A worldwide measles resurgence that stripped Canada of its disease-free status is hitting close to home across the Northern Plains, where falling vaccination rates have left communities vulnerable to the highly contagious virus.
South Dakota has reported 12 confirmed measles cases since May, according to the state Department of Health, with eight cases concentrated in Lincoln County and two each in Meade and Pennington counties. The state has recorded one hospitalization and zero deaths, but health officials warn that declining immunization rates create conditions ripe for wider outbreaks.
The South Dakota cases reflect a broader Northern Plains trend. North Dakota has reported 28 measles cases in 2025—its highest total since the state’s last case in 2011—while Minnesota has confirmed 24 cases. Nebraska has reported cases near the Pine Ridge Indian Reservation, prompting an urgent response from tribal health organizations.
Why it matters
The regional outbreak comes as measles vaccination rates across the Northern Plains have declined sharply. South Dakota’s MMR (measles, mumps and rubella) vaccination rate among kindergartners has dropped from 96 percent a decade ago to just 91 percent currently, according to Department of Health data. More than 40 South Dakota counties now fall below the 95 percent threshold health experts say is needed for community immunity, with 12 counties below 80 percent and five below 70 percent.
Faulk County has the state’s lowest rate at 56 percent, followed by Jones County at 60 percent. North Dakota’s kindergarten vaccination rate has similarly declined from 95 percent in the 2019–2020 school year to 90 percent currently, while Minnesota has seen its rate drop to 86.5 percent—one of the nation’s steepest declines.
“Measles is a highly contagious viral disease and spreads through the air from an infected person,” said Dr. Joshua Clayton, South Dakota’s state epidemiologist. “Individuals who lack immunity from vaccination or past infection are at high risk of measles infection if they have contact with an infected person.”
The Great Plains Tribal Leaders’ Health Board, which serves tribes across Iowa, Nebraska, and the Dakotas, has mobilized a coordinated response. The organization’s Oyate Health Center in Rapid City saw phones “ring off the hook” when cases appeared near Pine Ridge, said Darren Crowe, a vice president at the center.
Mobile vaccination clinics have visited tribal communities, including a June event where 5-year-old Makaito Cuny received his MMR shot. “I’m not going to be scared,” he announced before getting vaccinated. His mother, Shawna Palmier, a member of the Oglala Sioux Tribe, said she wanted to “do my part” to protect the community.
Data from South Dakota and Montana show Native American children are less likely than white children to be vaccinated on schedule, according to Dr. Meghan O’Connell, chief public health officer for the Great Plains Tribal Epidemiology Center. Native communities face particular challenges including unreliable transportation, living far from clinics, and high provider turnover.
The regional resurgence comes as the United States recorded 1,753 confirmed measles cases as of Nov. 18—more than in any year in the past three decades. If cases continue, the U.S. could lose its “measles elimination” status early next year.
Canada has already lost its measles-free designation after reporting 4,843 confirmed cases in 2025, up from just 147 cases in 2024. The Pan American Health Organization stripped Canada of its status on Nov. 10.
Health officials emphasize that two doses of MMR vaccine provide 97 percent protection against measles. The vaccine is typically given at 12–15 months, with a second dose at 4–6 years.
South Dakota’s Department of Health held special vaccination clinics in June following confirmed cases, but the effort yielded disappointing results—just 14 total vaccinations across 11 clinic locations, with seven sites administering zero shots.
