US loses measles elimination status for first time in 26 years as cases pass 5,400

The Pan American Health Organization (PAHO) has revoked the United States' measles elimination status, ending a designation the country has held since 2000. The Wall Street Journal first reported the decision on November 13, and Reuters and CBS News partner KFF Health News confirmed it. PAHO's Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission concluded at its annual meeting on November 10–13 that measles has circulated without interruption in the US for more than 12 months, meeting the definition of re-established endemic transmission. PAHO is scheduled to announce the decision formally at a news conference on Tuesday, November 17.

Worst outbreak in 35 years

Data from the Centers for Disease Control and Prevention (CDC) show 5,412 confirmed measles cases in the US so far in 2026, with more than 590 hospitalizations — the most cases since 1991 and about two and a half times the 2,242 cases recorded in all of 2025. Cases have been confirmed in 45 states and Washington, D.C. There have been 43 new outbreaks this year, each defined as three or more related cases, and about a third of this year's cases are tied to outbreaks that began in 2025 and are still spreading. Of the people infected in 2026, 96% were unvaccinated or had unknown vaccination status; only 2% were fully vaccinated.

Death toll disputed

State health departments have reported 10 measles-associated deaths this year, including seven in Pennsylvania, two in Wisconsin and New York's first in more than 30 years, while the CDC website lists six. Pennsylvania has reported more than 1,500 cases, the largest outbreak in the country. Health Secretary Robert F. Kennedy Jr. reportedly asked the CDC director not to count state-reported deaths in the official tally, citing a lack of evidence they were measles-associated; the CDC is working with the Council of State and Territorial Epidemiologists to establish a standardized definition for measles deaths.

Vaccination rate falls below threshold

Kindergarten coverage for the measles, mumps and rubella (MMR) vaccine has fallen from 95.2% in the 2019–2020 school year to 92.4% in 2025–2026, below the 95% level PAHO says is needed to sustain elimination. Two doses of MMR vaccine are about 97% effective at preventing measles. Experts say falling coverage has opened gaps in population immunity, so isolated cases no longer fizzle out but form continuing chains of transmission; babies, pregnant women and people with weakened immune systems cannot be vaccinated and rely on herd immunity for protection.

Twelve months without spread needed to regain status

To regain elimination status, the US must interrupt transmission and remain free of endemic spread of the same viral strain for 12 consecutive months. Canada lost its elimination status in 2025 and was, before this meeting, the only country in the Americas classified as endemic for measles; Spain and the United Kingdom have also recently lost the status. PAHO says the best way to maintain elimination is to keep vaccination coverage at 95% or higher, backed by sensitive surveillance, laboratory capacity and rapid outbreak response.