Category: infections, vaccination, and hygiene

Why After 25 Years, the United States May No Longer be Measles-Free

Did you know the U.S. may lose its measles-free status due to a significant outbreak affecting over 2,400 people? Dr. Ralph Abraham, the new CDC deputy, downplays this issue, attributing it to unvaccinated communities. Experts express concern over rising cases and stress the importance of vaccines amid loosening requirements.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.

I’m sharing this article originally published on KFF Health News. I have added hyperlinks for additional context. I have also added additional information for context, these are indicated in italics

As US Is Poised To Lose Measles-Free Status, RFK Jr.’s New CDC Deputy Downplays Its Significance

By Amy Maxmen January 21, 2026

After a year of ongoing measles outbreaks that have sickened more than 2,400 people, the United States is poised to lose its status as a measles-free country.

However, the newly appointed principal deputy director at the Centers for Disease Control and Prevention, Dr. Ralph Abraham, said he was unbothered by the prospect at a briefing for journalists this week.

Before entering public office, Abraham practiced medicine and veterinary medicine for decades. He represented Louisiana in Congress from 2014 to 2020 and was appointed surgeon general of Louisiana last year.

“It’s just the cost of doing business with our borders being somewhat porous for global and international travel,” Dr. Abraham said. “We have these communities that choose to be unvaccinated. That’s their personal freedom.”

Measles is highly contagious and spreads through the air when an infected person coughs or sneezes.

Infection from Abroad vs. Domestic

Infections from other countries, however, accounted for only about 10% of measles cases detected since Jan. 20, 2025, the official start of the deadly measles outbreak in West Texas, which spread to other states and Mexico. The rest were acquired domestically.

This marks a change since the U.S. eliminated measles in 2000. Measles occasionally popped up in the U.S. from people infected abroad, but the cases rarely sparked outbreaks, because of extremely high rates of vaccination. Two doses of the measles, mumps, and rubella vaccine strongly prevent infection and halt the virus’s spread.

Measles DNA detectives

To maintain its measles elimination status, the U.S. must prove that the virus has not circulated continuously in the nation for a year, between Jan. 20, 2025, and Jan. 20, 2026. To answer the question, scientists are examining whether the major outbreaks in South Carolina, Utah, Arizona, and Texas were linked.

Health officials confirmed that the main measles virus strain in each of these outbreaks is D8-9171. But because this strain also occurs in Canada and Mexico, CDC scientists are now analyzing the entire genomes of measles viruses — about 16,000 genetic letters long — to see whether those in the United States are more closely related to one another than to those in other countries.

The CDC expects to complete its studies within a couple of months and make the data public. Then the Pan American Health Organization, which oversees the Americas in partnership with the World Health Organization, will decide whether the U.S. will lose its measles elimination status. And that would mean that costly, potentially deadly, and preventable measles outbreaks could become common again.

(However, the United States has withdrawn from the World Health Organization.)

Reponse from Infection Experts

“When you hear somebody like Abraham say ‘the cost of doing business,’ how can you be more callous,” said pediatrician and vaccine specialist Paul Offit, in an online discussion hosted by the health blog Inside Medicine on Jan. 20, 2026.

Dr. Offit is the Director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia, as well as a Professor of Pediatrics at the University of Pennsylvania School of Medicine.

“Three people died of measles last year in this country,” Dr. Offit added. “We eliminated this virus in the year 2000 — eliminated it. Eliminated circulation of the most contagious human infection. That was something to be proud of.”

Jennifer Nuzzo, director of the Pandemic Center at Brown University, disparaged the Trump administration’s focus on finding genetic technicalities that may spare the country’s measles-free status. “This is the wrong thing to pay attention to. Our attention has to be on stopping the outbreaks,” she said.

“If we keep our status, it should be because we have stopped the spread of measles,” she said. “It’s like they’re trying to be graded on a curve.”

Jennifer Nuzzo is a nationally and globally recognized leader on global health security, public health preparedness and response, and health systems resilience.

HHS and CDC Vaccine Policy Shifts

Dr. Abraham said vaccination remains the most effective way to prevent measles but that parents must have the freedom to decide whether to vaccinate their children. Several states have loosened school vaccine requirements since 2020, and vaccine rates have dropped. A record rate of kindergartners, representing about 138,000 children, obtained vaccine exemptions for the 2024-25 school year.

CDC recommended measles vaccination for children

Information on vaccines has been muddied by Health and Human Services Secretary Robert F. Kennedy Jr., who previously founded an anti-vaccine organization. He has undermined vaccines throughout his tenure. On national television, he has repeated scientifically debunked rumors that vaccines may cause autism, brain swelling, and death.

The Trump administration impeded the CDC’s ability to assist West Texas during the first critical weeks of its outbreak and slowed the release of federal emergency funds, according to KFF Health News investigations.

However, the agency stepped up its activity last year, providing local health departments with measles vaccines, communication materials, and testing. Dr. Abraham said HHS would give South Carolina $1.5 million to respond to its outbreak, which began nearly four months ago and had reached 646 cases as of Jan. 20.

If the CDC’s genomic analyses show that last year’s outbreaks resulted from separate introductions from abroad, political appointees will probably credit Kennedy for saving the country’s status, said Demetre Daskalakis, a former director of the CDC’s national immunization center, who resigned in protest of Kennedy’s actions in August.

And if studies suggest the outbreaks are linked, Daskalakis predicted, the administration will cast doubt on the findings and downplay the reversal of the country’s status: “They’ll say, who cares.”

Indeed, at the briefing, Dr. Abraham told a reporter from Stat that a reversal in the nation’s status would not be significant: “Losing elimination status does not mean that the measles would be widespread.”

Data shows otherwise. Case counts last year were the highest since 1991, before the government enacted vaccine policies to ensure that all children could be protected with measles immunization.

Lauren Sausser contributed reporting.

Amy Maxmen, KFF Health News public health local editor and correspondent, covers efforts to prevent disease and improve well-being outside of the medical system, and the obstacles that stand in the way. Before joining KFF Health News in 2024, she was a senior reporter at Nature covering health inequities, global health, infectious diseases, and genomics. She earned a Ph.D. from Harvard University in evolutionary biology.

This story also ran on Healthbeat. It can be republished for free.

Oklahoma Voice shared this story.

Images in this Post

The cover illustration is a 3D graphic representation of a spherical-shaped, measles virus particle, that was studded with glycoprotein tubercles. Those tubercular studs colorized maroon, are known as H-proteins (hemagglutinin), while those colorized gray, represented what are referred to as F-proteins (fusion).

The F-protein is responsible for fusion of the virus and host cell membranes, viral penetration, and hemolysis. The H-protein is responsible for the binding of virions to cells. Both types of proteinaceous studs are embedded in the particle envelope’s lipid bilayer.

Illustrator: Alissa Eckert, Content provider:CDC/ Allison M. Maiuri, MPH, CHES, Public Domain

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The Surprising Benefits of Vaccines for Older Adults

In this post I share updates about the numerous off-target benefits of vaccinations for older adults, highlighting their potential to reduce risks of cardiovascular diseases and dementia. It emphasizes the importance of vaccinations like flu, shingles, and RSV, while noting that many older adults remain unvaccinated, missing out on these protective effects.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.

I think I am officially “older”. I qualify for Medicare and have reached my full retirement age. I receive the senior discount at restaurants. I remember many events that younger people have only heard about.

I find many advantages to having reached this age and in this article from KFF Health News I learned about more. The vaccines I have received to prevent infections may also protect me from cardiovascular disease and dementia.

I’m sharing this information with you here now, courtesy of KFF Health News.

VACCINE-PREVENTABLE DISEASES
This is not a complete list of all available vaccines.

Vaccines Are Helping Older People More Than We Knew

by Paula Span, January 14, 2026

Let’s be clear: The primary reason to be vaccinated against shingles is that two shots provide at least 90% protection against a painful, blistering disease that a third of Americans will suffer in their lifetimes, one that can cause lingering nerve pain and other nasty long-term consequences.

The most important reason for older adults to be vaccinated against the respiratory infection RSV is that their risk of being hospitalized with it declines by almost 70% in the year they get the shot, and by nearly 60% over two years.

And the main reason to roll up a sleeve for an annual flu, influenza, shot is that when people do get infected, it also reliably reduces the severity of illness. However, its effectiveness varies by how well scientists have predicted which strain of influenza shows up.

photo of a display at the Museum of Natural Science in Washington, DC, from Dr. Aletha

Off-Target Benefits



But other reasons for older people to be vaccinated are emerging. They are known, in doctor-speak, as off-target benefits, meaning that the shots do good things beyond preventing the diseases they were designed to avert.

The list of off-target benefits is lengthening as “the research has accumulated and accelerated over the last 10 years,” said William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee.

Some of these protections have been established by years of data; others are the subjects of more recent research, and the payoff is not yet as clear. The first RSV vaccines, for example, became available only in 2023.

Still, the findings “are really very consistent,” said Stefania Maggi, a geriatrician and senior fellow at the Institute of Neuroscience at the National Research Council in Padua, Italy.

She is the lead author of a recent meta-analysis, published in the British journal Age and Ageing, that found reduced risks of dementia after vaccination for an array of diseases. Given those “downstream effects,” she said, “vaccines are key tools to promote healthy aging and prevent physical and cognitive decline.”

Dr. Aletha inspecting her arm after a COVID-19 shot

I rolled up my sleeve for a COVID vaccination.



Yet too many older adults, whose weakening immune systems and high rates of chronic illness put them at higher risk of infectious diseases, have not taken advantage of vaccination.



The Centers for Disease Control and Prevention reported last week that about 31% of older adults had not yet received a flu shot. Only about 41% of adults 75 and older had ever been vaccinated against RSV, or respiratory syncytial virus, and about a third of seniors had received the most recent COVID-19 vaccine.

The CDC recommends the one-and-done pneumococcal vaccine for adults 50 and older. An analysis in the American Journal of Preventive Medicine, however, estimated that from 2022, when new guidelines were issued, through 2024, only about 12% of those 67 to 74 received it, and about 8% of those 75 and older. (The pneumoccal vaccine protects against disease from the bacteria Streptococcus pneumonia. )

Prevalence of High Level Penicillin Resistance in Streptococcus pneumoniae, United States.
This image was produced, by the Centers for Disease Control and Prevention (CDC) in 1997, It lists the percentages of penicillin resistant S. pneumoniae infections, during 1987, 1991, and 1993-94, based on data collected by both the Morbidity and Mortality Weekly Report (MMWR), The Journal of Infectious Diseases. Note how over this 8-year period, there was a steady increase in the occurrence of high level penicillin resistance. public domain

Benefit for Heart Disease Prevention



The strongest evidence for off-target benefits, dating back 25 years, shows reduced cardiovascular risk following flu shots.

Healthy older adults vaccinated against flu have substantially lower risks of hospitalization for heart failure, as well as for pneumonia and other respiratory infections. Vaccination against influenza has also been associated with lower risks of heart attack and stroke.

Moreover, many of these studies predate the more potent flu vaccines now recommended for older adults.

Could the RSV vaccine, protective against another respiratory illness, have similar cardiovascular effects? A recent large Danish study of older adults found a nearly 10% decline in cardiorespiratory hospitalizations — involving the heart and lungs — among the vaccinated versus a control group, a significant decrease.

a preserved human heart, from a museum exhibit
photo by Dr. Aletha at the Denver Museum of Natural Science



Lowered rates of cardiovascular hospitalizations and stroke did not reach statistical significance, however. That may reflect a short follow-up period or inadequate diagnostic testing, cautioned Helen Chu, an infectious disease specialist at the University of Washington and co-author of an accompanying editorial in JAMA.

“I don’t think RSV behaves differently from flu,” Chu said. “It’s just too early to have the information for RSV, but I think it will show the same effect, maybe even more so.”

Possible Dementia Prevention?



Probably the most provocative findings concern vaccination against shingles, aka herpes zoster. Researchers made headlines last year when they documented an association between shingles vaccination and lower rates of dementia — even with the less effective vaccine that has since been replaced by Shingrix, approved in 2017.

Nearly all studies of off-target benefits are observational, because scientists cannot ethically withhold a safe, effective vaccine from a control group whose members could then become infected with the disease.

That means such studies are subject to “healthy volunteer bias,” because vaccinated patients may also practice other healthy habits, differentiating them from those not vaccinated.

Although researchers try to control for a variety of potentially confounding differences, from age and sex to health and education, “we can only say there’s a strong association, not a cause and effect,” Maggi said.



But Stanford researchers seized on a natural experiment in Wales in 2013, when the first shingles vaccine, Zostavax, became available to older people who had not yet turned 80. Anyone who was 80 and older was ineligible.

Over seven years, dementia rates in participants who had been eligible for vaccination declined by 20% — even though only half had actually received the vaccine — compared with those who narrowly missed the cutoff.

“There are no reasons people born one week before were different from those born a few days later,” Maggi said. Studies in Australia and the United States have also found reductions in the odds of dementia following shingles shots.

In fact, in the meta-analysis Maggi and her team published, several other childhood and adult vaccinations appeared to have such effects.

Comparing a Healthy Brain with a brain affected with Alzheimer’s Disease; Credit: National Institute on Aging, National Institutes of Health

“We now know that many infections are associated with the onset of dementia, both Alzheimer’s and vascular,” she said.

In 21 studies involving more than 104 million participants in Europe, Asia, and North America, vaccination against shingles was associated with a 24% reduction in the risk of developing dementia. Flu vaccination was linked to a 13% reduction. Those vaccinated against pneumococcal disease had a 36% reduction in Alzheimer’s risk.

The Tdap vaccine against tetanus, diphtheria, and pertussis (whooping cough) is recommended for adults every 10 years, with vaccination among older adults often prompted by the birth of a grandchild, who cannot be fully vaccinated for months. It was associated with a one-third decline in dementia.

Other researchers are investigating the effects of shingles vaccination on heart attacks and stroke and of COVID vaccination on cancer survival.

Preventing Damage from Chronic Inflammation



What causes such vaccine bonuses? Most hypotheses focus on the inflammation that arises when the immune system mobilizes to fight off an infection. “You have damage to the surrounding environment in the body, and that takes time to calm down,” Chu said.



The effects of inflammation can far outlast the initial illness. It may allow other infections to take hold, or cause heart attacks and strokes when clots form in narrowed blood vessels. “If you prevent the infection, you prevent this other damage,” Chu said.

Hospitalization itself, during which older patients can become deconditioned or develop delirium, is a risk factor for dementia, among other health problems. Vaccines that reduce hospitalization might therefore delay or ward off cognitive decline.

Will Anti-Vaccine Public Policy Cause Missed Vaccinations in Adults?



Health officials in the Trump administration have assailed childhood vaccines more than adult ones, but their vocal opposition may be contributing to inadequate vaccination among older Americans, too.

Many will not only miss out on the emerging off-target benefits but will remain vulnerable to the diseases the vaccines prevent or diminish.

“The current national policy on vaccination is at best uncertain, and in instances appears anti-vaccine,” said Schaffner, a former member of the CDC’s Advisory Committee on Immunization Practices. “All of us in public health are very, very distressed.”




This story also ran in The New York Times
Shared without charge under a Creative Commons License by KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Exploring the HEART of Health

I’d love for you to follow this blog. I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Use this search box for related posts on this blog or other topics of interest to you.

Dr. Aletha