When Measles Came Back to Appalachia

By: Marcus J. Hopkins

January 28th, 2026

Imagine a United States in which measles is effectively eliminated, with fewer than 100 cases diagnosed nationwide each year.

You needn't imagine too hard: that was the case in the year 2000.

26 years later, and measles has seen a resurgence, not because the virus mutated, but because certain segments of the American populace have become convinced that vaccines are dangerous, and have opted to place the lives of their children and the children of others at risk.

"It's just a rash!" "It's not that big a deal!" "My grandfather got measles, and he turned out just fine!"

We are effectively living in the third generation of American residents for whom measles has been a rarity, thanks not to prayer and good feelings, but to science.

And yet, in the Year of Our Lord, Two-Thousand and Twenty-Six, good feelings and prayer have replaced competence and reasoned thinking.

A disease that primarily impacts children, measles is a highly infectious disease that can be very easily spread when someone coughs, sneezes, or even breathes near someone who is unvaccinated (World Health Organization, 2025).

While most children will recover, measles can have serious negative consequences, including:

• 1 in 5 unvaccinated people being hospitalized

• 1 in 20 children developing pneumonia, the most common cause of measles-related death among young children

• 1 in 1,000 children developing encephalitis, potentially leading to convulsions and/or leaving children deaf or with intellectual disabilities

These risks, however, have been largely forgotten by those fortunate to have lived in a time when measles wasn't a concern.

That time has ended.

For the first time since 1992, more than 2,000 cases of measles were diagnosed in the United States in 2025, the majority of which were diagnosed in Texas (n = 803; ArcGIS, 2026).

Appalachia, deciding that Texas had gotten enough attention, stepped up to seize defeat from the jaws of decades-long victory, with South Carolina seeing 311 cases in 2025, and 481 in JUST the first month of 2026 (South Carolina Department of Public Health, 2026).

Worse still...87.7% of people diagnosed with measles in South Carolina were entirely unvaccinated.

Without mincing words:

This is dumb.

We have all the tools we need to prevent a highly infectious disease, but rather than doing the right thing for their children, parents have decided to follow America's least competent Secretary of Health in determining that childhood vaccines aren't right for their children.

And now, the consequences of these arguably criminally negligent decisions are spreading throughout the region, with cases being identified in:

• Buncombe, Polk, and Rutherford Counties in North Carolina (North Carolina Department of Health and Human Services, 2026)

• The Mid- and Upper Cumberland regions of Tennessee (Tennessee Department of Health, 2026)

Let's not pretend that this has come out of nowhere. Distrust of medical institutions in the Appalachian Region is one of the highest barriers to health interventions.

Recent research conducted in Appalachian Ohio found that more than 25% of respondents reported high levels of mistrust toward healthcare organizations, with older respondents and those with self-identified health issues demonstrating the highest levels of mistrust (Thomas et al., 2023).

The problem here appears to be that people with high levels of mistrust toward healthcare organizations and government officials have been waiting for someone who speaks their language. The Trump Regime has delivered those people across the Department of Health and Human Services, from Robert Kennedy, Jr., leading the pack of conspiracy theorists across the various agencies, installing vaccine "skeptics" throughout the Centers for Disease Control and Prevention, and redirecting congressionally appropriated funds toward projects that send competent healthcare officials into paroxysms of rage.

This WILL have long-lasting consequences.

While those who've been anxiously awaiting someone to tear down the agencies they hate, the vast majority of Americans are learning the hard way that any institution that operates at the whims of political administrations can only be trusted so long as competent people are at the helm.

And they are not.

APPLI will continue to monitor ongoing measles outbreaks and report them as new information becomes available.