With over 2,280 confirmed cases and multiple deaths, the U.S. risks losing its measles elimination status.
The United States is grappling with its most severe measles outbreak since 1991, a public health crisis that experts say was both predictable and preventable. Federal data compiled through the end of 2025 confirm more than 2,280 cases across 45 jurisdictions, a staggering increase from the 285 cases reported in all of 2024. The surge has prompted concerns that the country could lose the measles elimination status it earned in 2000.
The outbreak began gaining momentum in early 2025, with West Texas emerging as a primary epicenter. Gaines County, where nearly 14 percent of schoolchildren had opted out of required vaccinations, became ground zero for rapid community transmission. By mid-year, Texas alone had logged more than 760 cases, and the virus had spread to dozens of other states. Three deaths—two children in Texas and an adult in New Mexico—marked the first measles fatalities in the United States in over a decade.
By fall, a major outbreak had taken hold in South Carolina’s Spartanburg County, which accumulated more than 960 cases by early 2026. Health officials deployed mobile vaccination units and held regular public briefings, but the virus continued to spread through unvaccinated communities. Approximately 93 percent of all confirmed cases occurred in individuals who were either unvaccinated or whose vaccination status was unknown.
Public health authorities point to a confluence of factors driving the resurgence. National vaccination coverage among kindergartners has dropped from 95.2 percent during the 2019–2020 school year to 92.5 percent in 2024–2025, falling below the 93–95 percent threshold necessary for herd immunity. At the local level, pockets of low coverage create fertile ground for outbreaks when the virus is introduced.
The erosion of trust in public health institutions has compounded the problem. Changes in federal health leadership during 2025, including a controversial overhaul of the CDC’s Advisory Committee on Immunization Practices, created confusion around vaccine recommendations. The CDC’s social media communications about measles dropped dramatically compared to prior years, leaving a void that was filled by news outlets and, in some cases, misinformation.
Medical organizations have responded forcefully. The American Academy of Pediatrics reaffirmed its recommendation for universal MMR vaccination, emphasizing that one dose of the vaccine is 93 percent effective and two doses provide 97 percent protection. Wastewater surveillance tools in states like California and Connecticut have added an early warning layer for detecting silent transmission.
Whether the United States ultimately loses its elimination status will depend on whether ongoing chains of transmission can be broken. Canada lost its own elimination status in November 2025 after sustained outbreaks. For American public health officials, the path forward hinges on rebuilding vaccination confidence and closing coverage gaps before the virus gains further ground.
Sources
1. “2025 measles cases highest since 1991” — AAP News, American Academy of Pediatrics, January 7, 2026. https://publications.aap.org/aapnews/news/34124/2025-measles-cases-highest-since-1991
2. “Measles Cases and Outbreaks” — CDC, February 20, 2026. https://www.cdc.gov/measles/data-research/index.html
3. “2025 Measles Outbreak” — South Carolina Department of Public Health, February 17, 2026. https://dph.sc.gov/diseases-conditions/infectious-diseases/measles-rubeola/2025-measles-outbreak
4. “Communicating About the Ongoing Measles Outbreak” — Public Health Communications Collaborative, February 14, 2026. https://publichealthcollaborative.org/communication-tools/communicating-about-the-2025-measles-outbreak/
5. “7 of the Biggest Moments in Public Health in 2025” — U.S. News & World Report, December 29, 2025. https://www.usnews.com/news/national-news/articles/2025-12-29/7-of-the-biggest-moments-in-public-health-in-2025
