The US Has 44 Days to Prove It Still Beat Measles

On April 13, a committee in Washington will vote on whether the United States is still a country that eliminated measles.

The answer, almost certainly, is no.

The numbers that got us here

As of February 26, the CDC has confirmed 1,136 measles cases in 2026. That's in less than two months. For context, all of 2025 had 2,281 cases. All of 2024 had 285.

The US is on pace to shatter every record since it declared measles eliminated in 2000.

South Carolina alone accounts for 632 of this year's cases. Utah has 117. Florida has 64. Twenty-eight states have reported infections. Three people died from measles in 2025 — two of them children in Texas.

And the week ending February 26 saw cases jump 7.9% from the week before. The curve isn't flattening. It's steepening.

What "elimination" actually means

Measles elimination doesn't mean zero cases. It means no continuous chain of the same virus strain spreading within the country for 12 months. Imported cases are expected. Sustained local transmission is what breaks the designation.

The Pan American Health Organization (PAHO) certified the US as measles-free in 2000. It was a public health triumph — the result of decades of vaccination campaigns that pushed MMR coverage above 95%, the threshold where herd immunity kicks in and the virus can't find enough unvaccinated hosts to survive.

PAHO has now invited the US to a review meeting on April 13. The question: are the 2025 and 2026 outbreaks linked by the same strain spreading domestically? If yes, the US loses its certification.

The BMJ reported this week that experts expect the answer to be yes.

The slow erosion nobody noticed

This didn't happen overnight. It happened over five years, one percentage point at a time.

MMR vaccination among US kindergartners dropped from 95.2% in the 2019-2020 school year to 92.5% in 2024-2025. That's below the 95% herd immunity threshold. It left approximately 286,000 kindergartners unprotected.

The national number hides worse pockets. Briscoe County, Texas — ground zero of the 2025 outbreak — had 80% kindergarten coverage. Childress County had 70.5%. These aren't remote villages. They're American communities where three in ten kids entering school had no measles protection.

Thirty-nine states now fall below the 95% target. In the 2019-2020 school year, that number was 28.

The confidence collapse

Here's where it gets uncomfortable.

A CIDRAP poll found that adult support for the MMR vaccine dropped from 90% to 82% in just a few months during 2025. That's a massive shift in public confidence toward a vaccine with decades of safety data behind it.

Robert F. Kennedy Jr., now leading the Department of Health and Human Services, overhauled the US childhood vaccine schedule shortly after taking office. His appointed Advisory Committee on Immunization Practices includes members with histories of vaccine skepticism. HHS's response to the outbreaks emphasized vitamin A and cod liver oil as treatments — not vaccination as prevention.

A Politico report from this week suggests the administration is now quietly pivoting away from vaccine messaging as midterm political calculations shift. The damage, though, is already baked in.

When the person running public health casts doubt on vaccines, some parents listen. The numbers show exactly how many.

What losing elimination means

Losing measles-free status doesn't trigger any immediate policy change. No borders close. No new mandates kick in.

But it sends a signal. The US would join a list of countries that achieved elimination and then lost it — a club that includes the UK (lost status in 2019), Albania, Czech Republic, and Greece. Canada is also under review.

For a country that spent billions building the world's most advanced public health infrastructure, it's a symbolic gutting. It says: we had this, and we let it go.

More practically, it means the virus has re-established itself. Outbreaks won't be occasional imports that burn out. They'll be domestic chains that keep spreading. More hospitalizations. More deaths. More school closures.

Measles is one of the most contagious diseases known. One infected person in a room can spread it to 90% of unvaccinated people nearby. It hangs in the air for two hours after an infected person leaves. There's no treatment. There's only prevention — and prevention requires a needle in an arm before exposure, not after.

The math ahead

Here's the arithmetic that matters. The US adds roughly 3.6 million kindergartners every year. At 92.5% coverage, that's about 270,000 unvaccinated kids entering the population annually. Each year the gap compounds.

Rebuilding from 92.5% to 95% isn't just a messaging problem. It requires reaching families who've actively opted out — not families who forgot or couldn't access care, but families who made a choice based on information they trusted.

That trust took decades to build. Eroding it took months.

Forty-four days

The PAHO committee meets April 13. By then, the US will likely have well over 2,000 cases for 2026 — surpassing all of 2025 before spring arrives.

The committee won't be making a political decision. They'll be reading the epidemiological data and asking a straightforward question: is measles spreading continuously within the United States?

The data already answers that. The vote is a formality.

Twenty-five years ago, the US proved that measles could be beaten with science, funding, and public trust working together. What April 13 will prove is what happens when one of those three legs breaks.