US Loses Measles Elimination Status After 26 Years as Outbreaks Outpace Vaccination

On Friday, a source close to the process told CNN 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 the country no longer qualifies. The Wall Street Journal reported the news first.

The decision had been widely expected. 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 test that, members study the genetic code of viruses sampled from patients. Each time the virus copies itself it makes tiny changes, and comparing genomes shows how closely cases are related and whether they belong to the same chain of transmission.

Utah supplied 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 the state's cases. It moved from the southwest corner of the state to central Utah and caused more than 600 cases between June 2025 and June 2026. South Carolina, Pennsylvania, Wisconsin, New York and other states have also had sustained outbreaks. 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 tough call. The Utah data alone, she said, would have been enough.

The numbers behind the decision are large. More than 5,400 cases have been reported this year, the most since 1991. Most trace to 43 new outbreaks, while more than 1,000 are tied to outbreaks that began last year. Nearly all of this year's cases were in people who were unvaccinated or whose status is unknown. The CDC says roughly 1 in 9 reported cases led to hospitalization, and state reports show at least 10 deaths. The country has logged record cases, hospitalizations and deaths for two years running, even as some members of the Trump administration, the president included, have questioned the safety and effectiveness of the vaccines.

Since 2000, outbreaks have still occurred every year, sparked by sick travelers bringing the virus in. High vaccination rates kept most of 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.

Experts described the loss in blunt terms. Dr. Demetre Daskalakis, a 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 country 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 here, vaccination rates are down nationwide, 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 country helped rid the world of smallpox and spent decades pushing measles offshore; it set its first elimination goal in 1978.

The risk is greatest for infants too young to be vaccinated and for people with weakened immunity from organ transplants, cancer or other conditions. Dr. William Moss of the Johns Hopkins Bloomberg School of Public Health noted that most patients recover after several 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, the worst being the progressive and fatal subacute sclerosing panencephalitis. Vaccination prevents all of these. The virus is also among the most contagious known: one infected person typically infects 12 to 18 others, and it can hang in the air of a room for hours.

The US is not alone. PAHO and the WHO declared the Americas' 35 countries free of ongoing measles transmission in 2016, but Canada lost its status last year after a long outbreak across several provinces. Mexico, with several large outbreaks of its own, is also at risk. Moss said the US must now be on a path to regaining status, but called that hard given diminished trust in vaccines, rising nonmedical school exemptions, falling kindergarten MMR coverage and the undermining of vaccine policy. It will not, he said, be a trivial task.