US set to lose measles elimination status next week as RFK Jr. takes fire

The Pan American Health Organization's advisory commission is meeting behind closed doors, poring over genetic evidence to decide whether the same measles virus has circulated for at least one year in North American outbreaks dating to 2024. Dr. Amesh Adalja, an infectious disease doctor in the Pittsburgh area and a senior scholar at the Johns Hopkins Center for Health Security, put it simply: “It’s solely based on genetics.” PAHO officials say they are scheduling an announcement of the findings for next week, and the commission will hand its determination to PAHO Director Dr. Jarbas Barbosa, who makes the final call.

The US is already having its worst measles year in decades. Eight measles-associated deaths have been recorded this year — more than in any year in over three decades — and the more than 5,100 confirmed cases are already double the 2025 tally, driven largely by an outbreak in Pennsylvania that has dwarfed earlier ones. Last year the virus exploded in Texas, Arizona, Utah and South Carolina.

Local health leaders aren't sugarcoating it. “It’s a big deal. The decision represents us moving backward,” said Dr. David Margolius, director of Cleveland's health department and a leader in a coalition of big-city health departments. Many public health experts argue the moment demands a full-throated vaccination campaign and more guidance for doctors, and they fault what they call a muted federal response — pointing at Health Secretary Robert F. Kennedy Jr., a leading anti-vaccine voice before President Donald Trump put him in charge of the nation's health agencies.

Kennedy has moved to shrink the childhood vaccination schedule and reshape a key vaccine advisory board. He has also praised Trump's executive order calling for spacing out the MMR vaccine, which runs against medical groups' recommendations and, experts say, would likely leave fewer children fully vaccinated. CDC Director Erica Schwartz said this week the agency's approach won't change either way: “The measles elimination designation is not what protects Americans. Vaccination does,” she said.

The US earned elimination status in 2000 after decades of campaigns pushed childhood measles vaccination above 97%; experts say 95% coverage is needed to block outbreaks when an infected traveler arrives. But rates have slipped for years, fueled by disproven autism claims, and fell to about 92% nationally last year. Trump claimed without evidence this year that the MMR vaccine is possibly “quite lethal.”

Mexico's path is different: it didn't achieve elimination until 2016, years after the US licensed a vaccine in 1963. Cases surged there early last year, and researchers believe an outbreak in Chihuahua stemmed from an unvaccinated Mennonite child who traveled to Gaines County, Texas, during an outbreak and returned infected. More than 20,500 confirmed cases and 50 deaths — most in children under 5 — have been reported nationwide this week. Canada lost its own status last year, and the WHO confirmed early this year that Armenia, Austria, Azerbaijan, Spain, the UK and Uzbekistan had lost theirs.