Dr. Peter Hotez, dean of Texas Children’s Hospital and president of the Sabin Vaccine Institute, foresees a dangerous measles epidemic erupting the Lone Star State by 2018 driven by plummeting vaccination rates while propelled by an anti-vaccination movement.

In Texas and Its Measles Epidemic, a perspective for the Public Library of Science (PLOS) Medicine Journal, Hotez warns the state appears headed for an outbreak given the sharp uptick in the number of parents filing for non-medical exemptions of the Mumps, Measles, and Rubella (MMR) vaccine in recent years. Hotez stated the trend is rooted in unproven connections between vaccines and autism, but the potential consequences may result in “measles time bombs.”

The Texas-based research scientist worries measles could erupt in school districts with “low vaccination coverage,” and the most vulnerable are infants too young to be vaccinated. He also writes the dangers unvaccinated children face are potentially more severe than many may realize.

The Texas Department of State Health Services (DSHS) reported of the 5.5 million children attending public, charter, and private schools nearly 45,000 (or 0.84 percent) opted out of school immunization laws via non-medical “conscientious” exemptions. That figure almost doubled since 2010, with a 19-fold increase when compared to 2003, the first year Texas allowed parents to reject vaccines for personal reasons. Only 18 states still allow these philosophical exemptions, Breitbart Texas reported.

The medical expert anticipates the number of unvaccinated school children will jump to 50,000 by next year, leaving Texas “dangerously close” to slipping below the 95 percent coverage rate to prevent outbreaks. Measles season generally runs from late winter to early spring. If the anti-vaxx trend continues, Hotez expects a February or March 2018 epidemic. He emphasized one contagious person could easily infect 12-18 infants too young to get the MMR vaccine. Previously, Hotez called measles a leading cause of child mortality, killing 100,000 youngsters worldwide each year.

He attributes the state’s alarming rise in vaccine exemptions to an anti-vaccination movement based on the work of leading anti-vaxx advocate Dr. Andrew Wakefield. His 1998 paper published in U.K. medical journal The Lancet alleged a connection between vaccines and autism. These claims were discredited by the medical community. The disgraced physician lost his medical license.

Wakefield relocated to Austin where he and Texans for Vaccine Choice “are heavily promoting the 2016 documentary “Vaxxed: From Cover-Up to Catastrophe,” Hotez wrote. Wakefield directed the film which alleges links between vaccines and autism plus a cover-up by the U.S. Centers for Disease Control and Prevention (CDC). Earlier this year, Robert DeNiro and the Tribeca Film Festival cancelled screening the film after conferring with “others in the scientific community.”

In August, Bexar County District Attorney Nico LaHood appeared in an 11-minute “Vaxxed” interview that aired on the Autism Media Channel. He claimed vaccines caused his five-year-old son’s autism.

However, Hotez, the father of an adult child with autism, stated scientific studies show no link between vaccinations and Autism Spectrum Disorder (ASD). Instead, he expressed intrigue “by data indicating that neurobiological changes in children with ASD begin early in pregnancy, well before vaccinations are given.”

Breitbart Texas spoke to Hotez in greater depth about his concerns regarding unvaccinated children. He finds it troubling that Texas, the nation’s second-most populous U.S. state, has become a battleground over MMR inoculations “despite the evidence base refuting links between vaccines autism.”

“As a vaccine developer and father of an adult child with autism and developmental delays, I point out there is not even any plausibility of the link to autism.”

Hotez identified autism as a genetic and epigenetic condition. In his article, Hotez credited anti-vaxxers with stirring the pot “conflated with fringe political elements to create a dangerous and toxic mix of pseudoscience and conspiracy theories.” He suggested they will lobby Texas lawmakers to push “anti-vaccine platforms.”

This troubles Hotez, concerned unvaccinated children and infants too young to receive vaccines are put at risk. Babies get their first MMR vaccine between 12 and 15 months. During the Disneyland outbreak, a four-month-old baby was one of nine infants under a year old who caught measles, Breitbart California reported.

Last year, a Journal of the American Medical Association (JAMA) study argued the MMR vaccine does not cause autism. Much anti-vaxx rhetoric hinges on thimerosal, a mercury-based preservative used to prevent contamination of multi-dose vials of vaccines. Between 1999 and 2001, thimerosal was removed or reduced to trace amounts in all childhood vaccines except for some flu vaccines. Since 2003, the CDC funded or conducted nine studies on thimerosal but found no autism-related link.

In the scientific journal article, Hotez addressed historical outcomes of U.S. childhood measles prior to the advent of a vaccine in the early 1960’s. “During that era, an estimated 50,000 hospitalizations occurred annually, together with 500 deaths and 4,000 cases of measles encephalitis, leading to permanent neurologic complications, deafness, or both, as well as billions of dollars in lost productivity and medical costs.”

Live Science reported on a rare yet deadly neurological disorder that can emerge several years after unvaccinated children contract measles–Subacute Sclerosing Panencephalitis (SSPE). Marked by swelling of the brain, SSPE victims die within a year after diagnosis. While some may live longer, the condition is always fatal and has no cure. In California, researchers identified 17 SSPE cases between 1998 and 2015. The average age of children who contracted the disease was 12. Some were diagnosed as young as three. Of these cases, 16 died and one remains in hospice care, according to the U.S. National Library of Medicine. They cite the MMR vaccine as highly effective in reducing potential childhood SSPE cases.

Hotez told Breitbart Texas, “Children who we thought recovered from their measles, in fact, go on to develop the serious and even deadly complication SSPE associated with seizures, coma, and death.”

He punctuated the overwhelming measles risk is to infants in the first year of life, explaining they are the “measles time bombs” in an outbreak involving large sectors of unvaccinated school children where the virus spreads to this delicate population. “Infantile measles is a scary and lethal disease. It’s why I wrote the article to warn about the risk to unvaccinated infants.”

Hotez addressed Austin-based Texans for Vaccine Choice, a political action committee (PAC) dedicated to “protecting personal liberties and informed consent for all individuals” at the forefront of the anti-vaxx debate. Breitbart Texas spoke by email with the group’s director, Julie Schlegel. She said they have thousands of members across the state from varying socioeconomic backgrounds, political party and religious affiliations. Some vaccinate their children. She qualified they were “all concerned with their rights being taken away.”

In 2015, state lawmakers proposed a handful of mandatory vaccination bills, although none passed through the legislature. One, authored by Representative Jason Villalba (R-Dallas), sought to end conscientious non-medical exemptions, similar to California’s SB 277,  which eliminated that option for Golden State public and private school children following the devastating Disneyland measles epidemic.

The CDC maintains vaccines are safe and do not cause autism. Schlegel asserted “nearly 4 billion dollars” was paid to individuals who claimed vaccine injuries. The U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) reports $3.5 billion was paid over 27 years (1988-2015) from the U.S. Court of Federal Claims through a “no fault” Vaccine Injury Compensation Program (VICP) to people who alleged vaccine injury. In 2009, this same court ruled vaccines do not cause autism, USA Today reported.

Between 2006-14, over 2.5 billion doses of various vaccines were distributed nationwide. Of all 3,637 petitions filed claiming vaccine injures, 2,287 were adjudicated by the “vaccine court.” That means, says HRSA, for every one million vaccine doses, only one person received compensation.

Follow Merrill Hope, a member of the original Breitbart Texas team, on Twitter.