US Loses Measles-Elimination Status After 26 Years as Outbreaks Surge Across Several States

The United States no longer has the status of a country that has eliminated measles. After holding the designation for 26 years, it lost it this week, according to The Wall Street Journal, which reported that the Pan American Health Organization had concluded the disease has returned to the country and is spreading continuously. Health officials had expected the ruling once the organization met.

The country earned the status in 2000, after decades of vaccination campaigns pushed childhood measles vaccination above 97%. Health experts say a 95% rate is what's needed: at that level, when an infected traveler arrives in a community, enough people are immune that no outbreak takes hold. Last year the national childhood vaccination rate fell to about 92%, and it was far lower in certain states and communities.

The numbers show how far things have moved. Before the vaccine arrived in 1963, the U.S. saw roughly 3 million to 4 million cases a year. After elimination, a normal year brought fewer than 200. Last year, large outbreaks erupted in Texas, Arizona, Utah and South Carolina. This year there are about 5,400 confirmed cases, double the 2025 total, driven largely by an outbreak in Pennsylvania that has dwarfed the earlier ones. It is the worst year for measles illness since 1991.

The human toll is part of that count. The country has recorded 10 measles-associated deaths this year, including two reported Friday, one in Pennsylvania and one in Wisconsin. Measles is among the most contagious viruses known: it can linger in the air for up to two hours, and about 9 in 10 susceptible people exposed will become infected, according to the CDC. It begins in the respiratory tract, then spreads through the body, bringing high fever, runny nose, cough and red, watery eyes. A rash follows three to five days after the first symptoms, starting as flat red spots on the face and moving down the body, and the fever can climb past 104 degrees Fahrenheit. Most children recover, but pneumonia, blindness, brain swelling and death are possible.

Dr. David Margolius, director of Cleveland's health department and a leader in a coalition of big-city health departments, told The Associated Press: "It's a big deal. The decision represents us moving backward."

The CDC was not immediately available for comment Saturday. In an earlier statement, CDC Director Erica Schwartz said the PAHO decision won't change how federal officials respond to outbreaks. "The measles elimination designation is not what protects Americans. Vaccination does," she said, adding that officials know where transmission is occurring and are working with state and local health departments to reach those communities.

KFF, a health policy research group, points to several drivers of the resurgence: funding and staffing cuts at federal, state and local public health agencies; mixed messages on measles and vaccines from Trump administration health officials, including Health Secretary Robert F. Kennedy Jr.; growing public skepticism about measles vaccines; and declining trust in health authorities generally. Kennedy has shortened the childhood vaccination schedule, reshaped a key vaccine advisory board, and praised a Trump executive order calling for spacing out the MMR vaccine. That order runs counter to medical groups' recommendations and, experts say, would likely leave fewer children fully vaccinated. Earlier this year, Trump claimed, without evidence, that the MMR vaccine might be "quite lethal."

Getting the status back will be slow. The Journal reports the U.S. must stop measles spread for at least a year, and experts told the paper it could take years. Canada and the U.K. have also lost their elimination status in recent years.