Latest news with #LowGermanMennonite
CBC
5 days ago
- Health
- CBC
Addressing fear in Alberta's Mennonite community amid a measles outbreak
Quelling the spread of measles involves immunization campaigns and public health protocols, but Tina Meggison says it also requires sitting down and having an open and honest conversation. That's what she's working to do within the Low German-speaking Mennonite community in Alberta. Meggison has more than a decade of professional — and a lifetime of personal — experience under her belt. Her team of community health representatives with Primary Care Alberta has seen a 25 per cent increase in demand for their services, which include accompanying patients to doctor's appointments and interpreting and answering questions in Low German, since the onset of an outbreak in March. That's about 350 calls per month on average, compared to 285 before the contagious disease spread to 1,656 people in the province. Meggison said the rise of people reaching out to the provincial health agency shows an interest to engage in the health-care system, which historically has not always been the case. The next step is taking that outstretched hand and placing knowledge into it. "We can invite our families to start thinking from a different lens, or see things through a different lens, and maybe start to answer those questions." Measles in Alberta Health-care hesitancy is rooted in fear for many Low German-speaking Mennonites. Meggison would know. She remembers a public health nurse rolling into her Mexican hometown of Durango on horse-and-buggy with a cooler of vaccines. The nurse told Meggison's mother to line up her 12 children in the yard, asked for their ages, and immunized them, without explanation. "She didn't know what had been given to her kids. She didn't have the language skills to ask the questions," Meggison said about her mother, whose primary language was Low German. Her family moved from Durango to Ontario when she was four years old, returned to Mexico more than a decade later, and then to Alberta in 2001. She started accompanying her mother to medical appointments and interpreting for her at 16 years old. "Unbeknownst to me at that time, I was training for this work," Meggison said, speaking from Lethbridge, near the Canadian Rocky Mountains. When she started this line of work in an official capacity, she estimates the Low German Mennonite population in Alberta was 15,000. That's since grown to approximately 25,000 to 30,000, based on her organization's last tally. But she says given the transient nature of the population, it's likely an underestimate. Many came from Mexico to work the land in Canada. They migrated to Ontario and Manitoba, and from there some made their way to Alberta. The government had offered religious and educational autonomy in exchange for agricultural labour in the 1870s. But that freedom never materialized, leading some to mistrust and question the government's authority, said Margarita Penner, a newcomer and Low German Mennonite family liaison with Barons-Eureka-Warner Family and Community Support Services based in Taber. Penner said Mennonites settled all over Alberta — from La Crete in the north to 40 Mile County in the south, on the border of Montana. Community health representatives dedicated to the Low German-speaking Mennonite community are currently only based in southern Alberta, with two full-timers based in Taber; Meggison in Lethbridge; and a roster of casuals. The demand has been so high that they boosted their availability from five to seven days a week. And now, Primary Care Alberta is hiring two more in the south, a third in the central health zone, and a fourth in the north. Vaccine coverage gaps Southern Alberta has 945 measles cases while the north zone has 534, and central has 108. There, 68 per cent of kids had one dose and 56 per cent had two doses of the measles vaccine by age two in 2024, according to the province's figures for southern Alberta. Local breakdowns for the age group show 40 per cent two-dose measles vaccine coverage in the Lethbridge County, 29 per cent in the Municipal District of Taber, and 71 per cent in the City of Medicine Hat. Dr. Joan Robinson, a pediatric infectious diseases physician in Edmonton, said the rest of the province is not much better off. Alberta has an average immunization of 80 per cent with one dose, and 68 per cent with two doses for two-year-olds. Robinson says Alberta's low vaccination rates are due to myriad of factors, including a broader mistrust in the health-care system and a public shift towards misinformation during the COVID-19 pandemic. She says people began getting information on immunizations on social media, rather than from medical experts, and began believing that vaccines are harmful. She also says it would be helpful if the Alberta government debunked this belief. Though Edmonton and Calgary have lower case counts than the rest of the province, she points to particular areas within the urban cities that are not much better. "The highest immunization rate in the whole province is barely over 80 per cent in Provost. It means that every community that measles is introduced into, there's a reasonable chance of more cases," Robinson said. "In order to prevent measles, we really do need community immunization rates as high as 95 per cent." Run and hide Meggison said health education starts with identifying misinformation that heightens deeply entrenched fear. She holds focus groups for Low German communities that open the door to seemingly simple, yet controversy-riddled topics, such as, what is measles? What are its long-term consequences? What is in the vaccine that prevents it? "If you don't know what it is you're preventing ... then what is the motivation to prevent it?" This is all done in Low German because many members of the community don't fluently speak or understand English, and don't read or write, making it challenging to access credible information, Meggison said. She shows them places they can source accurate facts, such as a YouTube channel where she hosts videos in Low German on health topics, with some gaining more than 1,000 views. Proudly, she recalls seeing a lightbulb go off for one woman who described an epiphany in one of her recent groups. "She said, 'I can make decisions for my family, and it doesn't have to be public knowledge. I can make these decisions and not share it with my family members if they ask and I can just say that's my business,"' Meggison said, and described other women nodded in response to this passionate declaration, which strays far from their community's everybody-knows-everything way of life. "You could see that there was a sense of freedom that came out of that group." Her hope is that conversation will spread within the tight-knit community. Needle is neutral Alberta's health-care system has translation services, but the challenge is Low German is not common outside of the community. It holds shared cultural significance, which makes interpretation hard to come by and word choice paramount. Nely Penner, a community health representative in Taber, said the word "vaccine" was an obvious roadblock to upping measles immunization in southern Alberta. "When I think of the word vaccine in German, I just think of the history of immunization in Mexico," Penner, who grew up in a Low German community in Mexico's northern Chihuahua region, said. Though Penner never personally experienced "vaccine nurses" like Meggison did, similar stories were passed down from her parents and grandparents. "People didn't understand what they were getting. It was fear-based. People would run and hide to not get these vaccines." To mitigate the negative connotation, she suggested Alberta health providers use the word needle instead. "Needle is just more neutral," Penner said. Little changes like this can have a big impact in facilitating a health space that feels safer, acknowledges and validates feelings of mistrust, Penner said.
CTV News
7 days ago
- Health
- CTV News
Addressing fear in Alberta's Mennonite community amid a measles outbreak
Tina Meggison, a community health rep for the Low German Mennonite community in southern Alberta, is seen with a sign in Low German at the Taber Community Health Clinic in Taber, Alta., Monday, July 28, 2025. THE CANADIAN PRESS/Jeff McIntosh Quelling the spread of measles involves immunization campaigns and public health protocols, but Tina Meggison says it also requires sitting down and having an open and honest conversation. That's what she's working to do within the Low German-speaking Mennonite community in Alberta. Meggison has more than a decade of professional — and a lifetime of personal — experience under her belt. Her team of community health representatives with Primary Care Alberta has seen a 25 per cent increase in demand for their services, which include accompanying patients to doctor's appointments and interpreting and answering questions in Low German, since the onset of an outbreak in March. That's about 350 calls per month on average, compared to 285 before the contagious disease spread to 1,656 people in the province. Meggison said the rise of people reaching out to the provincial health agency shows an interest to engage in the health-care system, which historically has not always been the case. The next step is taking that outstretched hand and placing knowledge into it. 'We can invite our families to start thinking from a different lens, or see things through a different lens, and maybe start to answer those questions.' Measles in Alberta Health-care hesitancy is rooted in fear for many Low German-speaking Mennonites. Meggison would know. She remembers a public health nurse rolling into her Mexican hometown of Durango on horse-and-buggy with a cooler of vaccines. The nurse told Meggison's mother to line up her 12 children in the yard, asked for their ages, and immunized them, without explanation. 'She didn't know what had been given to her kids. She didn't have the language skills to ask the questions,' Meggison said about her mother, whose primary language was Low German. Her family moved from Durango to Ontario when she was four years old, returned to Mexico more than a decade later, and then to Alberta in 2001. She started accompanying her mother to medical appointments and interpreting for her at 16 years old. 'Unbeknownst to me at that time, I was training for this work,' Meggison said, speaking from Lethbridge, near the Canadian Rocky Mountains. When she started this line of work in an official capacity, she estimates the Low German Mennonite population in Alberta was 15,000. That's since grown to approximately 25,000 to 30,000, based on her organization's last tally. But she says given the transient nature of the population, it's likely an underestimate. Many came from Mexico to work the land in Canada. They migrated to Ontario and Manitoba, and from there some made their way to Alberta. The government had offered religious and educational autonomy in exchange for agricultural labour in the 1870s. But that freedom never materialized, leading some to mistrust and question the government's authority, said Margarita Penner, a newcomer and Low German Mennonite family liaison with Barons-Eureka-Warner Family and Community Support Services based in Taber. Penner said Mennonites settled all over Alberta – from La Crete in the north to 40 Mile County in the south, on the border of Montana. Community health representatives dedicated to the Low German-speaking Mennonite community are currently only based in southern Alberta, with two full-timers based in Taber; Meggison in Lethbridge; and a roster of casuals. The demand has been so high that they boosted their availability from five to seven days a week. And now, Primary Care Alberta is hiring two more in the south, a third in the central health zone, and a fourth in the north. Southern Alberta has 945 measles cases while the north zone has 534, and central has 108. There, 68 per cent of kids had one dose and 56 per cent had two doses of the measles vaccine by age two in 2024, according to the province's figures for southern Alberta. Local breakdowns for the age group show 40 per cent two-dose measles vaccine coverage in Lethbridge, 29 per cent in Taber, and 71 per cent in Medicine Hat. Dr. Joan Robinson, a pediatric infectious diseases physician in Edmonton, said the rest of the province is not much better off. Alberta has an average immunization of 80 per cent with one dose, and 68 per cent with two doses for two-year-olds. Robinson says Alberta's low vaccination rates are due to myriad of factors, including a broader mistrust in the health-care system and a public shift towards misinformation during the COVID-19 pandemic. She says people began getting information on immunizations on social media, rather than from medical experts, and began believing that vaccines are harmful. She also says it would be helpful if the Alberta government debunked this belief. Though Edmonton and Calgary have lower case counts than the rest of the province, she points to particular areas within the urban cities that are not much better. 'The highest immunization rate in the whole province is barely over 80 per cent in Provost. It means that every community that measles is introduced into, there's a reasonable chance of more cases,' Robinson said. 'In order to prevent measles, we really do need community immunization rates as high as 95 per cent.' Run and hide Meggison said health education starts with identifying misinformation that heightens deeply entrenched fear. She holds focus groups for Low German communities that open the door to seemingly simple, yet controversy-riddled topics, such as, what is measles? What are its long-term consequences? What is in the vaccine that prevents it? 'If you don't know what it is you're preventing ... then what is the motivation to prevent it?' This is all done in Low German because many members of the community don't fluently speak or understand English, and don't read or write, making it challenging to access credible information, Meggison said. She shows them places they can source accurate facts, such as a YouTube channel where she hosts videos in Low German on health topics, with some gaining more than 1,000 views. Proudly, she recalls seeing a lightbulb go off for one woman who described an epiphany in one of her recent groups. 'She said, 'I can make decisions for my family, and it doesn't have to be public knowledge. I can make these decisions and not share it with my family members if they ask and I can just say that's my business,'' Meggison said, and described other women nodded in response to this passionate declaration, which strays far from their community's everybody-knows-everything way of life. 'You could see that there was a sense of freedom that came out of that group.' Her hope is that conversation will spread within the tight-knit community. Needle is neutral Alberta's health-care system has translation services, but the challenge is Low German is not common outside of the community. It holds shared cultural significance, which makes interpretation hard to come by and word choice paramount. Nely Penner, a community health representative in Taber, said the word 'vaccine' was an obvious roadblock to upping measles immunization in southern Alberta. 'When I think of the word vaccine in German, I just think of the history of immunization in Mexico,' Penner, who grew up in a Low German community in Mexico's northern Chihuahua region, said. Though Penner never personally experienced 'vaccine nurses' like Meggison did, similar stories were passed down from her parents and grandparents. 'People didn't understand what they were getting. It was fear-based. People would run and hide to not get these vaccines.' To mitigate the negative connotation, she suggested Alberta health providers use the word needle instead. 'Needle is just more neutral,' Penner said. Little changes like this can have a big impact in facilitating a health space that feels safer, acknowledges and validates feelings of mistrust, Penner said. 'When you're getting information, especially sensitive information, you want to be able to trust that person. And so that's such a huge part of what we do.' This report by The Canadian Press was first published Aug. 4, 2025. Hannah Alberga, The Canadian Press Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Toronto Star
7 days ago
- Health
- Toronto Star
Addressing fear in Alberta's Mennonite community amid a measles outbreak
Tina Meggison, a community health rep for the Low German Mennonite community in southern Alberta, is seen with a sign in Low German at the Taber Community Health Clinic in Taber, Alta., Monday, July 28, 2025. THE CANADIAN PRESS/Jeff McIntosh JMC flag wire: true flag sponsored: false article_type: : sWebsitePrimaryPublication : publications/toronto_star bHasMigratedAvatar : false :
Winnipeg Free Press
7 days ago
- Health
- Winnipeg Free Press
Addressing fear in Alberta's Mennonite community amid a measles outbreak
Quelling the spread of measles involves immunization campaigns and public health protocols, but Tina Meggison says it also requires sitting down and having an open and honest conversation. That's what she's working to do within the Low German-speaking Mennonite community in Alberta. Meggison has more than a decade of professional — and a lifetime of personal — experience under her belt. Her team of community health representatives with Primary Care Alberta has seen a 25 per cent increase in demand for their services, which include accompanying patients to doctor's appointments and interpreting and answering questions in Low German, since the onset of an outbreak in March. That's about 350 calls per month on average, compared to 285 before the contagious disease spread to 1,656 people in the province. Meggison said the rise of people reaching out to the provincial health agency shows an interest to engage in the health-care system, which historically has not always been the case. The next step is taking that outstretched hand and placing knowledge into it. 'We can invite our families to start thinking from a different lens, or see things through a different lens, and maybe start to answer those questions.' MEASLES IN ALBERTA Health-care hesitancy is rooted in fear for many Low German-speaking Mennonites. Meggison would know. She remembers a public health nurse rolling into her Mexican hometown of Durango on horse-and-buggy with a cooler of vaccines. The nurse told Meggison's mother to line up her 12 children in the yard, asked for their ages, and immunized them, without explanation. 'She didn't know what had been given to her kids. She didn't have the language skills to ask the questions,' Meggison said about her mother, whose primary language was Low German. Her family moved from Durango to Ontario when she was four years old, returned to Mexico more than a decade later, and then to Alberta in 2001. She started accompanying her mother to medical appointments and interpreting for her at 16 years old. 'Unbeknownst to me at that time, I was training for this work,' Meggison said, speaking from Lethbridge, near the Canadian Rocky Mountains. When she started this line of work in an official capacity, she estimates the Low German Mennonite population in Alberta was 15,000. That's since grown to approximately 25,000 to 30,000, based on her organization's last tally. But she says given the transient nature of the population, it's likely an underestimate. Many came from Mexico to work the land in Canada. They migrated to Ontario and Manitoba, and from there some made their way to Alberta. The government had offered religious and educational autonomy in exchange for agricultural labour in the 1870s. But that freedom never materialized, leading some to mistrust and question the government's authority, said Margarita Penner, a newcomer and Low German Mennonite family liaison with Barons-Eureka-Warner Family and Community Support Services based in Taber. Penner said Mennonites settled all over Alberta – from La Crete in the north to 40 Mile County in the south, on the border of Montana. Community health representatives dedicated to the Low German-speaking Mennonite community are currently only based in southern Alberta, with two full-timers based in Taber; Meggison in Lethbridge; and a roster of casuals. The demand has been so high that they boosted their availability from five to seven days a week. And now, Primary Care Alberta is hiring two more in the south, a third in the central health zone, and a fourth in the north. Southern Alberta has 945 measles cases while the north zone has 534, and central has 108. There, 68 per cent of kids had one dose and 56 per cent had two doses of the measles vaccine by age two in 2024, according to the province's figures for southern Alberta. Local breakdowns for the age group show 40 per cent two-dose measles vaccine coverage in Lethbridge, 29 per cent in Taber, and 71 per cent in Medicine Hat. Dr. Joan Robinson, a pediatric infectious diseases physician in Edmonton, said the rest of the province is not much better off. Alberta has an average immunization of 80 per cent with one dose, and 68 per cent with two doses for two-year-olds. Robinson says Alberta's low vaccination rates are due to myriad of factors, including a broader mistrust in the health-care system and a public shift towards misinformation during the COVID-19 pandemic. She says people began getting information on immunizations on social media, rather than from medical experts, and began believing that vaccines are harmful. She also says it would be helpful if the Alberta government debunked this belief. Though Edmonton and Calgary have lower case counts than the rest of the province, she points to particular areas within the urban cities that are not much better. 'The highest immunization rate in the whole province is barely over 80 per cent in Provost. It means that every community that measles is introduced into, there's a reasonable chance of more cases,' Robinson said. 'In order to prevent measles, we really do need community immunization rates as high as 95 per cent.' RUN AND HIDE Meggison said health education starts with identifying misinformation that heightens deeply entrenched fear. She holds focus groups for Low German communities that open the door to seemingly simple, yet controversy-riddled topics, such as, what is measles? What are its long-term consequences? What is in the vaccine that prevents it? 'If you don't know what it is you're preventing … then what is the motivation to prevent it?' This is all done in Low German because many members of the community don't fluently speak or understand English, and don't read or write, making it challenging to access credible information, Meggison said. She shows them places they can source accurate facts, such as a YouTube channel where she hosts videos in Low German on health topics, with some gaining more than 1,000 views. Proudly, she recalls seeing a lightbulb go off for one woman who described an epiphany in one of her recent groups. 'She said, 'I can make decisions for my family, and it doesn't have to be public knowledge. I can make these decisions and not share it with my family members if they ask and I can just say that's my business,'' Meggison said, and described other women nodded in response to this passionate declaration, which strays far from their community's everybody-knows-everything way of life. 'You could see that there was a sense of freedom that came out of that group.' Her hope is that conversation will spread within the tight-knit community. NEEDLE IS NEUTRAL Alberta's health-care system has translation services, but the challenge is Low German is not common outside of the community. It holds shared cultural significance, which makes interpretation hard to come by and word choice paramount. Nely Penner, a community health representative in Taber, said the word 'vaccine' was an obvious roadblock to upping measles immunization in southern Alberta. 'When I think of the word vaccine in German, I just think of the history of immunization in Mexico,' Penner, who grew up in a Low German community in Mexico's northern Chihuahua region, said. Though Penner never personally experienced 'vaccine nurses' like Meggison did, similar stories were passed down from her parents and grandparents. 'People didn't understand what they were getting. It was fear-based. People would run and hide to not get these vaccines.' To mitigate the negative connotation, she suggested Alberta health providers use the word needle instead. 'Needle is just more neutral,' Penner said. Little changes like this can have a big impact in facilitating a health space that feels safer, acknowledges and validates feelings of mistrust, Penner said. 'When you're getting information, especially sensitive information, you want to be able to trust that person. And so that's such a huge part of what we do.' This report by The Canadian Press was first published Aug. 4, 2025. Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Yahoo
12-04-2025
- Health
- Yahoo
Deadly measles outbreak does little to counter vaccine scepticism in Texas
On an unusually crisp April day in a rural Texas town, dozens of Mennonite community members gathered alongside the nation's top health official, Robert F Kennedy Jr, to mourn an eight-year-old. Daisy Hildebrand is the second unvaccinated girl from the community to die from measles within two months. Officials in Seminole town also joined the reception after her funeral to support the family, said South Plains Public Health Director Zach Holbrooks. This time, there was no talk of the vaccine that prevents measles deaths - unlike many of his long days since the outbreak began. "The focus was on their healing," Mr Holbrooks said. "You never want to see anybody pass away, especially a child that young, from any kind of illness, because there is a prevention for it - the MMR vaccine." Like other Seminole natives, Mr Holbrooks was not vaccinated against measles as a child. He got a shot in college, and another in February, when his hometown became the epicentre of one of the country's worst measles outbreaks in a decade. The US has seen more than 700 cases this year. The majority of infections - 541 as of Friday - occurred in western Texas, with 56 patients sent to the hospital. Cases in New Mexico, Oklahoma and Kansas also are linked to the outbreak. Two children, including Daisy, have died - the first recorded fatalities from measles in the US since 2015. It's not slowing down either, public health experts say. They try to reach vaccine-hesitant residents, but struggle with those who carry on with daily life as usual and with mixed messaging from federal officials, including Kennedy who has endorsed immunization conspiracy theories in the past. "I wish there were more coming in to get the vaccine," Mr Holbrooks said. "We can put messaging out, but it's up to them to come see us." The western Texas town of Seminole - population 7,000 - is bordered by miles of rural farmland and oil fields. Among billboards for restaurants, gun silencers and tractors, a digital sign hints at the crisis gripping the community: a warning about the dangers of measles, which can cause complications including pneumonia, brain swelling and death. It has spread rapidly among Mennonites, a religious community living near Seminole. Mr Holbrooks estimates the population could be as many as 40,000 across several counties. In those areas, public school vaccination rates are as low as 82%. Roughly 95% of a community must be vaccinated against the measles to achieve herd immunity, when enough of a group is immune to a disease that its spread is limited and the unvaccinated are protected. Mr Holbrooks remembers when the Low German Mennonite group began immigrating to his hometown and nearby states in the 1970s. The religion has no specific doctrines against vaccinations, but they tend to avoid many modern aspects of life, including the health care system. Their community is not alone. At least 118,000 kindergartners in Texas are exempt from one or more vaccines, mostly in rural areas, said Terri Burke, director of Texas vaccine advocacy group, the Immunization Partnership. Parents can get a waiver to exempt their child from school vaccine requirements for a variety of reasons, including religion. Savannah Knelsen, an 18-year-old server at a Seminole barbecue restaurant, has not been vaccinated against measles - or anything else. Many of her family members and friends - also unvaccinated - caught the measles in recent weeks. One relative developed a fever of 104.5 F (40.2 C), but still chose not to go to the hospital. The recent deaths of two children have not convinced her to get vaccinated, she said, adding that she was healthy and wanted to let her body "fight off" infections. Experts agree the vaccine is the best way to prevent infections - including severe ones. Ms Knelsen's 19-year-old co-worker, Jessica Giesbrecht, along with her family, has been vaccinated against the measles. "I'm worried for my baby niece," Ms Giesbrecht said, adding she was too young to be vaccinated. Still, the two said the outbreak doesn't weigh heavily on daily life. Others in Seminole agree. A cashier at a local pharmacy said no one has stopped by for measles vaccinations since the outbreak started. "People are just going about their lives," she said. On Sunday, Kennedy made his first trip to the region since the outbreak to attend the 8-year-old girl's funeral. The top US health official is an unlikely figure to spearhead the fight against measles - he has in the past endorsed conspiracy theories about immunizations, including debunked claims about links to autism. He downplayed the outbreak in western Texas at first, calling it "not unusual". Trump echoed these remarks last weekend, saying that only a "fairly small number of people" had been impacted, when he was asked by the BBC about the outbreak aboard Air Force One. It was "not something new", he added. On Wednesday, Kennedy gave his strongest statement yet in support of the measles vaccine, telling the BBC's US partner CBS News, "The federal government's position, my position, is that people should get the measles vaccine." The remarks were met with social media backlash from some anti-vaccine supporters. Kennedy added, however, that the government "should not be mandating" vaccines. The influence of some of his earlier remarks lingers. In one of several Mennonite-owned natural-health stores in Seminole, dozens of bottles of cod liver oil - a supplement that contains vitamin A - are on display. Alongside the vaccine, Kennedy has promoted vitamin A as an alternative measles treatment, a remedy doctors say should not be given without guidance from a physician and is no substitute for the vaccine. The treatment has at times proven dangerous. Covenant Children's Hospital in nearby Lubbock told the BBC it has treated several unvaccinated children with measles for vitamin A toxicity - some had used it a preventative measure. The community needs federal officials to provide stronger messaging to help convince people to get vaccinated and slow the outbreak, said Gordon Mattimoe, director of the health department in nearby Andrews County. "People look to their leaders to lead," he said. Jeff Hutt, a former spokesperson for the Make America Healthy Again political action committee and Kennedy's former national field director, argued that the health secretary had to "cover the middle ground", providing statements that are "politically adequate" while also providing sceptical stances on vaccines. "In covering the middle ground, I'm not necessarily sure he was able to reassure folks that he had a handle on [measles], or that he was able to reassure folks that he was sticking to his guns," Mr Hutt said. The Trump administration's health policies could have other consequences in Texas, officials say. Local health departments are at risk of losing critical resources because of attempts to cut $11.4b (£8.8) in public health grants. The move was temporarily blocked by a judge last week. Mr Mattimoe said that because of the potential cuts - around $250,000 in grant funding for his health department - he is not able to hire a new nurse to give immunizations. In a statement to the BBC, the US Department of Health and Human Services said it deployed the "necessary" resources from the US Centers for Disease Control and Prevention (CDC) to respond to the outbreak. "The CDC is in close, constant communication with local and state health officials on the ground to ensure they have what they need," the official said. The Texas Department of Health Services could lose as much as $550m in grant funding. It has provided staff, vaccines, testing and other support to local health departments, but likely will need extra funding, said spokesperson Chris Van Deusen told the BBC. Mr Mattimoe contacted lawmakers and the state for help, but is not hopeful. "I don't think they have the funds," he said. In nearby Lubbock, Texas, just two days after the news of Daisy's death, all was quiet at the health department's vaccination clinic. Other days have been busier, with as many as 20 people coming in for vaccines, said Katherine Wells, director of public health for the city, where hospitals receive children with severe measles cases from more rural counties. Since the outbreak began in January, the city of Seminole has vaccinated 103 adults and 143 children against the measles, Mr Holbrooks said. The neighbouring three rural counties decided to close their underused vaccine clinics and send more staff to hard-hit Seminole. "There's always talk on, what else can we do, and are we doing enough?" Mr Holbrooks said. "We want to build trust, not tear it down." At times, local health officials have seen progress. A Mennonite doctor in Andrews County gained community members' trust and encouraged them to get vaccinated, said Mr Mattimoe. "Those trusted messengers in those communities - I think that's very important," he said. Ms Wells hopes vaccinations will start to pick up after the latest measles death and the city's new guidance to vaccinate children as young as six months, instead of one year. The bigger city saw an outbreak at a daycare among children too young to be fully vaccinated, a situation she believes will be helped by the earlier shots. But, "there's always going to be some people that we don't reach", Ms Wells said. That means the virus is likely to circulate for a while in western Texas regions where people are unvaccinated, officials said. "We're just at the beginning of it," Mr Mattimoe said. "It's going to have to run through the community. Until they get that natural immunity, it'll just keep running its course." Second child dies of measles as Texas outbreak worsens Measles cases pick up as RFK promotes unproven treatments RFK's measles response under scrutiny as deadly outbreak frightens Texas parents
