The United States has lost its measles elimination status, ending a decades-long designation held since 2000 as health agencies record the nation’s highest case count in 35 years.
The decision by the Pan American Health Organization, a regional office for the World Health Organization, followed a review of epidemiological and laboratory evidence submitted by the U.S. Centers for Disease Control and Prevention. PAHO determined that the country sustained uninterrupted measles transmission for 12 months or longer, crossing the threshold from imported cases to endemic spread.
The sixth annual meeting of PAHO’s Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission ran from November 10 to 13, 2026, assessing data from 2025 and the first half of 2026 covering vaccination coverage, surveillance quality, molecular and virological laboratory evidence, and outbreak response.
The RVC first invited the United States and Mexico to a review in April 2026, following outbreaks beginning January 20, 2025, in the U.S. and February 1, 2025, in Mexico.
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said that revoking the status merely recognizes a reality that has persisted on the ground for months. He pointed to Canada as an example, noting that PAHO revoked Canada’s elimination status after it recorded more than 5,000 cases in a population of 40 million.
The loss of status arrives amid a sharp surge in infections. The CDC confirmed more than 5,400 measles cases across 45 states and Washington, D.C., in 2026, surpassing the 2,289 cases reported in all of 2025. State health departments have reported 10 measles deaths this year, including seven in Pennsylvania, two in Wisconsin, and one in New York.
Public health experts trace the resurgence to declining immunization coverage. Vaccination rates among U.S. kindergarteners dropped from 95.2 percent during the 2019-2020 school year to 92.4 percent in the 2025-2026 school year, falling short of the 95 percent threshold required to sustain herd immunity. Eighteen states now maintain MMR vaccination rates below 90 percent, with Idaho reporting a rate of 75.2 percent. Nationwide, roughly 300,000 kindergartners entered classrooms without being vaccinated.
Children and teenagers account for about 59 percent of confirmed cases in 2026. Data shows children under five make up 18 percent of infections, while those between ages five and 19 represent 41 percent. Ninety-six percent of infected individuals were either unvvaccinated or had an unknown vaccination status.
A tool modeling these impacts estimated that 2025 measles outbreaks involving 2,289 confirmed cases carried an economic cost of more than $37 million, including $1.1 million for 48 cases reported in New York. Across nationwide outbreaks, expenses include public health response costs, productivity losses, and direct medical costs, driven largely by labor-intensive contact tracing and containment efforts.
Even if you don’t get the infection, the contact costs you, said Mattingly, according to CNBC.
To regain measles elimination status, the United States must completely stop the spread of the disease for a year.
Readers evaluating guidance on immunization and personal health risks should consult qualified medical professionals or public health agencies for personalized advice.
Jennifer Nuzzo, an epidemiologist and director of Brown University’s Pandemic Center, described the designation loss as a symbolic loss of standing, stature, and achievement. Noel Brewer, a public health professor at the University of North Carolina and chair of an independent advisory panel on measles, called the widespread transmission of a fully preventable disease unconscionable.
Readers with questions regarding vaccination schedules, exposure risks, or individual health concerns should consult qualified healthcare professionals or local health departments.
Earlier coverage: US Measles Cases Hit 5,400, Losing Elimination Status
