The United States is poised to lose its measles elimination status as nationwide infections have surpassed 5,400 cases in 2026, according to data from the Centers for Disease Control and Prevention.
The Pan American Health Organization (PAHO) is currently reviewing the nation’s status, which has been held since the country interrupted endemic transmission of the virus in 2000. The Wall Street Journal reported Friday that the organization has determined the status should be revoked following a period of uninterrupted domestic spread.
“Loss of measles elimination status in the US signals to the world that we are not up to this task and may diminish their own aspirations to achieve and sustain measles elimination,” William Moss, MD, MPH, an infectious disease epidemiologist at Johns Hopkins Bloomberg School of Public Health, said.
Robert F. Kennedy Jr. in a 2021 book wrote that Americans had been "misled … into believing that measles is a deadly disease." He said measles outbreaks had been "fabricated" to push people towards vaccines. https://t.co/lBXK42mpjj pic.twitter.com/lo7ZA0nv8F
“Losing elimination status means that we are less prepared as a nation to address infectious and noninfectious disease challenges,” said Dr. Demetre Daskalakis, who previously led the National Center for Immunization and Respiratory Diseases at the US Centers for Disease Control and Prevention, per CNN.
Measles cases rise while costs climb
The current outbreak represents the highest number of measles cases reported by the CDC since 1991. In 2025, the country recorded 2,289 confirmed cases, a figure that has more than doubled by November 2026. While the CDC reported 5,182 confirmed cases through November 5, 2026, other reports indicate that 5,412 infections have been reported across 45 states. Experts suggest both tallies may be undercounts.
A new tool developed by researchers estimates that the 2026 outbreaks could cost the U.S. nearly $83 million. CNBC reported that this estimate accounts for almost $25 million in lost productivity, over $1.8 million in direct medical expenses, and $56 million for public health response costs. According to a model cited by CNBC, the costs are largely labor-driven, estimating roughly $298,000 in fixed costs and approximately $16,300 for each additional case.
For comparison, the 2025 outbreaks carried an estimated economic cost of more than $37 million, according to the same tool. Mattingly said that the economic burden of outbreaks can quickly exceed the investment needed for vaccination, stating, “Even if you don't get the infection, the contact costs you.”
Declining vaccination rates
Public health experts point to a decline in immunization coverage as a primary driver of the resurgence. Vaccination rates among U.S. kindergarteners have fallen from 95.2 percent during the 2019-2020 school year to 92.4 percent for the 2025-2026 school year, Al Jazeera reported. This drop leaves roughly 300,000 kindergarteners entering classrooms without vaccination this year.
This 92.4 percent rate sits below the 95 percent threshold required to sustain herd immunity. The CDC notes that the majority of cases—4,993 in total—were associated with specific outbreaks. The demographic breakdown of the 2026 cases shows that children and teenagers account for approximately 59 percent of confirmed infections. Specifically, children below the age of five make up 18 percent of cases, while those between ages five and 19 account for 41 percent, Al Jazeera reported.
The virus is highly contagious; a single infected person can typically spread it to 12 to 18 others. It is an airborne virus that can remain in the air for two hours after an infected person has left a room. Nearly all of the 2026 cases have been found in individuals who had not received the measles-mumps-rubella (MMR) vaccine or whose vaccination status is unknown.
Disputes over mortality data
While the CDC has reported four measles deaths in 2026, state officials have reported higher totals. As of November 13, ABC News reported that the nationwide death toll has reached 10, including seven in Pennsylvania, one in New York, and two in Wisconsin. Pennsylvania’s Department of Health reported six deaths and 1,487 cases in the state this year.
A dispute has emerged between Pennsylvania Governor Josh Shapiro and U.S. Health Secretary Robert F. Kennedy Jr. regarding how these deaths are classified. Al Jazeera reported that the CDC removed two deaths from its national tally after Kennedy questioned whether measles had caused or contributed to the fatalities. Kennedy has previously argued, without evidence, that some Pennsylvania deaths may not be linked to the virus.
The CDC stated it is working with the U.S. Council of State and Territorial Epidemiologists to establish a standardized definition for measles deaths. Infectious disease experts have warned that this classification dispute places the CDC at odds with traditional methods of tracking disease consequences.
Medical complications from measles can be severe. The CDC describes that the virus can cause pneumonia, encephalitis (swelling of the brain), or death in 1 to 3 of every 1,000 infected children. Other complications include ear infections and diarrhea, which affect one in 10 children. One in 20 children with measles may develop pneumonia, and encephalitis can lead to seizures, deafness, or intellectual disability.
Next steps for elimination status
The official decision regarding the United States’ measles elimination status is expected to be announced on November 17, 2026. A panel of scientists from the World Health Organization’s Pan American Health Organization will determine if the country has maintained more than 12 months of uninterrupted transmission, Yahoo News reported.
According to the Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission (RVC), a country loses its status if transmission is re-established and continues for at least 12 months.
Maimuna Majumder, a scholar in the Computational Health Informatics Program at Boston Children’s Hospital, previously noted to Live Science that the rise in cases in January 2025 felt like a “point of no return,” though she added that elimination has always been a tenuous prospect.
In an interview with The Guardian, Dr. Paul Offit, who serves as director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said that the potential loss of status is a tremendous step backwards.
To regain elimination status, the U.S. must go 12 months without continuous spread of the virus. Experts emphasize that the MMR vaccine is safe and effective, with two doses providing 97 percent protection against infection. For those seeking information regarding vaccination or specific health concerns, individuals should consult a qualified medical professional.
Earlier coverage: U.S. Measles Cases Surpass 5,100 as Elimination Status Faces Risk