Since 2000, the United States has been considered to have “eliminated” measles, indicating that the country had not experienced significant outbreaks or prolonged periods of uncontrolled transmission of the virus. However, a series of outbreaks that began in early 2025 is still ongoing, with U.S. states reporting 5,412 measles cases from January 2025 through November 13, 2026. The ongoing transmission of measles in the U.S. can be attributed to several factors, including reductions in funding and staffing for public health efforts at the federal, state, and local levels, which have impacted prevention and response efforts nationwide.
Additionally, conflicting guidance from federal health officials, such as Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., has contributed to the issue. Furthermore, increasing skepticism among the public regarding the safety and effectiveness of measles vaccines, as well as a decline in trust of health authorities, has led to lower measles vaccination rates and complicated outreach efforts. As “eliminated” means the country had not seen very large outbreaks and had not had 12 months or more of uncontrolled domestic transmission of the virus since before that time, the current situation raises concerns about the U.S. elimination status.
What the Numbers Show
Measles is highly contagious, and when it spreads in a population without prior immunity, one case can lead to 12 to 18 additional cases. While most measles infections are not severe, approximately 30 percent of cases result in health complications, and about 1 in 1,000 infections are fatal. Young children and immunocompromised individuals are at a higher risk of severe outcomes. In 2025, among the 2,288 confirmed measles cases, 243 were hospitalized, and three deaths occurred. Measles can also have long-term negative effects on the immune system, particularly in children, making them more susceptible to serious outcomes from other infections.
Measles vaccines have been available in the U.S. since 1963 and are safe and effective in providing protection against illness and infection. Two doses of a measles-containing vaccine are estimated to be 97 percent effective in preventing infection. The CDC recommends that children receive their first measles vaccine dose between 12 and 15 months of age and the second dose between 4 and 6 years of age, before entering school. The most common measles-containing vaccine in the U.S. is the combination measles, mumps, and rubella (MMR) vaccine. Epidemiologists estimate that when more than 95 percent of a population has immunity to measles, either through previous infection or vaccination, “herd immunity” is achieved, and measles transmission is interrupted.
Therefore, achieving at least 95 percent coverage with two doses of the measles vaccine is a common goal for immunization campaigns and is the current target in the U.S. as part of the Healthy People 2030 initiative. However, in 2025, national two-dose MMR coverage for children entering kindergarten was estimated to be 92.4 percent, a decline from 94.7 percent in 2011. Coverage varied significantly across states, ranging from 75.2 percent in Idaho to 98.9 percent in West Virginia, with only 10 states reporting coverage levels at or above 95 percent in 2025-2026.
Regional and Global Context
The U.S. is not alone in experiencing a surge in measles cases since 2025. Large outbreaks have also occurred in Mexico, with 6,213 reported cases in 2025, and Canada, with 5,463 reported cases in 2025. In November 2025, the Pan American Health Organization (PAHO) declared that Canada no longer holds measles elimination status due to having over 12 months of continuous measles transmission.
Like in the U.S., these outbreaks have been concentrated in communities with low vaccination rates. According to PAHO, the region of the Americas reported a total of 14,975 measles cases in 2025 across 13 countries, with the majority coming from North America. The World Health Organization (WHO) reports that, as of November 13, 2026, there were 344,136 measles cases globally, with significant outbreaks in the European and Eastern Mediterranean regions, in addition to the Americas.
Elimination Status and Future Risks
The most recent meeting of the Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission (MRE-RVC) categorized the U.S. as “sustained with major concerns.” This designation follows a review process based on epidemiological data and programmatic indicators, which assess the quality of surveillance and the interruption of endemic transmission. The current outbreak data shows a higher percentage of local transmission compared to the period from 2001 to 2011. During the elimination period, there were 64 measles outbreaks over ten years, whereas in 2025 alone, there were 48 outbreaks, and 43 new outbreaks occurred in 2026 through November 13.
