Vaccination authorities in Mexico race against time due to a measles outbreak spreading from a Mennonite community, causing widespread concern.
Roaming to Rural Outposts: The Battle Against Measles
Situated in a worn-out white Nissan, nurse Sandra Aguirre and her vaccination team venture past verdant apple groves and cornbells leading to the scorching desert. Aguirre knocks on doors throughout one of Latin America's largest Mennonite enclaves, her cooler filled with measles vaccines. In this tight-knit society, she knows many will shy away from vaccines or even close their doors. Yet, some may ask questions, and a select few might agree to receive jabs on the spot.
"We're out here day in and day out," Aguirre said, pausing at an empty farm, calling out to potential residents. "To earn the trust of the Mennonites - since they're reserved and closed-off people - you must meet them on their terms, exhibit a friendly visage."
Aguirre's work is part of a nationwide effort by health authorities across the country to contain Mexico's most significant measles outbreak in years. Infection numbers are rising, not merely in the Mennonite community but throughout the U.S. and Canada. In the northern border state of Chihuahua, cases have primarily concentrated among the Mennonite populace, which harbors longstanding skepticism towards vaccines and mutual suspicions of authorities.
Officials admit their efforts alongside Mennonite leaders have shown mixed results - while reporting tens of thousands of new vaccinations in Chihuahua, infections have increased, and the spread of the virus to other populations has occurred.
In Chihuahua, officials have documented 922 cases and a single death. Numerous local leaders, health workers, and officials claim that these numbers may be underestimated, highlighting misinformation about vaccines and deep-rooted distrust of authorities as their main challenges.
Cramped together along the edges of the tiny northern city of Cuauhtemoc, the Mennonite settlement here encompasses approximately 40 kilometers (25 miles). With 23,000 residents, it serves as one of Cuauhtemoc's crucial economic engines. Yet, it remains an insular haven where families keep to themselves. Some have turned to social media and anti-vaccine websites for research, while others employ little technology and visit family in the United States, where they encounter further misinformation, which then spreads through word of mouth.
The community's location in Chihuahua is especially concerning for authorities, as a border state, the risk of the preventable disease continuing its spread internationally and affecting the most vulnerable is substantial.
"We have a massive flow of people," said Alexis Hernández, a Cuauhtemoc health official. "That makes things a lot more complicated."
The Resurgence of Measles in Mexico
Mexico once declared measles eradicated in 1998. Yet, its vaccination rate against the virus hovers around 76% as of 2023, according to the World Health Organization, a decrease from previous years, and far below the 95% rate experts believe is necessary to prevent outbreaks.
Mexico's current outbreak began in March, with officials tracing it back to an 8-year-old unvaccinated Mennonite boy who visited relatives in Seminole, Texas, the epicenter of the U.S. outbreak.
Cases quickly multiplied amongst Chihuahua's 46,000-strong Mennonite community via schools and churches, according to religious and health leaders. From there, they spreading to workers in orchards and cheese plants.
Gloria Elizabeth Vega, an Indigenous Raramuri woman and single mother, fell ill in March. Though vaccinated, measles didn't occur to her until hives started appearing. Her supervisor at the cheese factory, also infected, told her to take ten days of leave and withheld 40% of her pay for the week, Vega explained.
It's uncommon for vaccinated individuals to contract measles, but officials suggest that this might account for up to 10% of cases here, albeit typically in milder forms.
Vega secluded herself in the back of her two-room dwelling, hoping her daughter and mother - both vaccinated - would remain healthy. She wishes people would consider others when considering vaccination.
"They say, 'Well, I have enough to make it,'" she said. "But they don't ponder if that other person nearby might not have enough, or if that person has the means to live."
Vaccination isn't mandatory in Mexico. Schools can request vaccination records, federal health department spokesman Carlos Mateos said, but they cannot bar entry to education.
In Chihuahua, some schools have begun reaching out to parents for copies of vaccination cards and encouraging shots, said Rodolfo Cortés, state health ministry spokesman.
The vaccination rate within the Mennonite community remains unclear.
Gabriella Villegas, head of vaccination at a clinic treating Mennonites with measles, estimated 70% of community members haven't been vaccinated. Other health authorities have estimated the vaccination rate closer to 50%.
Along with Measles, Misinformation Spreads
Mennonites who spoke with The Associated Press, usually on condition of anonymity, fearing retribution, repeatedly pointed to vaccine misinformation. One man hailed U.S. Health Secretary Robert F. Kennedy Jr., who has a long track record of advocating against vaccines and has called vaccination a personal choice, as a hero.
"I don't accept vaccines; it's that simple," said the man, Jacob Goertzen. "Since we don't live in a democracy, if we can't make our own decisions, we're not really living."
Cuauhtemoc's health director, Hernández, attributes the community's vaccine beliefs to outside influences.
"The Mennonite population is exposed to a lot of social media and family members in the U.S. and Canada, where numerous myths have taken root and more 'anti-vaccine' groups exist than those in Mexico," he said.
During nurse Aguirre's vaccination campaign, one man simply stated that the Mennonites "prefer to heal themselves in their way." A mother described getting measles as a "privilege" and spoke of intentionally exposing her unvaccinated 5- and 7-year-olds at a party so that everyone could contract and recover - a dangerous strategy that medical professionals have long criticized.
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Consequences for the Vaccine-Wary
Mexico's single death from measles was a 31-year-old Mennonite man in the settlement, who also suffered from diabetes and high blood pressure, underlying conditions that often exacerbate illnesses.
Health officials are particularly worried about vulnerable populations, including Indigenous groups, many of whom have fewer resources to cope. Vega, the single mother who caught measles, said her position at the cheese factory used to be a blessing, providing health insurance and stable pay. Yet, the forced leave and docked pay left her in a precarious financial position. She now grapples with paying bills, her daughter's school supplies, lunches, and tennis shoes.
"I have a daughter to support," she said. "It's not like I have the luxury to wait and save up for things, like food."
- Nurse Sandra Aguirre, venturing in her white Nissan, approaches the Mennonite settlement in Cuauhtemoc, Mexico, where she has to be friendly and understanding to earn the community's trust.
- Aguirre's work in outreach is part of a broader effort to combat Mexico's resurgent measles outbreak, a nationwide effort which includes school and church networks.
- In the nearby northern border state of Chihuahua, where measles cases have primarily focused on the Mennonite population, vaccine skepticism and distrust of authorities remain significant challenges.
- Aguirre's efforts and those of other health officials are undertaken in the face of misinformation about vaccines, which has caused increasing infections despite the tens of thousands of new vaccinations documented in Chihuahua.
- Alexis Hernández, a Cuauhtemoc health official, expresses concern about the spread of measles to other populations due to the community's location in a border state and its international connections.
- Vaccination is not mandatory in Mexico, making it essential for schools and authorities to emphasize the importance of inoculations through education and outreach.
- Gloria Elizabeth Vega, a vaccinated worker who contracted measles, advocates for fellow community members to consider the potential consequences their choices might have for the vulnerable around them when deciding about vaccination.
