U.S. faces loss of measles elimination status

The United States is on the verge of losing its official status as a country free from measles.

More than 4,400 cases and at least three deaths were reported nationwide in 2026. This follows a year in which nearly 2,300 cases were recorded. Experts say the return of the disease signals deeper problems in how the nation protects its population.

The U.S. declared measles eliminated in 2000. For over two decades, the virus was rare, typically appearing only in travelers. Recent outbreaks have been driven by local transmission in communities where vaccination coverage is low. Jennifer Nuzzo, an epidemiology professor at Brown University, described measles as a warning sign for other vaccine-preventable illnesses.

The Pan American Health Organization will review the U.S. status in mid-November in Washington, D.C. Nuzzo, who serves on the committee, said that failing to control measles speaks to the country's ability to handle future health threats.

Data from the Centers for Disease Control and Prevention shows vaccination coverage for kindergarteners fell to 92.4% in the 2025-2026 school year. This figure is below the 95% threshold required to prevent sustained transmission. The CDC reports that 280,000 kindergarteners did not complete the two-dose series for measles, mumps, and rubella. Exemptions from vaccination also rose to a record 4.2% for incoming kindergartners.

William Moss, an epidemiology professor at Johns Hopkins Bloomberg School of Public Health, noted that outbreaks often occur in closely knit communities with frequent contact and low immunity. While many Americans support vaccines, a July survey by the Kaiser Family Foundation found a large group remains uncertain, creating room for conflicting information to influence decisions.

Federal policy changes have added to the uncertainty. President Donald Trump signed an executive order in August suggesting the combined measles, mumps, and rubella vaccine be split into separate shots. Health and Human Services Secretary Robert F. Kennedy Jr. has restructured the federal advisory committee on childhood immunizations, though those changes are paused due to lawsuits. Scott Weaver, a virologist at Galveston National Laboratory, stated that the CDC lost many experienced scientists during the pandemic and no longer immediately updates its national tally with state-reported deaths.

A model published in JAMA in April 2025 projected that if current vaccination rates persist, measles could become endemic again. The model estimates 851,300 cases over 25 years, leading to 170,200 hospitalizations and 2,550 deaths. Michael Osterholm, an epidemiologist at the University of Minnesota, pointed to Canada, which lost its elimination status in November after more than 5,400 cases in 2025. He warned that a similar experience in the U.S. could result in up to 50,000 cases.

Coverage for other childhood diseases has also declined. Polio vaccination fell to 92.4% for kindergarteners, while coverage for diphtheria, tetanus, and pertussis dropped to 92%. Reported pertussis cases reached roughly 43,300 in 2024 and nearly 28,000 in 2025. The JAMA model also examined the impact of falling immunization rates on other eliminated diseases. In a scenario where childhood vaccination rates fell by half, the model projected 9.9 million cases of rubella and 4.3 million cases of polio over 25 years.