The United States is at risk of losing its measles-free status due to a surge in outbreaks, with over 2,400 reported cases this year, raising concerns among health officials.
After a year marked by ongoing measles outbreaks that have affected more than 2,400 individuals, the United States is on the verge of losing its designation as a measles-free country. This alarming trend has prompted discussions among health officials, including Ralph Abraham, the newly appointed principal deputy director at the Centers for Disease Control and Prevention (CDC).
During a recent briefing for journalists, Abraham expressed a nonchalant attitude toward the potential loss of the measles-free status. “It’s just the cost of doing business with our borders being somewhat porous for global and international travel,” he stated. He added, “We have these communities that choose to be unvaccinated. That’s their personal freedom.”
Interestingly, infections from other countries accounted for only about 10% of the measles cases reported since January 20, 2025, the official start of the current outbreak in West Texas, which has since spread to other states and Mexico. The majority of cases were acquired domestically, marking a significant shift since the U.S. eliminated measles in 2000. Previously, while occasional cases emerged from international travelers, they rarely led to outbreaks due to the high vaccination rates in the country. Two doses of the measles, mumps, and rubella (MMR) vaccine are known to effectively prevent infection and curb the virus’s spread.
To retain its measles elimination status, the U.S. must demonstrate that the virus has not circulated continuously within the nation for a year, specifically between January 20, 2025, and January 20, 2026. In response to this requirement, scientists are currently investigating whether the significant outbreaks in South Carolina, Utah, Arizona, and Texas are interconnected.
Health officials have confirmed that the primary strain of the measles virus involved in these outbreaks is D8-9171. However, since this strain is also present in Canada and Mexico, CDC scientists are conducting a comprehensive analysis of the entire genomes of measles viruses—approximately 16,000 genetic letters long—to determine whether the strains in the U.S. are more closely related to each other than to those found in other countries.
The CDC anticipates completing its genomic studies within the next couple of months, after which the findings will be made public. The Pan American Health Organization, in collaboration with the World Health Organization, will then decide whether the U.S. will lose its measles elimination status. Such a loss could lead to an increase in costly, preventable measles outbreaks.
Measles was declared eliminated in the U.S. in 2000, a significant public health achievement. However, pediatrician and vaccine specialist Paul Offit criticized Abraham’s remarks, stating, “When you hear somebody like Abraham say ‘the cost of doing business,’ how can you be more callous? Three people died of measles last year in this country.” Offit emphasized the importance of the elimination status, noting, “We eliminated this virus in the year 2000—eliminated it. Eliminated circulation of the most contagious human infection. That was something to be proud of.”
While Abraham maintained that vaccination is the most effective means of preventing measles, he also acknowledged that parents should have the autonomy to decide whether to vaccinate their children. Since 2020, several states have relaxed school vaccine requirements, leading to a decline in vaccination rates. A record number of kindergartners—approximately 138,000 children—obtained vaccine exemptions for the 2024-25 school year.
Compounding the issue, misinformation regarding vaccines has proliferated, fueled in part by Health and Human Services Secretary Robert F. Kennedy Jr., who previously founded an anti-vaccine organization. Throughout his tenure, Kennedy has perpetuated scientifically debunked claims linking vaccines to autism, brain swelling, and death.
Jennifer Nuzzo, director of the Pandemic Center at Brown University, criticized the focus on genetic details that may allow the U.S. to retain its measles-free status. “This is the wrong thing to pay attention to. Our attention has to be on stopping the outbreaks,” she stated. Nuzzo added, “If we keep our status, it should be because we have stopped the spread of measles. It’s like they’re trying to be graded on a curve.”
Investigations by KFF Health News revealed that the Trump administration hindered the CDC’s ability to assist West Texas during the initial critical weeks of the outbreak and delayed the release of federal emergency funds. Nevertheless, the agency increased its efforts last year by providing local health departments with measles vaccines, communication materials, and testing resources. Abraham confirmed that HHS would allocate $1.5 million to South Carolina to address its outbreak, which has reached 646 cases as of January 20.
Last year’s case counts were the highest since 1991, prior to the implementation of government vaccine policies designed to protect all children through measles immunization. If the CDC’s genomic analyses reveal that the outbreaks stemmed from separate introductions from abroad, political appointees may credit Kennedy for preserving the country’s measles-free status. Conversely, if the studies indicate that the outbreaks are linked, former CDC national immunization center director Demetre Daskalakis predicted that the administration would downplay the findings, suggesting that a reversal of the country’s status is insignificant.
Indeed, during the briefing, Abraham told a reporter from Stat that a change in the nation’s status would not be particularly concerning: “Losing elimination status does not mean that the measles would be widespread.” However, data suggests otherwise, as the case counts from last year indicate a troubling trend in the resurgence of this highly contagious disease.
For more information on the current measles situation, visit the CDC’s real-time measles update.
According to KFF Health News, the ongoing situation underscores the critical need for public health initiatives aimed at increasing vaccination rates and combating misinformation surrounding vaccines.