain pathways related to behavior, synapse organization and inflammation also improved.

The team looked a genes that were rescued by the treatment, finding a large amount occurred in astrocytes that regulate things like neurotransmitters and metabolism.

While excitatory neurons held the largest proportion of recovery. These are involved in the transmission of signals in the brain.

The researchers said the findings show that Lactobacillus murinus ‘[improves ASD-related social behavior deficits through bacteria-gut-brain communication.’

‘Our findings align with and extend previous research, which has shown that Lactobacillus murinu rescues behavioral deficits.’

Colorado’s spending on highly effective but costly weight-loss drugs for state workers more than quadrupled from 2023 to 2024 — and costs have been doubling every six months.

Now, the state wants to scrap the benefit, arguing that it’s financially unsustainable.

But the potential removal of the popular benefit has sparked blowback among state workers. The state employees’ union argues ending coverage will cost the health plan in other ways — increasing spending on obesity-related diseases and leading to a less healthy workforce.

“[State employees] are very upset about this,” said Hilary Glasgow, executive director of the union, Colorado WINS. “Long-term obesity drives a lot of the major fatal diseases in America, and the employees I’ve talked to feel like they’re losing a lifeline that got thrown to them.”

The Colorado case underscores the broader struggle of states — many of which are facing budget shortfalls this year — that cover weight-loss drugs like Ozempic and Wegovy for state workers. Over the past three years, a growing number of states have taken leaps of faith in covering the expensive class of drugs, hoping that the benefit would lead to healthier workforces that would be less expensive to insure.

But with the number of prescriptions skyrocketing past projections — more than 1 in 10 Americans reported taking a GLP-1 drug, according to a May 2024 KFF Health Tracking poll — some states are limiting or ending the benefit.

At least two others — North Carolina and West Virginia — have already eliminated coverage due to cost concerns. That means state employees seeking the drugs for weight loss in those states will have to pay up to $1,500 a month for the treatments.

The issue is forcing states into difficult deliberations: Keep covering the drugs and risk depleting their budgets — and potentially increase premiums for everyone on their plans — or eliminate a benefit that many employees now rely on.

The dilemma also comes as states face their toughest budgetary pressures in years, in large part because federal cash they received during the pandemic has disappeared. And the Trump administration’s aggressive efforts to slash federal funding threatens to create further fiscal duress for states.

In a Fox News interview that aired Sunday, President Donald Trump lambasted the high price of the drugs.

“In London you get it for $88. In New York you get it for $1,200,” he said. “It’s very unfair.”

And if Trump follows through on his threat to impose tariffs on Denmark, the move could further drive up the costs of Ozempic and Wegovy, which are manufactured by Danish drugmaker Novo Nordisk — and create even greater fiscal challenges for state policymakers.

“The problem is the near-term cost is so high, and the benefits that you would gain are over a longer-term period,” said Charles Sallee, director of the New Mexico Legislative Finance Committee, which is exploring options to reduce the costs of covering the drugs for state employees. “But is that person still going to be in your health plan five years from now?”

Balancing costs and benefits

Because states can choose whether to cover GLP-1 drugs for weight loss, there is a patchwork of coverage for state employees across the country. At least 17 state employee health plans — an almost even mix of red and blue states — cover the drugs for weight loss, according to the Leverage Obesity Coverage Nexus.

The potential market for the drugs is massive — more than 40 percent of adults in the U.S. are obese — and has seen explosive growth. The number of Americans taking GLP-1s for weight loss rose more than 700 percent between 2019 and 2023, according to a recent study.

North Carolina opted to end coverage of the drugs for weight loss last year after estimating that the costs over the next six years could reach more than $1 billion. And West Virginia last year abruptly ended a subsidy program that helped state employees pay for the weight-loss drugs, saying the treatments were too expensive. Both states still cover the drugs for other conditions, like diabetes and cardiovascular disease.

Delaware started covering GLP-1s for weight loss for state employees in 2023, expecting to spend $1.8 million that year. The state ended up spending $14.2 million. For 2025, the plan expects to spend $52.8 million on weight-loss drugs.

The plan raised premiums 27 percent for fiscal year 2025 to address rising costs of prescription drugs and increased health care expenses overall. The state committee that manages the health plan has had discussions about limiting, or potentially ending, coverage. But adding restrictions raises another risk: Drugmakers might threaten to pull back tens of millions of dollars in rebates that plans receive for offering coverage.

“Once you’ve done it, it is difficult to take it away,” said Shaun O’Brien, a member of the Delaware State Employee Benefits Committee and the policy director of the American Federation of State, County, and Municipal Employees.

The health plan for New Mexico’s nearly 60,000 state and local government workers is projecting a $85 million budget shortfall in fiscal year 2025, according to a presentation from the state Health Care Authority obtained by POLITICO. The agency, which runs the plan, estimates GLP-1 costs for weight loss alone may exceed $20 million in 2025.

The Health Care Authority is projecting a $87 million budget shortfall and a more than 10 percent increase in drug spending in fiscal year 2026, largely driven by GLP-1 costs, according to the presentation. That means the plan would need a 29 percent premium increase in 2026 to cover the rising costs of medical and prescription drug claims.

New Mexico is struggling to contain the costs without ending coverage, said Sallee, the director of the Legislative Finance Committee. The panel is working with the Health Care Authority on options — including more restrictions on who can access the drugs, like a higher BMI threshold.

“Taking away what is widely seen as a highly effective drug at helping people lead healthier lives purely based on cost of a drug could be challenging,” said Sallee. “We should be working on getting better prices for the drugs.”

The committee has also floated purchasing compounded versions of the drugs, which can be cheaper than brand-name versions sold by drugmakers like Novo Nordisk and Eli Lilly. Compounded drugs contain the same basic ingredients as the brand-name versions, but the FDA doesn’t review them for safety and efficacy, posing risks for states looking to purchase them directly.

Colorado’s state employee union is trying to get Democratic Gov. Jared Polis to keep coverage of the drugs, which his administration proposed scrapping in its latest budget request. The state is facing a $1 billion budget shortfall, and the threat of suspension of some federal funding is compounding the financial challenges. Colorado WINS and the governor’s office are weighing how to continue covering the drugs against how much premiums might increase for everyone on the plan due to rising costs.

“To eliminate GLP-1s is short-sighted because of the cost of life-saving drugs later on for things like heart disease, cancer — the myriad of diseases that are driven by obesity or have obesity as a factor,” said Glasgow, the union executive director.

“Going in the wrong direction”

Connecticut’s state employee health plan last year took an experimental approach to coverage — requiring employees to enroll in a lifestyle management program called Flyte before receiving the medications. The program offers tools for weight management and personalized care plans. The state hoped adding the requirement would reverse the drugs’ cost trend, which was projected to reach $30 million in 2023.

The program showed early success in reducing the number of GLP-1 prescriptions, cutting the cost trend in half. The experiment also offered a potential road map for other organizations working through how to afford the drugs.

And clinically, the program has been a success: Enrollees have had a 16 percent drop in weight and BMI and a 14 percent drop in blood pressure. The outcomes have led to a happier and more productive workforce, said Connecticut State Comptroller Sean Scanlon.

But 19 months in, more and more state employees are enrolling in the program. Between October and January, more than 3,500 state employees joined Flyte, bringing the total to nearly 12,000 members. And while the program initially slashed the state’s $30 million cost for the drugs in half, those costs are creeping back up. The state now projects it will spend $23 million on the treatments in fiscal year 2025.

“Our cost trend is kind of now going back in the wrong direction,” said Scanlon. “But at the end of the day, I still believe that this is the right policy.”