U.S. at Risk of Losing Measles-Elimination Status as Outbreaks Spread — Experts Warn 'House Is On Fire'

Measles outbreaks are expanding across the United States, and public‑health experts warn the country could lose its measles-elimination designation after 12 months of continuous transmission — a milestone that could be reached as soon as Jan. 20. Health officials say falling vaccination rates, widespread misinformation and recent policy shifts at the Department of Health and Human Services (HHS) have worsened the situation.

Major flare-ups this year include a large outbreak in West Texas with more than 700 confirmed cases since January and two child deaths, and a South Carolina cluster that prompted quarantine orders for at least 254 people after officials confirmed more than two dozen cases. The Centers for Disease Control and Prevention (CDC) reports 47 separate measles outbreaks nationwide this year.

Experts Cite Vaccine Hesitancy And Policy Shifts

Public-health specialists say decades of misinformation about vaccines have contributed to falling immunization coverage in many communities. Fiona Havers, an adjunct associate professor at Emory School of Medicine and a former CDC infectious-disease staffer, called the situation "extremely embarrassing" and said declining vaccination rates have made containment more difficult.

"This is a very clear example of the damage that the anti-vaccine movement has done in the United States," Havers said.

Many experts have pointed to the appointment of Robert F. Kennedy Jr. as HHS secretary as a complicating factor. Kennedy, once a prominent critic of vaccines, has taken steps to reshape HHS vaccine advisory structures. After the death of an 8-year-old girl in Texas from measles, Kennedy publicly stated that the measles-mumps-rubella (MMR) vaccine is "the most effective way to prevent the spread of measles," a notable shift from earlier comments in which he questioned vaccine safety.

Kennedy has previously promoted unproven or nonstandard approaches — such as vitamin A supplements, cod liver oil and budesonide — for managing measles. Infectious-disease specialists say these measures are unlikely to be harmful but offer no proven benefit compared with routine prevention (vaccination) and established clinical care.

What Losing Elimination Status Means

Formally, a country loses measles-elimination status when the virus transmits continuously for at least 12 months. Canada lost that status last month after a major surge; public-health officials there are coordinating with regional partners to interrupt transmission. Regaining elimination requires 12 months without transmission of the current strain.

"We can already say the damn house is on fire," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "Whether we formally lose that elimination status, to me, isn’t even that important — we already know we’ve got a terrible, terrible problem on our hands."

Osterholm noted that Canada's more than 5,000 cases this year in a population of roughly 41 million underscore how large outbreaks could scale in the U.S. population of about 340 million if transmission continues.

An HHS spokesperson, Andrew Nixon, responded that elimination status depends on 12 months of continuous transmission and said, "our current assessment is that we have not met that criteria." He reiterated that "Secretary Kennedy has been very clear that vaccination is the most effective way to prevent measles" and urged individuals to consult their health-care providers.

Public-health officials emphasize that vaccination remains the primary way to prevent measles. Local and state health departments continue outbreak investigations, contact tracing and vaccination campaigns to limit further spread.