Researchers say US has lost measles elimination status as outbreaks spread
Researchers familiar with international health deliberations say the United States has lost its measles elimination status, achieved a quarter century ago. They say the Pan American Health Organization (PAHO), which works with the World Health Organization, concluded this week that regular transmission has returned. Public announcement was planned for November 17; this is the researchers' account, not a public PAHO announcement.
In public health terms, elimination depends on a country's sporadic outbreaks ending within a year, and that is no longer happening in the United States; researchers anticipated the decision after an outbreak in Utah passed the one-year mark in June. PAHO based its assessment on two analyses, one by the US Centers for Disease Control and Prevention and another by an independent group of measles experts. Elimination still allows occasional outbreaks, because measles is not eradicated worldwide and a small fraction of people, such as young infants, cannot be protected by vaccines. After the status was gained in 2000, infections brought in from abroad sparked occasional flare-ups, but they fizzled out because of herd immunity, the protection created when about 95 percent of a community is immunized.
Worst resurgence in decades
The CDC reported 5,412 measles cases nationwide as of November 12, up 230 from its previous update. States have reported 13 measles-associated deaths, including a seven-month-old in New York and infants in Pennsylvania and Wisconsin in recent months; babies are typically not vaccinated before their first birthday. Pennsylvania recorded its seventh measles-linked death this year, an unvaccinated resident of Montour County, and has reported 1,542 cases across 46 counties including 305 hospitalizations; Wisconsin reported the death of a second child. Over the past two years more than 830 people have been hospitalized with measles in the United States and more than 8,000 sickened, in outbreaks that researchers at Johns Hopkins University estimate have cost roughly 125 million dollars in medical care, public health response and lost productivity. Two doses of the measles, mumps and rubella vaccine prevent about 97 percent of infections, so the outbreaks are considered entirely preventable.
A former CDC deputy director, epidemiologist Anne Schuchat, who was not involved in the decision, called it a very sad moment, saying measles causes unnecessary suffering, from high fever and missed work and school to long-term complications such as progressive degenerative nerve disease and death. Former CDC microbiologist Paul Rota said that to regain elimination status, current outbreaks must end and future ones must stop spreading within a year, a moment not on the horizon with outbreaks expanding in several states. Bigger fires create more embers, he said, and any one of them can seed another fire.
How the response has changed
For more than three decades the federal government treated measles as a preventable tragedy, with sizable outbreaks triggering national efforts to boost vaccination. A pediatric nurse during the country's last major surge before elimination, from 1989 to 1991, recalled an entire hospital ward devoted to children with measles, two of whom died. Back then, she said, officials held press conferences, issued clinical guidelines and published timely reports that drove policy; when many sick children were found unvaccinated because of cost, the government launched a program providing free immunizations to underinsured families. In 2015 an outbreak among unvaccinated visitors to California theme parks was treated by Congress as an emergency, and in 2019 committees met again as a large outbreak took hold in New York and New Jersey. A Tennessee Republican senator said at the time that internet fraudsters claiming vaccines are unsafe were creating an entirely preventable public health hazard.
Just after President Donald Trump took office in 2025, a measles outbreak exploded in West Texas; within seven months it surpassed any US outbreak since 1992, spread to Mexico and at least three other states, sickened more than 4,500 people in the two countries and killed at least 16. Critics say that instead of clear, repeated messages on vaccination, Health Secretary Robert F. Kennedy Jr. falsely claimed on television that the vaccines lead to deaths every year; Congress called no hearing and the health department sent funds only after the emergency had subsided. Many scientists blame the administration for spreading vaccine misinformation, cutting millions of dollars from state children's immunization programs and terminating research on vaccine hesitancy. After Kennedy dismissed CDC director Susan Monarez in August 2025, she told Congress she was fired because she would not preapprove changes to vaccine recommendations without reviewing the evidence.
The administration rejects that account. A health department spokesperson attributed the resurgence to vaccination gaps that opened years before this administration, noting childhood vaccination rates have declined steadily since the COVID pandemic began, and said the suggestion that the department is deliberately suppressing information about measles or other vaccine-preventable diseases is false. She said Kennedy and the CDC have provided about 100 million dollars in additional outbreak-response funding. A White House spokesperson said the president and the secretary have repeatedly encouraged measles vaccination, coordinated with states and facilitated the deployment of vaccine doses across the country.
Claims of delayed science and altered messaging
Current CDC officials and scientists, speaking anonymously for fear of retaliation, say political appointees have delayed or blocked several articles in the agency's flagship journal, which has historically guided emergency response, and that measles reports from West Texas and New Mexico were intentionally shelved; they say detailed reports on major outbreaks in South Carolina, Utah and Pennsylvania have still not appeared, and the journal's annual national measles update has not been published this year. One official said there are now, in their words, two CDCs: one staffed by scientists and civil servants committed to public health, and the other of political appointees who go in and change the website. A newspaper also reported that an urgent CDC report on the risks of measles to pregnant women was withheld, and that the head of the National Institutes of Health, while temporarily leading the CDC, blocked publication of a study finding COVID vaccines halved the likelihood of emergency department visits. The health department spokesperson said the timing of journal reports varies because of data analysis and scientific review.
Critics also point to changes in public messaging. The CDC's measles dashboard counts four fewer measles deaths than state health departments have reported this year; Kennedy has disputed some deaths and made unsubstantiated claims that Pennsylvania health officials misrepresented data. He told a newspaper last year that he personally instructed the CDC to alter language on a webpage that said vaccines do not cause autism; the page now suggests a potential link and no longer lists the peer-reviewed studies that rigorously searched for an association and found none, replacing them with speculation about a correlation, according to the same reporting. Trump incorrectly said in August that the measles-mumps-rubella vaccine could be, in his words, quite lethal, and repeated the debunked idea that vaccines may cause autism; his White House chief of staff has falsely said doctors pump children full of shots days after birth with no understanding of the long-term consequences. A vaccine policy researcher at the University of California said the administration has muddied the message on vaccines, and Schuchat called the dissemination of rumors and falsehoods by top leadership unforgivable. Kennedy has also replaced vaccine experts on a panel advising the CDC with researchers holding anti-vaccine views and, under his leadership, the agency has laid off or forced out many vaccine specialists; he has devoted resources to searching for potential harms from vaccines, including an attempted clinical trial that medical societies and the World Health Organization considered unnecessary and unethical.
Earlier prevention and later reports
Measles Collaborative director Patsy Stinchfield recalled protecting children with cancer and weakened immunity during the 1989-1991 surge. Poor response to one vaccine dose led advisers to recommend two, while Vaccines for Children addressed cost barriers. In 2015 Congress sought testimony when the Disney-parks outbreak involved about 125 cases. Surgeon General Vivek Murthy discussed vaccines with Elmo on television; California and Vermont tightened rules. In 2019, outbreaks in Orthodox Jewish communities prompted hearings, and Alex Azar and Robert Redfield stressed on-time vaccination. Senator Lamar Alexander warned about online misinformation. Emergency reports appeared within weeks in 2014,2015 and 2019.
Researcher Dorit Reiss compared the missing routine response to the dog that did not bark. More than a year after data collection, a study of 60 hospitalized Texas patients showed two needed intubation and ventilation and an infected mother's baby developed brain swelling. Scientists say publication has become unpredictable, while less urgent methods papers appear. Jay Bhattacharya was the official accused of blocking the COVID study. Emily Hilliard gave the health department denial; Allison Schuster gave the White House defense. Stephen Miller made the unsupported claim about unknown vaccine-schedule effects, although vaccines and their schedule have been thoroughly studied. Kennedy and Trump endorsed vaccination when pressed, critics noted, but not consistently and unprompted. The entire CDC branch partnering with communities and pharmacies was among the specialists lost.