US Stripped of Measles Elimination Status as Virus Resurges After a Quarter Century

The United States has officially lost the designation it earned a quarter century ago as a nation where measles had been eliminated, marking the collapse of one of public health’s most significant achievements.

Researchers with direct knowledge of the review told KFF Health News that the Pan American Health Organization concluded this week that measles has reestablished sustained transmission within the country. PAHO had scheduled a public announcement for Nov. 17. In public health terms, elimination status depends on sporadic outbreaks resolving within a year. That threshold is no longer being met in the United States.

“It’s a very sad moment,” said Anne Schuchat, an epidemiologist and former deputy director at the Centers for Disease Control and Prevention who was not involved in PAHO’s determination. “Measles causes so much unnecessary suffering, everything from a high fever and missed work and school to long-term complications like progressive degenerative nerve disease and death.”

Measles outbreaks are entirely preventable. Two doses of the measles-mumps-rubella vaccine prevent roughly 97% of infections, so when nearly everyone in a community is fully vaccinated, the virus cannot gain a foothold.

Over the past two years, more than 830 people have been hospitalized with measles in the U.S. Researchers at Johns Hopkins University estimate that more than 8,000 people have been sickened in outbreaks that have generated approximately $125 million in costs across medical care, public health response, and lost productivity. States have reported 13 measles-associated deaths, including a 7-month-old in New York and infants in Pennsylvania and Wisconsin in recent months. Infants are typically not vaccinated until they reach one year of age.

PAHO, the international body that oversees health across the Americas and collaborates with the World Health Organization, based its assessment on two analyses: one conducted by the CDC and another by an independent panel of measles experts. Researchers had anticipated the outcome after an outbreak in Utah crossed the one-year threshold in June.

Emily Hilliard, a spokesperson for the Department of Health and Human Services, attributed the resurgence to vaccination gaps that emerged years before the current administration. Childhood vaccination rates have indeed declined steadily since the onset of the covid pandemic.

Many scientists, however, also hold the Trump administration responsible for amplifying vaccine misinformation and undermining a rapid, forceful response to outbreaks. The administration has, for example, cut millions of dollars from childhood immunization programs administered by state health departments and terminated funding for research on vaccine hesitancy.

After Health Secretary Robert F. Kennedy Jr. removed CDC director Susan Monarez in August 2025, she told Congress that she had been fired for refusing to preapprove changes to vaccine recommendations “without reviewing the evidence.” She added that “we already have seen the largest measles outbreak in more than 30 years” and warned that “if vaccine protections are weakened, preventable diseases will return.”

Spokespeople for HHS and the White House defended the administration, including Kennedy, who led a prominent anti-vaccine organization before taking over the department. “The President and the Secretary have repeatedly encouraged measles vaccination, coordinated with states, and facilitated the deployment of vaccine doses across the country,” White House spokesperson Allison Schuster wrote in an email.

Past Administrations Sounded the Alarm

For more than three decades, the federal government treated measles as a preventable tragedy, and major outbreaks routinely prompted national campaigns to raise vaccination rates and halt the virus’s spread. That posture has changed, said Patsy Stinchfield, executive director of the Measles Collaborative, a new initiative that educates the public about vaccines and supports health workers responding to outbreaks.

Stinchfield was a pediatric nurse at a children’s hospital in Minnesota during the country’s last major measles surge before elimination, which ran from 1989 to 1991. She recalled an entire ward dedicated to children with measles and the immense effort required to keep the virus away from young patients with cancer and compromised immune systems. Two children at the hospital died from measles. “That changed my career forever,” she said.

In that era, she said, the federal government “saw the urgency.” Officials convened press conferences, discussed vaccines on the news, issued clinical guidelines, and published reports in the CDC’s flagship journal, the Morbidity and Mortality Weekly Report, or MMWR, that shaped policy.

When data indicated that some children did not mount a strong response to a single dose of the measles-mumps-rubella vaccine, a CDC advisory committee recommended a two-dose regimen. When CDC analyses showed that many children who contracted measles had gone unvaccinated because of cost, the government launched the Vaccines for Children program to provide immunizations free of charge to underinsured families.

Cases fell sharply. By 2000, the CDC and PAHO had determined that measles no longer posed a national threat, having been eliminated from domestic transmission. Elimination permits occasional outbreaks, since measles has not been eradicated worldwide and a small segment of the population, such as young infants, cannot be protected by vaccines.

Travelers infected abroad sparked sporadic outbreaks after U.S. elimination, but until recently those chains of transmission died out because of herd immunity. With at least 95% of people in a given community immunized, outbreaks fizzled and vulnerable individuals remained protected.

Fourteen years would pass before the next significant U.S. outbreak. Then, in 2015, the virus spread among unvaccinated children at Disney theme parks in California, seeding outbreaks elsewhere. Congress treated some 125 cases as an emergency and called on Schuchat to testify about the situation. “Vaccination wasn’t a partisan issue,” she recalled. “This was about problem-solving: What can we do about this?”

National television broadcast a segment featuring then-Surgeon General Vivek Murthy discussing vaccination with Sesame Street‘s Elmo. HHS officials worked with vaccine experts to develop strategies for rebuilding public confidence. California and Vermont strengthened their vaccine requirements.

In 2019, House and Senate committees convened again on measles as a large outbreak took hold in Orthodox Jewish communities in New York and New Jersey. Congress pressed HHS leaders on how the administration intended to curb the spread of vaccine misinformation online.

“Internet fraudsters who claim that vaccines are not safe are preying on the unfounded fears and daily struggles of parents, and they are creating a public health hazard that is entirely preventable,” Lamar Alexander, then a Republican senator from Tennessee, said at the time.

Alex Azar, health secretary during the first Trump administration, and then-CDC Director Robert Redfield held a press conference emphasizing the “importance of on-time vaccination.”

During the 2014, 2015, and 2019 outbreaks, the CDC’s MMWR published detailed articles within weeks of collecting data. Timing is critical, since those reports guide emergency response. “The MMWR is the voice of the CDC,” Schuchat said. “It alerts the nation, the media, clinicians, and public health experts to events that require action.”

‘The Dog Didn’t Bark’

Shortly after President Donald Trump took office in 2025, a measles outbreak erupted in West Texas. Within seven months, it had grown larger than any U.S. outbreak since 1992, spread to Mexico and at least three other states, sickened more than 4,500 people across the two countries, and killed at least 16. Rather than delivering clear, repeated messages about the importance of measles vaccination, Kennedy falsely claimed on Fox News that the shots cause “deaths every year.”

Congress held no hearing, and HHS released no funding until after the West Texas emergency had subsided. Aside from an annual measles update, the MMWR published no report on the outbreaks that year.

“A lot of this is the dog didn’t bark,” said Dorit Reiss, a vaccine policy researcher at the University of California Law-San Francisco. “Something that normally happens isn’t happening.”

Political appointees have delayed or blocked several MMWR articles, according to multiple CDC officials who spoke with KFF Health News on condition of anonymity, citing fears of retaliation. “There’s a deliberate effort to downplay vaccine-preventable diseases by the administration,” one official said.

“Measles reports from West Texas and New Mexico were intentionally shelved,” another agency scientist said. In April, The Washington Post reported that Jay Bhattacharya, who temporarily led the CDC this year and continues to head the National Institutes of Health, had blocked publication of an MMWR study finding that covid vaccines halved the likelihood of emergency department visits.

“The suggestion that HHS is deliberately suppressing information about measles or other vaccine-preventable diseases is false,” Hilliard, the HHS spokesperson, said in an email to KFF Health News. She noted that Kennedy and the CDC had provided approximately $100 million in additional funding to respond to outbreaks, and said the timing of MMWR reports varies according to factors such as data analysis and scientific review.

More than a year after data was collected in Texas, a handful of reports appeared in the CDC’s journal. One study of 60 people hospitalized with measles in West Texas found that two required intubation and mechanical ventilation, and that a baby born to a mother with measles suffered potentially fatal brain swelling caused by the virus.

The MMWR still has not published detailed reports on the large outbreaks in South Carolina, Utah, and Pennsylvania. Nor has the CDC’s national measles update appeared in the journal this year. In its place, the publication has run less urgent articles on scientific methods that could help characterize future outbreaks.

CDC scientists told KFF Health News that they continue to analyze data but no longer expect to publish their findings in the MMWR, because the process has become slow, opaque, and unpredictable. An urgent CDC report on the risks measles poses to pregnant women was withheld, according to The Washington Post.

“We have two CDCs now,” one agency official said. “One is staffed by CDC scientists and civil servants who are committed to public health, and the other is political appointees who go in and change the website.”

The CDC’s measles dashboard counts four fewer deaths than state health departments have reported this year. Kennedy has disputed some of those deaths and made unsubstantiated claims that Pennsylvania health officials misrepresented their data.

Kennedy personally directed the CDC to revise language on a webpage stating that vaccines do not cause autism, he told The New York Times last year. The page now suggests a possible link and no longer cites the body of peer-reviewed research that rigorously searched for an association and found none. In their place are speculation about a correlation and unsubstantiated assertions that the scientific establishment concealed a potential link “to prevent vaccine hesitancy.”

The Trump administration has muddled the message on vaccines in other ways, Reiss said. Trump incorrectly claimed in August that the measles-mumps-rubella vaccine could be “quite lethal,” and repeated the discredited notion that vaccines may cause autism. Stephen Miller, now Trump’s White House chief of staff, has falsely said that doctors “pump your kids full of shots days after birth with no understanding of the long-term consequences.” Recommended vaccines and the immunization schedule have been thoroughly studied.

Kennedy has promoted such claims for two decades, a pattern that has continued during his tenure as health secretary. “Having top leadership disseminating rumors, disinformation, and flat-out falsehoods has been unforgivable,” Schuchat said.

When pressed by journalists and members of Congress, Kennedy and Trump have recommended measles vaccination. But they have not delivered that message clearly and without prompting on social media or on the podcasts and videos in which Kennedy regularly appears.

Kennedy has also replaced vaccine experts on the CDC’s advisory panel with fringe researchers who hold anti-vaccine views. Under his leadership, the agency has laid off or forced out many vaccine specialists, including every member of the Immunization Services Division partnership branch, which works with community organizations and pharmacies.

At the same time, Kennedy has directed resources toward investigating potential vaccine harms, including through a proposed clinical trial that medical societies and the WHO have deemed unnecessary and unethical.

Regaining elimination status will require the current U.S. outbreaks to end, followed by future outbreaks ceasing to spread within a year, said Paul Rota, a microbiologist and former CDC official. With outbreaks expanding across several states, he said, that milestone is nowhere in sight.

“Bigger fires create more embers, and any one of those embers can seed another fire,” he said.

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