Measles had struck this West Texas town, sickening dozens of children, but at the Community Church of Seminole, nearly 400 congregants gathered for a Sunday service. Sitting elbow-to-elbow, they filled the pews, siblings in matching button-down shirts and dresses, little girls’ hair tied neatly into pink bows. Fathers shushed babbling toddlers as their wives snuck out to change infants' diapers. A little girl in this mostly Mennonite congregation was among those who’d fallen ill with the highly contagious respiratory disease, senior pastor David Klassen said — but she’s doing fine, and she happily played through her quarantine. He's heard that at least two Mennonite schools shut down for a bit to disinfect. What he hasn’t heard: Any direct outreach from public health officials on what to do as the number of those sickened with measles has grown to 146 and a school-age child has died. And though Klassen is a trusted church and community leader, his congregants haven’t asked about whether they should vaccinate their kids – and he wouldn’t want to weigh in. “With this measles situation, I can honestly just tell you we haven’t taken any steps as a church,” the senior pastor said. “We did leave it up to the mothers.” As measles — a preventable disease the U.S. considered eliminated in 2000 — spreads through West Texas’ rural expanse, Klassen is sticking to an approach on vaccines that is a key tenet for Mennonites. Family leaders are the top decision-making authority — — not outside recommendations, certainly not government mandates. Alongside measles in this region, where voters overwhelmingly supported President Donald J. Trump, there’s another outbreak: one of misinformation about vaccines, distrust of local public health officials and fear of governmental authority overruling family autonomy. And on the national stage, Robert F. Kennedy Jr., the country’s top health official and an anti-vaccine activist, dismissed the Texas outbreak as “not unusual.” “Do I trust all the vaccines?” Klassen said. “No. I get from (Kennedy) that he doesn’t trust all the vaccines, either. And he is very well-educated, and I’m not.” In an opinion piece for Fox News Digital, Kennedy wrote about the value of the vaccine but stopped short of calling on families to get it, calling the decision “a personal one.” He urged parents to speak to their health care providers about options. Vaccine skepticism has also been spurred by state lawmakers who this year filed more than 10 bills that would strengthen or expand vaccine exemptions, which Texas already allows for “reasons of conscience, including a religious belief.” At hospitals in Lubbock, 80 miles to the north and on the front lines of the outbreak, babies with measles are struggling to breathe. Dr. Summer Davies, a Texas Tech Physicians pediatrician, said she has treated about 10 of the outbreak’s patients, most very young or teens. She said children have had to be intubated, including one younger than 6 months old. Others come in with such high fevers or severe sore throats that they refuse to eat or drink to the point of dehydration. “You see them struggle, you see them struggling to breathe.” she said. “They don't want to eat or drink. They get they're dehydrated. They have high fever. They're miserable. They look miserable. And we do our best to support them through that. But it is very, very hard to watch.” In Lubbock County, 92% of kindergarteners are up to date on their measles, mumps and rubella shots, according to the Texas Department of State Health Services. That’s lower than the 95% threshold experts say is needed to prevent measles from spreading. Gaines County, which includes Seminole, has a 90% MMR vaccination rate, though rates for homeschooled or private school students may be much lower. The vaccine series is required for kids before entering kindergarten in public schools nationwide. Many Mennonite families don’t send children to public schools. All of the children admitted with measles to Covenant Children’s Hospital in Lubbock were unvaccinated, officials said last week. Dr. Lara Johnson, the hospital’s chief medical officer, told The Associated Press that Covenant has seen more than 20 patients, including children, teens and pregnant mothers, since the outbreak began a month ago. The small towns of West Texas may look completely isolated on a map, with little between them beyond oil and gas facilities and sprawling desert. But the region is connected by its people, who regularly travel long distances to grocery stores, hospitals and houses of worship. Across the region, people expressed support for routine childhood vaccinations in interviews with the AP and The Texas Tribune. Often, though, they are less supportive of COVID-19 and flu shots. Macey Lane, 31, of Hobbs, said: “I do support Donald Trump. I don’t support not requiring vaccines.”