US Loses Measles Elimination Status After 26 Years

The United States has lost its measles elimination status after 26 years, forfeiting a distinction held since 2000 as surging outbreaks pushed case counts to their highest level in over three decades.

An independent commission of experts reporting to the director of the Pan American Health Organization determined that the country no longer qualified as having eliminated the disease, according to a source close to the process. Confirmed cases surpassed 5,400 nationwide this year. This total is more than double the 2,289 cases recorded in 2025 following months of escalating transmission.

Robert F. Kennedy Jr. in a 2021 book wrote that Americans had been "misled … into believing that measles is a deadly disease." He said measles outbreaks had been "fabricated" to push people towards vaccines. https://t.co/lBXK42mpjj pic.twitter.com/lo7ZA0nv8F

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“The measles elimination designation is not what protects Americans. Vaccination does. We know where transmission is occurring and we're working with state and local health departments to reach those communities. Losing a designation doesn't mean we abandon an evidence-based approach. It means we remain focused on stopping outbreaks,” CDC Director Erica Schwartz said in a statement.

Achieving elimination in 2000 required decades of sustained immunization campaigns that drove childhood vaccination rates above 97 percent. Health experts said that a 95 percent vaccination rate is necessary to preserve herd immunity and prevent an imported traveler from sparking widespread community transmission.

A country loses its elimination status if transmission is re-established and continues uninterrupted for at least 12 months, according to the Pan American Health Organization’s Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission.

National vaccination coverage among kindergarteners dropped to 92.4 percent in the 2025–2026 school year. This is down from 95.2 percent during the 2019–2020 school year. Vaccine skepticism expanded during the COVID-19 pandemic. Eighteen states now report MMR vaccination rates below 90 percent across the country. Idaho recorded 75.2 percent, and researchers identified numerous counties where coverage sits below 60 percent.

“That is a tremendous step backwards,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

Two doses of the measles, mumps, and rubella vaccine remain safe and roughly 97 percent effective at preventing infection, health officials said. A large pool of susceptible adults in their twenties, thirties, and forties who grew up when the virus was not circulating left portions of the population vulnerable.

These adults were neither naturally infected nor vaccinated. Outbreaks also impacted unique populations. Unvaccinated Amish and Mennonite communities in Pennsylvania who do not use traditional health care systems were affected.

The resurgence proved fatal in multiple states, with measles-associated deaths reported across the nation this year. A baby in Wisconsin and an unvaccinated patient in Pennsylvania died. Most fatalities involved children younger than 5 years old. The virus causes symptoms such as ear infections, diarrhea, pneumonia, and encephalitis, a serious swelling of the brain, in addition to general misery.

Researchers estimate that the outbreaks carry a massive economic cost. Public health response costs reached $56 million, and lost productivity totaled nearly $25 million. Direct medical expenses exceeded $1.8 million.

“Even if you don’t get the infection, the contact costs you,” researchers said, pointing out that exposed people often must quarantine while agencies absorb heavy labor-driven containment expenses.

Reclaiming elimination status will present a formidable challenge. Diminished public trust in vaccines, rising nonmedical exemptions in schools, and the undermining of federal vaccine policies complicate the work. Brazil lost its elimination status in 2019 before regaining it in 2024, demonstrating that recovery is possible.

“So it’s not going to be a trivial task for the United States to regain its measles elimination status,” said William Moss, MD, MPH, an infectious disease epidemiologist at Johns Hopkins Bloomberg School of Public Health.

More on this story: US Health Officials Exclude Pennsylvania Measles Deaths From National Counts · New York declares state of emergency amid measles outbreak · Philippine Measles Drive Revives Dangerous Vaccine Misinformation