The U.S. may be on the cusp of losing its measles elimination status

The U.S. is almost certainly no longer deserving of its measles elimination status, public health experts say—and it could officially lose it as soon as this week. Officials at the Pan American Health Organization (PAHO) are meeting to discuss whether the country has seen enough endemic spread of the potentially deadly and highly preventable disease to warrant taking away that accolade. If PAHO does opt to remove the elimination status, then it represents a public health failure of the highest degree, experts say.

“It's astounding to me,” says Elizabeth Jacobs, a professor emeritus at the University of Arizona. “I'm just beside myself about all of this. I literally cannot believe this is happening in the United States.”

The sixth annual meeting of PAHO's Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission runs from November 10 to 13. At the meeting, an international team of experts in epidemiology, public health, virology and other medical fields assess the status of these disease in the Americas. The U.S. was declared to have eliminated measles in 2000—what this means is that the disease did not spread within the country for an entire year. Isolated cases were possible, but quickly contained.

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That is no longer the case.

For the past two years, successive measles outbreaks around the country have expanded at rates that haven’t been seen in decades. So far in 2026, there have been 5,182 confirmed cases of measles, according to the Centers for Disease Control and Prevention (CDC). That's up from 2,289 in all of 2025 and just 285 in 2024. The disease has been detected in almost every state, and local health departments have reported eight deaths connected to the outbreaks this year (the CDC has recorded four deaths).

Revoking the U.S.' elimination status would merely recognize what’s been a fact on the ground for months, says Michael Osterholm, president of the Center for Infectious Disease Research and Policy at the University of Minnesota.

“When a semi hits your car at 60 miles an hour at an intersection, you don't need more assessments showing you've had an accident,” he says.

Revoking the U.S.’s elimination status holds no formal consequences, but is a blow to the wealthiest country in the world and its public health system. Many public health experts blame the Department of Health and Human Services (HHS), which Jacobs describes as an “epidemiological crime scene” under the leadership of Robert F. Kennedy, Jr.

Kennedy, a longtime vaccine critic, has occasionally recommended that parents get their kids the mumps, measles and rubella (MMR) vaccine, but he has also recommended ineffective treatments for the disease and sowed doubt as to the effectiveness and safety of vaccines for years.

“I’ve seen Kennedy say that the reason that this is happening is because parents didn’t get their kids vaccinated during COVID, and to the extent that that is true, he has been in office for 18 months,” says Jacobs. “He has had ample time to go and form a really rigorous and thorough vaccination program, and he can barely say that MMR vaccination is the only way to prevent measles effectively.” HHS did not immediately respond to a request for comment.

Around the country, vaccine rates have been in decline for years. The percentage of children who received the MMR vaccine has fallen below the 95 percent rate required to sustain herd immunity. According to the CDC, 92.4 percent of kindergartners were vaccinated against measles in 2026, down from 95.2 percent in 2020. Rates vary by state; 18 states have MMR vaccination rates below 90 percent, with Idaho, for example, reporting a vaccination rate of just 75.2 percent.

Those numbers don't reflect the true extent of the crisis, says Osterholm. Vaccination rates can vary wildly within states, leading to pockets of people who are unprotected against measles. A study in Nature Health from January, for example, found numerous counties across the country with MMR vaccination coverage under 60 percent.

“There's an old line that describes this well: When your head’s in the freezer and your feet are in the oven, you’re on average very comfortable,” Osterholm says. “We have a situation right now where in a state like Minnesota, with one of the most progressive public health departments in the country, we have schools that have 80 percent level of vaccination [and] we have a number of school districts that are at the 40 percent level.”

More than 40 percent of the U.S. measles cases this year have occurred in people over the age of 20. Given that 96 percent of all measles cases were in people who were either unvaccinated or whose vaccinations status was unknown, many of these adults likely didn’t get vaccinated as children.

Jacobs says that while anti-vaccine sentiment has been brewing for years, the rise of social media has “supercharged” the problem. “This whole thing blew up right around the same time Facebook did, and I could see it happening, and there's no way to stop it,” she says.

Osterholm warns that the situation could get much worse, pointing to Canada as an example. Last year, PAHO revoked Canada’s measles elimination status after the country recorded more than 5,000 cases.

“That was in a population of 40 million,” he says. “Here we are sitting at 350 million, and if we were to see similar rates as Canada saw, that would be over 50,000 cases of measles a year.”

Canada can also offer some hope. Jacobs points out that last month, Canada’s outbreak was declared over.

For the U.S. to follow suit, urgent action would be needed on the part of state and federal health authorities. If that doesn’t happen, Jacobs warns that there could be more infectious disease outbreaks on the horizon.

“As vaccination rates decrease, measles pops up first because it’s so contagious,” she says. “But the other vaccine-preventable diseases are simmering in the background, and as we have learned, it really doesn't take much for things to start tearing through a population.”