U.S. Measles Cases Top 2,000 in 2025 as Elimination Status Faces Loss

As of December 31, 2025, the Johns Hopkins University Measles Tracker listed 2,071 measles cases in the United States for the year. Only 167 of them were imported from other countries. The rest were spread inside U.S. borders, which is the fact that shapes everything else in the story: the country is about to lose a status it earned in 2000.

The clock traces back to January 2025 and an outbreak in Gaines County, West Texas. The Pan American Health Organization, the regional office of the World Health Organization that rules on measles elimination in the Americas, gives countries a standard 12 months from the start of an outbreak to bring it under control. That window closes this month. Canada was held to the same timeline and lost its elimination status in November 2025. Since the Texas outbreak, the tracker has also logged cases in parts of Arizona, New Mexico, South Carolina, Utah, Kansas, Montana and New York state.

The author of this Forbes opinion piece argues that the problem is much older than one year. The U.S. reached elimination by keeping childhood vaccination rates well above 95 percent, the threshold needed to stop the virus from spreading through a community. After 2000, those rates slipped as misinformation about the vaccine spread. Experts warned for two decades that coverage would fall below that line, and the author wrote about the risk in Forbes in 2018. Outbreaks grew more frequent from the late 2010s onward. Today only 815 of the 3,244 U.S. counties and county equivalents are at or above 95 percent.

William Moss, a physician and epidemiologist at the Johns Hopkins Bloomberg School of Public Health and executive director of the International Vaccine Access Center, called the situation an embarrassment and a symbolic representation of the continuing undermining of vaccination in the U.S. He said the 12-month benchmark is somewhat arbitrary, and that a month or two more would not change much. The time to act was before the outbreaks, or within their first few months. By the nine- or ten-month mark in both the U.S. and Canada, it was increasingly clear the virus had re-established itself.

Moss stressed that measles is not a mild childhood illness. Three people died of it in 2025, about 10 percent of cases were hospitalized, and the disease can cause rarer neurologic complications for which there are no good treatments. He also pointed to the costs of outbreak response and patient care, which the author says will rise now that the virus is circulating domestically and vaccination rates continue to fall. Those costs ultimately fall on taxpayers and people who pay for insurance.

Regaining status will be hard. Measles is more contagious than the coronavirus that causes COVID-19; one infected person can on average pass it to 12 to 18 susceptible people. Containment depends on isolating contagious people and quarantining those exposed for at least 10 to 14 days, which requires strong surveillance. Moss said the U.S. is probably going backwards on that front, citing cuts and layoffs at the CDC, pulled scientific funding, the dismantling of USAID and the U.S. withdrawal from the WHO, which he said will weaken surveillance globally as well.

Raising vaccination rates, Moss said, means addressing two buckets: access and demand. Access covers people who want vaccines but lack health services, such as in the northwest corner of Arizona, which has had outbreaks over the past year. Demand is the will and interest to get vaccinated, which the author says has been eroded by downplaying measles and promoting unfounded claims about vaccine side effects. The author criticizes Trump administration steps this year, including cuts to science funding, mass layoffs of federal scientists, the removal of experts from the CDC's Advisory Committee on Immunization Practices, and a new CDC "Autism and Vaccines" webpage that he says carries unsupported claims.

Moss worries the news of lost status will come and go and be quickly forgotten, leaving state and local governments to pick up the pieces, with academia stepping in where it can. Johns Hopkins' tracker is one example, much as a Johns Hopkins graduate student built a COVID-19 case tracker when the federal government did not. The author's view is that piecemeal efforts did not work well then and are unlikely to now. What to watch next is the formal PAHO decision this month, and whether surveillance and vaccination coverage move at all.