Fears of an increasing measles outbreak among children are rising in Texas, as most of the population is reportedly unvaccinated.

An outbreak of measles in West Texas has been reported by the Texas Dept. of State Health Services. 10 cases have been identified and seven of those have been hospitalized. Eight of the cases are among school-aged children.

Public health practitioners warn such outbreaks will become more common because of scores of laws around the U.S. that ultimately lower vaccine rates.

On January 30, officials reported two measles cases in unvaccinated, school-age children in Gaines County, which sits at the border of New Mexico and is around 90 miles southwest of Lubbock, Texas. Both children were hospitalized in Lubbock and had been discharged.

A small county in West Texas has 15 measles cases, mostly in school-aged children. Gaines County, which borders New Mexico, has one of the highest rates of vaccine exemptions in the state.

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Two of the four cases are in Lubbock, which hasn’t seen a case in more than 20 years. Measles vaccination rates in Texas have fallen over the last four years.