MENAHGA, Minn. — The culture in this north central Minnesota city is defined by faith, farming and Finnish heritage.

A statue of St. Urho, the fictional patron saint of Finland, stands 12 feet tall in the middle of Menahga. Pews in the Lutheran churches, which outnumber bars and restaurants in this community of 1,400, fill each Sunday with large, young families.

And many of the children in those families are unvaccinated for measles, according to new data from the Minnesota Department of Health.

In Menahga’s public school, the rate of unvaccinated kindergartners is nearly 40 percentage points below the state average, data shows.

Minnesota now has one of the nation’s lowest rates of measles vaccinations for kindergartners as more parents file conscientious exemptions, a non-medical waiver to attend school without the vaccine. That trend is most prevalent in the state’s rural communities, but nowhere as stark as it is in Menahga.

Fewer than half of its 85 kindergartners are vaccinated, almost entirely due to exemptions. Statewide, about 7% of kindergartners get exemptions.

Vaccine hesitancy has been surging nationally since the pandemic. Major measles outbreaks — including children’s deaths — have erupted in states including Texas, Oklahoma and South Carolina, with critics blaming federal leaders’ vaccine skepticism.

Nationally, 92% of kindergartners are vaccinated against measles; in Minnesota, it’s 86%.

Minnesota has been spared a large outbreak so far, but public health officials worry that as more families opt out, the risk of an outbreak grows.

“Ultimately, we don’t think anything will change unless something serious probably happens,” said Sarah Ness, director of Wadena County Public Health.

Parents in Menahga who said they vaccinate their kids said it’s well known that many families here don’t, and they weren’t surprised to hear Menahga has such a low vaccination rate.

“Folks don’t vaccinate here and I really don’t know why,” Menahga Superintendent Jay Kjos said. “They just don’t.”

Ask residents and public health officials why measles vaccination is so low, and they will say that families prefer holistic health methods like essential oils, saunas or a popular chiropractor in town. And then there is the tight-knit religious community.

The Laestadian Lutheran Church and Apostolic Lutheran Church, a branch of the Laestadian movement, have a large presence in Menahga. They are not affiliated with mainstream Lutheran denominations. Congregation members are known for a modest, insular lifestyle.

Laestadians and Apostolic Lutherans are generally associated with vaccine hesitancy, pastors and local public health officials said. They said members tend to be skeptical of government and modern medicine.

Pastors and congregants say the churches don’t preach about or make directives on vaccines. Pastors say these are personal decisions. Views on vaccines are not universal within the churches, or even the families who attend.

The Aho family has called Menahga home for generations. After a recent Sunday service at Spruce Grove Apostolic Lutheran Church, older congregants said people used to vaccinate without much thought.

But now, Aho cousins with young children said they didn’t vaccinate, while others still do. Some said they homeschool but most send their kids to public school, or plan to.

“I don’t really have a problem with vaccination. ... It’s just more so my trust would be found in Christ above all,” said Raul Aho, who is expecting his fourth child in five years with wife Shelby Aho.

Shelby Aho said they vaccinate for measles, but not the flu or COVID. “I would say our kids get vaccinated at a slower rate,” she said. “But I also don’t feel like our doctor’s office pushes vaccines super hard.”

Some Aho family members who declined to provide their first names said they are against vaccinating their kids but are familiar with vaccinating cattle. They believe good hygiene and nutrition protects people from disease and there are too many vaccine requirements nowadays.

Dayna Anderson, secretary at Spruce Grove, said around 400 members attend church and the average family has around eight kids. She said opinions on vaccines differ.

Her five adopted children are vaccinated. She said people don’t typically vaccinate their kids or even talk about vaccines, so it was strange to hear the subject discussed out loud.

Right to choose

Menahga has been on the radar of local public health officials for years as they noticed plummeting herd immunity and a surge in exemptions.

Ness, the local public health director, said the religious population in town is more than likely linked to this data trend, and it’s skewing the county’s data.

“Everyone has their right to choose,” she said. “We just care about the health of our community.”

Wadena County has the second-lowest overall measles vaccination rate in the state. Nearby Clearwater County has the lowest rate because many children are marked as “partially vaccinated,” meaning they haven’t received both doses, but don’t have an exemption.

In 2000, measles was eliminated from the U.S. due to high coverage of both doses. The federal threshold for herd immunity is 95% vaccination.

Ben Christianson, an epidemiologist at the state health department, said there have been 17 measles cases in Minnesota so far this year.

“There’s definitely measles cases in many communities right now, and so the risk is higher when you see that level of disease spread,” he said.

Measles is highly contagious, staying in the air for up to 2 hours after an infected person leaves a room. But the vaccine has been around over 50 years and is highly effective, Christianson said.

Several measles outbreaks in the U.S. have been within other tight-knit, religious communities with large families, he added.

The nation’s largest measles outbreak in more than 35 years killed two Mennonite girls in Texas last year. More than 700 Texans were sickened, 99 hospitalized, and Mennonites at the center of the outbreak felt blamed, the Texas Tribune reported.

While there hasn’t been a measles outbreak in Menahga, last school year there was a large chickenpox outbreak, Ness said, adding that this is fairly common given the school’s large families. The superintendent said there were 50 chickenpox cases at school in 2025.

Outreach to families with anti-vaccination beliefs has “always been very challenging,” she said.

“We provide the education, but I think their mind is already kind of made up. It’s difficult to infiltrate,” she said. “We share it. But nothing really moves that forward.”

Ness said she doesn’t know the likelihood of an outbreak, “but I do know the further we drop below herd immunity, the higher the likelihood becomes.”

Searching for compromise

On a recent afternoon, as students passed by the Lutheran church inches away from school, a mom pulled into the parking lot in a 12-passenger van to let her kids play on the sugar sand beach of Spirit Lake.

She declined to give her name but said her eight children are unvaccinated and she will continue sending them to public school so long as she can file exemptions.

A bill was reintroduced at the Legislature this year to prohibit measles exemptions. It would still allow waivers for medical reasons, but not personal or religious ones.

Sen. Liz Boldon, DFL-Rochester, authored the bill but said it’s unlikely to pass. It faced heavy pushback from groups advocating for parental choice.

“It is a hot-button topic and I feel like even just the word vaccine puts people in a mindset of either offense or defense,” she said.

Boldon said as a registered nurse, she will continue carrying the legislation in an effort to keep communities safe.

“I don’t know if there’s a compromise in this space, but I hope that we can keep listening to each other to try to understand where we’re coming from on both sides of it.”

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