After 26 Years, the US Loses Its Measles Elimination Status Amid Record Case Counts

A source close to the process told CNN on Friday that the United States has lost the measles elimination status it had held since 2000. An independent commission of experts that reports to the director of the Pan American Health Organization concluded that the country no longer qualifies as having eliminated the disease. The Wall Street Journal reported the news first.

The decision was widely expected after years of declining vaccination and rising case counts. It is no less a blow to American public health. The committee treats measles as endemic when infections from the same strain pass from person to person within a country for at least a year. To judge that, members study the genetic code of viruses sampled from patients. Each time the virus copies itself, it makes small changes, and comparing genomes in an outbreak shows how closely cases are related and whether they belong to the same chain of transmission.

Utah supplied some of the clearest evidence. In August, scientists at the state's public health laboratory published a preprint showing that one strain had circulated there for more than a year and accounted for over 95% of cases. It moved from the southwest of the state to central Utah and caused more than 600 cases between June 2025 and June 2026. Sustained outbreaks have also occurred in South Carolina, Pennsylvania, Wisconsin and New York, among other states. It is not clear what data the committee used, but Dr. Angela Rassmussen, a virologist at the University of Saskatchewan and editor-in-chief of the journal Vaccine, said it was not a hard call. The Utah data alone, she said, would have been enough.

The numbers are stark. More than 5,400 measles cases have been reported in the US this year, the most since 1991. Most are tied to 43 new outbreaks this year, while more than 1,000 stem from outbreaks that began last year. Nearly all involved people who were unvaccinated or whose status is unknown. The CDC reports hospitalization in roughly 1 in 9 cases, and state reports show at least 10 deaths. Cases, hospitalizations and deaths have set records for two years running, even as some members of the Trump administration, including the president, have cast doubt on the safety and effectiveness of the vaccines.

Since 2000 the country has still had outbreaks each year, started by sick travelers bringing the virus in. High vaccination rates usually kept them small and short. In 2025 and 2026, the virus found more unvaccinated families and communities. Two doses of the MMR vaccine cut an exposed person's chance of getting sick by 97% compared with someone unvaccinated. Measles is among the most contagious viruses known: one infected person typically infects 12 to 18 others, and the airborne virus can linger in a room for hours.

Experts described the loss as a verdict on more than measles. Dr. Demetre Daskalakis, former director of the CDC's National Center for Immunization and Respiratory Diseases, called elimination a vital sign for the public health system and said losing it means the nation is less prepared for both infectious and noninfectious challenges. Dr. Peter Hotez of Texas Children's Hospital called it incredibly embarrassing, but said the formal status matters less than the fact that measles is pervasive, vaccination rates are down, and he does not expect a return to normal soon. Dr. Nuwan Gunawardhana, an epidemiologist at Columbia University Irvine Medical Center, said it points toward reversing a generation of progress.

The risk falls hardest on infants too young to be vaccinated and on people with weakened immunity from transplants, cancer or other conditions. Dr. William Moss of the Johns Hopkins Bloomberg School of Public Health noted that most people recover after days of fever, rash and misery, but the disease is not benign. Measles can erase the immune system's memory of past infections, leaving people open to pneumonia or diarrhea. A pregnant woman can pass it to her baby in the womb, endangering the child's life. Rarely, neurologic complications appear years later, including the progressive, fatal illness SSPE. Vaccination prevents all of these.

The US set its first elimination goal in 1978 and helped lead the eradication of smallpox. In 2016, PAHO and the WHO declared the Americas' 35 countries free of ongoing measles transmission; Canada lost that status last year after a long, multi-province outbreak. Mexico, which has had several large outbreaks, is also at risk. Moss said the US must now be on a path to regaining status, but called that far from trivial given diminished trust in vaccines, rising nonmedical school exemptions, falling kindergarten MMR coverage, and the undermining of vaccine policy.