Just one year after the worst measles outbreak in the country began in West Texas, public health officials said the U.S. could lose its measles elimination status. Public health leaders from North Texas and Lubbock warn declining vaccination rates could increase risk of future measles outbreaks.

It’s unclear whether the United States can keep its designation as a country that officially eliminated the disease.

Data: The Washington Post; Map: Jacque Schrag/Axios Much of Southeast Texas — including Harris, Montgomery and Galveston counties — failed to meet the herd immunity threshold for measles, with vaccination rates for kindergarteners below the 95% mark,

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When a measles outbreak hit West Texas this year, school absences surged to levels far beyond the number of children who likely became sick, according to a study, as students were excluded or kept home by their families to minimize the spread of the disease.