Measles mayhem
Measles cases in the US last year hit a 34-year high while Health and Human Services Secretary Robert F. Kennedy Jr. was rolling back longstanding federal vaccine guidance.
The US Centers for Disease Control and Prevention reported 2,144 confirmed measles infections in 2025 – the highest level since 1991.
That number included 49 outbreaks, defined as three or more cases, across 44 states. The majority of infections were among unvaccinated children.
The US’s 1989-1991 measles epidemic revealed that the high cost of vaccinations had kept many children and young adults from getting the shots. This lead to the creation of the Vaccines for Children program in 1994, which provided millions of free shots to nearly half of kids in the US. This effort, along with vigorous public information campaigns to encourage parents to vaccinate their children, helped the US achieve formal elimination of measles in 2000, with no cases continuously spreading in the nation for more than 12 months.
Decades later, things have sure changed. In November 2024, Donald Trump named longtime vaccine critic Robert F. Kennedy Jr. as his pick to head HHS shortly after he was reelected as president. Once Kennedy was sworn in last February, he began to dismantle policies that contributed to US public health successes.
Kennedy fired all the members of the CDC’s expert panel on vaccines. His replacements withdrew infant inoculation recommendations and banned the use of a mercury-based vaccine preservative. Kennedy launched investigations questioning the safety of the RSV and Covid shots. HHS ended contracts to develop vaccines using mRNA. And this week Kennedy cut the number of recommended shots against diseases for children to 11.
While the new childhood vaccine schedule still recommends ones for measles, public health officials and doctors’ groups have warned that these moves, along with Kennedy’s frequent criticisms of inoculations, have undermined the public’s faith in the shots.
Kennedy, who’s a lawyer, not a trained physician, has persistently questioned the safety of vaccines despite large studies over many decades that have shown them to be safe. The measles vaccine, which is combined with immunizations against mumps and rubella into a shot called the MMR, is 97% effective after two doses, making it one of the most protective immunizations on the market.
But misinformation and negative comments have taken their toll on public attitudes. Americans’ — in particular, Republicans’ — support for children receiving shots before starting school is fading. The kindergarten vaccination rates for the 2024-2025 school year fell to 92.5%, according to the CDC, below the 95% level needed to achieve herd immunity. At least 10 states – including Texas and Utah – have passed laws increasing parents’ abilities to get vaccination exemptions for their children, according to a KFF analysis.
Religious beliefs also drove decreases in vaccination rates and fueled the 2025 case surge. In January, an outbreak in West Texas started among the largely unvaccinated Mennonite region. Weeks later, cases exploded and spread across state borders to New Mexico, Kansas and Oklahoma. Two unvaccinated children and one New Mexico adult died, marking the first US death in over a decade from the disease. Measles can also lead to severe complications like encephalitis and pneumonia.
By August, Texas was able to slow cases through increased vaccinations and the state’s health department ended the outbreak. Weeks later, another large outbreak popped up on the border of Utah and Arizona among fundamentalist Mormons. Toward the end of the year, an outbreak in South Carolina sent more than 300 hundred people into quarantine after they were exposed at local schools and churches.
The US is not alone. Canada’s measles cases also surged last year, causing the loss of its formal elimination status. The US could be next on the chopping block as this month marks the one-year anniversary of the start of Texas’s outbreak. Even though that outbreak is considered over, health officials are still working to trace the Texas strain to determine whether other clusters are connected.
As the vaccine guidance continues to be altered and parental confusion mounts, health experts worry that more diseases could reemerge.
“We will see cases of meningitis popping up. We’ll see more whooping cough,” said former acting director of the CDC Rich Besser, who’s now president of the Robert Wood Johnson Foundation. “Heaven forbid we’d see polio.” — Jessica Nix