How Prepared Is Northern Michigan For A Measles Outbreak?

Like it or not, measles is back.

Twenty-five years after it was declared “eliminated” in the United States, measles is enjoying its most viral year of the century. As of October 21, there have been 1,618 reported cases in the U.S. in 2025. 28 of those have occurred in Michigan – including, this summer, four in Grand Traverse County. With cold and flu season approaching, vaccines in the national headlines due to Florida’s move to eliminate childhood immunization mandates, and measles outbreaks currently raging in Utah and Arizona and in South Carolina, The Ticker crunched the numbers to see where Grand Traverse County lands for outbreak risk and preparedness.

Prior to this year, the most measles cases diagnosed in the U.S. in the 21st century came in 2019, which saw 1,274 cases. With more than two months left to go, 2025 has already surpassed that peak by 21.2 percent.

The upticks come amidst a widespread decline in vaccine trust. In a recent nationwide survey conducted by KFF and The Washington Post, one in every six parents said they have “delayed or skipped at least one vaccine for their children,” not including vaccines for seasonal flu or COVID-19. Reasons given include “concerns about side effects, a lack of trust in vaccine safety, and a belief that not all recommended vaccines are necessary.”

Earlier this month, the decline in vaccine trust led USA TODAY to publish new maps of county-level vaccination coverage for the U.S. According to the research, only a quarter of U.S. counties meet the 95 percent threshold for vaccination coverage among school-aged children that doctors recommend “for full protection from disease outbreaks.” During the 2017-18 school year, 49 percent of U.S. counties met that threshold.

One of the counties missing the mark is Grand Traverse County. USA TODAY puts “recent vaccination coverage” here at 88.4 percent of kindergarten students, down about a percentage point compared to pre-pandemic. Those numbers encompass all relevant vaccinations, including DTP/DTaP (diphtheria, pertussis, and tetanus), polio, MMR (measles, mumps, and rubella), Hepatitis B, and varicella (chickenpox).

Statewide, only 1.2 percent of counties meet the 95 percent threshold. That’s actually significantly worse than Texas (50.6 percent), which tallied more than 800 measles cases this year in the midst of an outbreak that hospitalized 99 people and killed two. It’s also worse than Florida (17.9 percent), which announced plans earlier this fall to end all vaccine mandates for school-aged children.

Dr. Joe Santangelo, a pediatrician who serves as the chief medical, quality, and safety officer for Munson Healthcare, is concerned about Florida’s decision. In Santangelo’s view, vaccine mandates are there to trigger important conversations between families and their doctors about whether to proceed with immunizations.

“If there is a reason you should not get a mandated vaccine, in the state of Michigan, for school, there is a process to go through that involves assuring you've been educated of the risks and benefits, and then there's a way to bypass that mandatory vaccine,” Santangelo explains. “We don't recommend that for most patients, but there are going to be times where it's necessary.”

“The worry, if a situation like Florida were to happen in Michigan, is that lots more people who should get the vaccines – and who probably would get the vaccines, if they had that informed conversation with a medical provider – would end up not getting them, just because it's putting more barriers in place between you and vaccines,” Santangelo continues. “And thus, we have more people unvaccinated, and we'd have an increase in vaccine-preventable diseases.”

For a community like Traverse City, increases are problematic for a variety of reasons, Santangelo says. One is the disproportionate risk placed on children, who are significantly more vulnerable to vaccine-preventable diseases like measles and whooping cough. In this year’s Texas outbreak, more than two-thirds of cases were children, including both deaths. Santangelo also says most hospital systems aren’t prepared to face down a widespread outbreak of vaccine-preventable diseases like measles.

“Most physicians who trained in the 2000s, the 2010s, or 2020s have never seen a patient with measles, because it's so uncommon,” Santangelo says. “Until these last few years, I saw relatively few cases of measles, and I practiced a long time ago.”

If there was a silver lining of this year’s small-scale measles outbreak in Traverse City, Santangelo says, it was that it forced Munson Healthcare to get familiar with this once-eliminated virus again.

“Similar to what we did at the beginning of COVID, we did a lot of education to say, ‘Hey, measles is out there and we want you to be aware,’” Santangelo says. “We were answering questions like ‘How do I diagnose it?’ ‘When should I be thinking about it?’ ‘How do I test for it?’ Because these folks might not have ever ordered a measles test in their whole life.”

This year’s outbreak also prompted Munson to dust off COVID-era protocols for minimizing exposure risk for other patients.

“The Health Department would call us and say, ‘We have somebody we think might have measles,’ and then we would have ways to do the testing outside of the hospital so we weren’t bringing those people in,” Santangelo says. “If we’re going to be seeing more of measles, then we know we need to be keeping patients as safe as possible by not commingling someone who might have an infectious disease with others.”