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 autismbrain 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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Public Health Under Fire: HHS and CDC Tensions Explained

In this post I review HHS Secretary Robert Kennedy Jr. at the Senate Finance Committee regarding his dismissal of CDC Director Dr. Susan Monarez and concerns over his anti-vaccine stance. This culminated in resignations from senior CDC officials alarmed by political interference affecting scientific integrity and public health safety.

updated September 20. 2025

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.

Kennedy visits the Senate

On September 4, 2025, HHS Secretary Robert Kennedy Jr. appeared before the Senate Finance Committee and was heatedly questioned about several issues. Most of his testimony centered around his firing of the newly confirmed CDC Director Dr. Susan Monarez.

He was also grilled on his seeming lack of support for vaccination as an important public health measure. They questioned why he appointed several antivaccine scientists to the Advisory Committee on Vaccines. Even the Republican Senators who had voted for his appointment expressed frustration with his leadership.

In this post I explain some of what lead to this confrontation.

Trump appoints a CDC Director

After being without a CDC Director since he took office in January 2025, President Trump and the Senate confirmed Dr. Susan Monarez. This is the first time in history that a CDC Director needed Senate approval.

President Trump posted this on social media about his choice for CDC director.

“Dr. Monarez brings decades of experience championing Innovation, Transparency, and strong Public Health Systems. She has a Ph.D. from the University of Wisconsin, and PostDoctoral training in Microbiology and Immunology at Stanford University School of Medicine.

“As an incredible mother and dedicated public servant, Dr. Monarez understands the importance of protecting our children, our communities, and our future. Americans have lost confidence in the CDC due to political bias and disastrous mismanagement.

Dr. Monarez will work closely with our GREAT Secretary of Health and Human Services, Robert Kennedy Jr. Together, they will prioritize Accountability, High Standards, and Disease Prevention to finally address the Chronic Disease Epidemic and, MAKE AMERICA HEALTHY AGAIN!”

President Trump and Secretary Kennedy at the MAHA commission meeting

That was in July 2025. Something changed by late August.

I share this article published by KFF Health News. It was written by Dr. Celine Gounder, a physician and medical journalist who specializes in infectious diseases and global health. She was a member of the COVID-19 Advisory Board of President Joe Biden.

(I have edited the article slightly for length.)

Senior CDC Officials Resign After Dr. Monarez’s Ouster, Citing Concerns Over Scientific Independence

Written by Dr. Céline Gounder August 29, 2025

Four senior officials with the CDC, Centers for Disease Control and Prevention, announced their resignations in recent days, citing what they described as growing political interference in the agency’s scientific work, particularly regarding vaccines.

Two of them — Dr. Debra Houry, the CDC’s chief science and medical officer, and Dr. Demetre Daskalakis, who led the National Center for Immunization and Respiratory Diseases — stepped down on Aug. 27, hours after the White House announced the firing of CDC Director Susan Monarez.

Dr. Monarez, confirmed by the Senate in late July, was removed less than a month into her tenure.

White House spokesperson Kush Desai said Monarez “was not aligned with the President’s agenda of Making America Healthy Again.” Monarez’s attorneys argue that the dismissal is unlawful, as only the apresident can remove a Senate-confirmed director.

On Aug. 28, Jim O’Neill, the deputy secretary of the Department of Health and Human Services, was chosen to serve as acting CDC director. In an internal email sent to CDC staffers Secretary Robert F. Kennedy Jr. confirmed O’Neill as the acting CDC director without addressing Monarez’s departure. 

“I am committed to working with you to restore trust, transparency, and credibility to the CDC,” Kennedy told CDC employees, later writing that

“President Trump and I are aligned on the commonsense vision for the CDC: Strengthen the public health infrastructure by returning to its core mission of protecting Americans from communicable diseases by investing in innovation to prevent, detect, and respond to future threats.”

HHS Secretary Robert Kennedy, Jr.

Concern for Vaccine Policy

Houry and Daskalakis said they had become increasingly uneasy about how vaccine policy was being handled. Both pointed to preparations for the Advisory Committee on Immunization Practices, ACIP, meeting, which recommends vaccine schedules.

Houry said they feared “some decisions had been made before there was even the data or the science to support those. We are scientists, and that was concerning to us.”

Daskalakis added that he was “very concerned that there’s going to be an attempt to relitigate vaccines that have already had clear recommendations with science that has been vetted,” which he warned could undermine public trust. “If you can’t attack access, then why not attack trust? And that’s what I think the playbook is,” he said.

“there’s going to be an attempt to relitigate vaccines that have already had clear recommendations with science that has been vetted,

If you can’t attack access, then why not attack trust? And that’s what I think the playbook is,”

Dr. Demetre Daskalakis

Lack of communication and transparency

Both officials cited instances in which evidence reviews were altered or withdrawn. A CDC analysis of thimerosal, a vaccine preservative, was briefly posted before being taken down at the HHS’ direction.

“If there’s something that doesn’t line up with the recommendations, then that information will be taken down, and it’s not there for the public to see for openness and transparency,” Houry said.

The two also criticized the lack of direct communication between CDC scientists and HHS leadership. Daskalakis said his team was never invited to brief Kennedy on measles and COVID-19.

When asked about Kennedy’s calls for “radical transparency,” Houry and Daskalakis learned about changes to the COVID-19 vaccine schedule for children through social media, not through internal channels.

“The radical transparency manifested itself by a Twitter post, which is how Dr. Houry and I learned that the secretary had mandated the change in the children’s vaccine schedule for COVID,” Daskalakis recalled.

“What is the background that led to that decision? And we were denied access to that information. So, I don’t think that that’s radically transparent,” Daskalakis said.

CBS News and KFF Health News reached out to HHS for comment on some of the allegations made by Houry and Daskalakis but did not immediately hear back.

Scientists Raise An Alarm for Public Health

Both officials said they had no jobs lined up when they resigned. Houry described the decision as an effort to raise the alarm about the direction of the agency.

“For us, this was really sending out a bat signal,” Houry said. “We were the very senior scientists and career leaders at CDC. We thought this was the time to stand together and try to do what we could to raise the alarm around public health in our country.”

Daskalakis said remaining at the CDC under current conditions would have made them complicit in what he called the “weaponization” of public health.

“The safety has already been compromised. … We are flying blind in the U.S. already. If we continued … we would be complicit and would be facilitating the ability to go from flying blind to actively harming people,” he said.

Houry emphasized the severity of the moment by noting that she left without a backup plan.

“My leaving without a job was really just showing how dire the circumstances had become,” Houry said.

Daskalakis said his decision was also shaped by his medical oath.

“As a physician, I take the Hippocratic oath: First, do no harm. I am seeing ideology permeating science in a way that is going to harm children and adults. … I think we are seeing things that are happening that are making our country less prepared to be able to respond to the everyday pathogens … but also … to the next big thing.”

Both also expressed concerns about their personal safety in the current climate.

“The environment we live in … stoked by misinformation, especially from people considered by some to be health authorities, makes me worried for all of us in public health,” Daskalakis said. “I am concerned, but that’s part of our job … to be brave and continue to speak the truth even when we are outside of the CDC.”

Photo by Photo By: Kaboompics.com on Pexels.com

Gun Violence-Another Public Health Issue

The resignations came weeks after a shooting outside the CDC’s Atlanta headquarters, which law enforcement linked to COVID misinformation.

Houry said the White House response to the shooting was muted. Kennedy toured the site but later gave an interview expressing distrust of experts.

“That was after the attack. It was based on COVID misinformation. So this is when we were trying to build trust,” she said.

Daskalakis added that while Kennedy later described mass shootings as a public health crisis, he believed the secretary should address misinformation as a root cause.

“The misinformation about the COVID-19 vaccine — that has been documented by the Georgia Bureau of Investigation” as the reason for the CDC shooting. “I would really recommend that the secretary actually do take his own advice and actually address the core problem that led to that shooting as well,” he said.

He also noted that the CDC’s gun violence prevention programs had been sharply reduced. “We talk about violence as a public health problem.

It is, and there’s things we can do to prevent it. Unfortunately, the majority of that program, the staff are terminated,” he said.

“We talk about violence as a public health problem.
It is, and there’s things we can do to prevent it. Unfortunately, the majority of that program, the staff are terminated,”

Dr. Daskalakis

The firings and resignations have sparked calls for oversight. Independent Sen. Bernie Sanders of Vermont called for a bipartisan investigation, Democratic Sen. Patty Murray of Washington urged Kennedy’s removal, and Republican Sen. Bill Cassidy of Louisiana — who voted to confirm Kennedy’s appointment as HHS secretary — said the developments would “require oversight.”

The events come as the FDA narrowed eligibility for updated COVID-19 vaccines to older adults and people with risk factors for severe COVID.

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.

Subscribe to KFF Health News’ free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Dr. Monarez Speaks to the Senate

On September 17, 2025, “She testified that she was ousted last month because she refused to cede to Health Secretary Robert F. Kennedy Jr.’s demands to pre-approve vaccine recommendations for the public and fire career scientists.

“He just wanted blanket approval,” Monarez told members of the Senate Committee on Health, Education, Labor and Pensions on Wednesday. “Even under pressure, I could not replace evidence with ideology.”

Monarez described a string of events that she said eventually led to her dismissal, culminating with a “tense” meeting in late August when she clashed with Kennedy over his plans for an influential CDC committee that issues recommendations on vaccines.”

Read the full report from NPR at this link

Ousted CDC director testifies she was fired for resisting pressure from RFK Jr.

Learn about the CDC

I hope you will take the time to learn more about the Centers for Disease Control and Prevention. According to the website, the

  • CDC is the nation’s leading science-based, data-driven, service organization that protects the public’s health.
  • CDC puts science into action to help children stay healthy so they can grow and learn; to help families, businesses, and communities fight disease and stay strong; and to protect the public’s health.

The professionals at the CDC cannot do their job alone. They need the support of elected and appointed government officials and the people they serve.

Health and safety threats are often new and unpredictable, like a viral pandemic or natural disaster, and multiple agencies need to work together to successfully manage threats. Cooperation and support are needed. Blaming and accusations are unproductive and unprofessional and contribute to lack of trust by the people they serve.

Post Graphics

The two graphics about vaccines are currently on the CDC website. The cover photo of CDC headquarters is also on the site.

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.

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Medical stethoscope and heart on a textured background

Dr Aletha