The US is teetering on the brink of a public health setback: its hard-won measles elimination status is under serious threat. This isn't just about numbers on a chart; it's about a highly contagious disease making a comeback, putting vulnerable populations at risk. But here's where it gets controversial: is this solely a failure of public health policy, or are deeper societal issues at play?
Published at 1:57 pm, January 21, 2026 | Updated at 1:59 pm, January 21, 2026
By Devi Shastri, Associated Press
WASHINGTON (AP) — A year after a measles outbreak erupted in West Texas, international health authorities are poised to decide in April whether the US will join Canada in losing its measles-free designation. This decision, while largely symbolic, hinges on a crucial question: has a single measles outbreak persisted uninterrupted within the US for at least 12 months?
And this is the part most people miss: even if the US technically retains its elimination status, experts agree that the country faces a growing measles problem.
Public health officials across the nation are investigating potential links between the now-contained Texas outbreak and ongoing outbreaks in Utah, Arizona, and South Carolina. Dr. Jonathan Temte, a Wisconsin family physician who played a key role in certifying the US as measles-free in 2000, emphasizes the core issue: "The conditions are ripe for these outbreaks to occur, and that stems from a growing reluctance to embrace a safe and effective vaccine."
The numbers are alarming. The Centers for Disease Control and Prevention (CDC) reported 2,242 measles cases across 44 states in 2025, the highest since 1991, with nearly 50 separate outbreaks. This resurgence didn't happen overnight. It's the culmination of years of declining vaccination rates due to parental waivers, healthcare access disparities, and the spread of misinformation.
Here's where it gets even more concerning: recent actions by the Trump administration have exacerbated the problem. Health officials, including Health Secretary Robert F. Kennedy Jr., have publicly questioned vaccine safety, sowing doubt and undermining public trust. Simultaneously, funding for local vaccination initiatives has been slashed.
Jennifer Nuzzo, director of Brown University’s Pandemic Center, highlights the urgency: "Our primary focus must be on ensuring that those who aren't vaccinated get vaccinated. We haven't communicated this message clearly enough."
While a Department of Health and Human Services spokesperson stated that Kennedy has emphasized vaccines as the best defense against measles, and the CDC is actively responding to outbreaks and working to increase vaccination rates, the damage may already be done.
During a recent briefing, department officials admitted they lack evidence of a single measles chain spreading for a full year. However, the CDC’s principal deputy director, Dr. Ralph Abraham, downplayed the potential loss of elimination status, calling it the "cost of doing business" globally. He controversially added, "We have communities that choose to remain unvaccinated. That’s their personal freedom."
But is it truly a matter of personal freedom when the consequences affect the entire community? Measles is incredibly contagious, infecting 9 out of 10 unvaccinated individuals exposed. Achieving herd immunity requires a 95% vaccination rate, yet the national average currently stands at 92.5%, with many communities falling far below this threshold.
The Texas outbreak, which began in January 2025, serves as a stark example. It rapidly spread, officially infecting 762 people, primarily in rural Gaines County, and claiming the lives of two children. State health officials suspect a significant undercount, with 182 potential cases among children in Gaines County going unconfirmed in March 2025 alone.
These data gaps, common in outbreak situations, are compounded by barriers faced by affected communities, including limited healthcare access and distrust of government institutions. Contact tracing, crucial for containing outbreaks, is also expensive, with a single measles case costing public health departments tens of thousands of dollars.
While the CDC's measles data remains among the best globally, Noel Brewer, a behavioral scientist and chair of the US committee responsible for finalizing data for international health officials, notes a concerning trend: "The US has reduced its investment in public health, limiting our ability to conduct the comprehensive case tracking we once did."
Genetic sequencing can partially bridge these gaps. Scientists have identified the same measles strain in Texas, New Mexico, Utah, Arizona, South Carolina, Canada, Mexico, and other North American countries. However, Sebastian Oliel, a spokesperson for the Pan American Health Organization (PAHO), which will make the final decision on US measles elimination in April, cautions that genetic similarity doesn't always prove direct outbreak connections.
This raises a crucial question: how will PAHO experts navigate these data gaps when making their decision? Dr. Andrew Pavia, a Utah physician and longtime CDC consultant, predicts, "My best guess is we will lose elimination status. The evidence against continuous transmission is weak, and I believe they will err on the side of declaring a loss of elimination status."
Oliel explains PAHO's approach: when a case of unknown origin occurs in a country with ongoing local spread, it's generally considered part of the existing national transmission.
Mexico, which is also under review by PAHO, provides a stark illustration of the cross-border nature of this crisis. Its largest outbreak originated in Texas, sparked by an 8-year-old boy from Chihuahua state who fell ill after visiting family in Seminole, Texas. Since February 2025, 6,000 people have been infected in Mexico, with 21 deaths in Chihuahua state.
However, PAHO's definition of elimination considers borders. If a measles chain originating in the US spreads to Mexico and then returns to the US, it's classified as a new chain, a standard many experts deem outdated.
The impact of the 2025 measles resurgence has been widespread, infiltrating schools, daycares, churches, hospital waiting rooms, and even a detention center. New Mexico reported 100 cases, including one adult death. Kansas battled a seven-month outbreak affecting nearly 90 people across 10 counties. Ohio confirmed 40 cases, while Montana, North Dakota, and Wisconsin each reported 36.
The crisis continues in 2026, with over 800 cases reported across Utah, Arizona, and South Carolina since late summer, showing no signs of abating.
"2025 was the year of measles," reflects Brewer. "Will 2026 see a rise or fall in cases? Will the situation worsen or improve? The answer remains uncertain."
What do you think? Is the potential loss of measles elimination status a failure of public health policy, a reflection of broader societal issues, or a combination of both? Share your thoughts in the comments below.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
