In November 2025, Canada lost its measles elimination status. By definition, this means the Americas, of which the United States is part, also lost its measles elimination status. In public health, elimination is a technical term that means for a defined period of time, the pathogen is no longer consistently spreading in a country or region. When we are talking about measles in the U.S., elimination means that measles virus introduced from a single case does not continue to spread from one person to another in the U.S. continuously over a period of at least 12 months.
Measles was declared eliminated from the U.S. in 2000, and even though the Americas has lost its elimination status, for now, the U.S. is still considered to have eliminated measles. However, if you have been listening to the news over the last year, you are likely aware that measles is very much present in the U.S. By late December 2025, more than 2,000 confirmed cases and three deaths had been recorded. Two points about these numbers are important. First, because not every case is confirmed, the actual number of cases is likely much higher. Second, the deaths in children from measles are the first child deaths to occur in the U.S. in the last 20 years.
Because the first cases occurred in late January 2025, the U.S. could lose its elimination status in 2026. So, what does this mean for families?
First: The status is a formality, but it results from an established surveillance system that involves an intentional and thorough process of which most people are unaware.
Measles elimination status is based on an extensive annual review of measles cases. Throughout the year, public health officials collect information and data related to each measles case, including tracing lines of spread; genetic typing of the virus; vaccination status, age and travel history of affected individuals; and other details. In the U.S. an independent committee of scientists and public health officials reviews these data in the form of a report prepared by the Centers for Disease Control and Prevention (CDC). The committee, known as the National Sustainability Committee for the Elimination of Measles, Rubella, and Congenital Rubella Syndrome (NSC), meets with CDC officials to ask questions or request additional information, and then they interpret the data and create recommendations for the U.S. to maintain its status.
The CDC report and the NSC interpretation and recommendations are submitted to the regional office of the World Health Organization (WHO), which for the U.S. is the Pan-American Health Organization, or PAHO. Within PAHO, the Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission (RVC) reviews the materials, asks follow-up questions, and ultimately determines whether the country maintains its status.
The important points about this process for families are three-fold:
- An understanding that groups are monitoring the spread of measles and determining whether the virus is changing as well as ensuring the vaccine remains effective.
- While the CDC is involved in this effort, the interpretation of data, recommendations, and assignment of elimination status are independent of the CDC.
- For a family making decisions about their health, this formal process is worth knowing about, but the reality is that even if measles “remains eliminated” based on the formal review of data, at this moment, it’s important to listen to the steady drumbeat of cases occurring in the U.S. Measles is present— cases were reported in 44 of 50 states in 2025— and the best protection is prevention through vaccination.
Second: Loss of measles elimination status is a warning about our systems.
Measles has been eliminated from this country for 25 years. If the U.S. loses its measles elimination status, it is an important warning for all of us because it means the public health infrastructure in the U.S. is not functioning effectively. Most people don’t pay attention to public health efforts. The absence of disease in communities is not something that people notice, but communities free of infectious disease outbreaks don’t happen by chance. They happen through a lot of behind-the-scenes work, including disease surveillance; vaccine infrastructure, including ensuring that people who couldn’t otherwise afford vaccines can get them (so we can all benefit from community immunity); and education about the ways to protect ourselves and our families.
The current breakdown in community immunity related to measles tells us enough children are not being vaccinated that a protection enjoyed by previous generations no longer extends to babies born today. We should all heed the warning of a few thousand measles cases and a handful of deaths before the situation worsens, and we start seeing tens of thousands of measles cases and tens or hundreds of deaths from a disease that was once eliminated.
We can all contribute not only by personally seeking out and following science-based recommendations but also by advocating for a fully funded and staffed public health infrastructure and strong, science-based public health policies. Public health has been weakened under the current administration, and while some celebrate this as “payback” for mistakes made during the COVID-19 pandemic, it is important to realize that we will all suffer the effects of the “break-it-rather-than-learn-from-it" approach that has been taken.
Third: Measles is no joke, and it is usually the first, but not the only, pathogen to show itself.
Regardless of whether PAHO determines that the U.S. has lost its measles elimination status, we know that measles outbreaks have been occurring in states throughout the U.S., and because measles is one of the most contagious diseases, it is the first to return when immunization rates drop.
Measles is a nasty virus. While most people survive a measles infection, some characteristics of measles make it uniquely dangerous:
- The virus hangs in the air for a couple of hours, so people can be exposed without even coming into contact with a measles-infected person. This is why we hear community alerts when someone with measles was in a public setting, like a store, airport or healthcare office.
- Measles can cause many different complications; about 3 of every 10 people with measles will have at least one complication. Some of the scarier complications can include blood clotting problems and suppression of a person’s immune system, increasing their chance of getting another infection just when they seem to be recovering from measles. Measles can also cause problems during pregnancy, including miscarriage. In rare instances, it can cause a condition called hemorrhagic measles, which is characterized by bleeding from openings on the body or under the skin, delirium, and difficulty breathing. (Find a more comprehensive list of symptoms and complications on the VEC’s “Vaccines & Diseases” webpage related to measles.)
- After a person recovers from measles, they can still suffer effects, like immune amnesia in which they lose immunity to other pathogens that they were previously protected against. It can take several years to recover or regenerate this protection. Likewise, a small number of people, particularly children who had measles in the first year of life, can also develop a fatal disease called subacute sclerosing panencephalitis, or SSPE. SSPE occurs when the virus continues to replicate in the person’s brain even after they have recovered from the initial infection. Years later, these individuals experience neurological deterioration that worsens over time. Early symptoms can include loss of vocabulary or personality changes; the condition ultimately culminates in death.
The increasing presence of measles in communities throughout the U.S. means three things for families. First, being exposed to measles in the community is more likely than it was even a year ago. Second, measles is usually the first infectious disease to return, but if vaccines are cast aside, it will not be the only disease to return. Third, it’s important to make sure everyone in your family who can be is protected against measles, and if someone can’t get vaccinated against measles for some reason (e.g., health conditions or age), you should monitor reports of the disease in your area or where you are going if you are traveling.
If you are interested in learning more about measles, check our webpage or “VEC Vaccine Notes” video or podcast.
In November 2025, Canada lost its measles elimination status. By definition, this means the Americas, of which the United States is part, also lost its measles elimination status. In public health, elimination is a technical term that means for a defined period of time, the pathogen is no longer consistently spreading in a country or region. When we are talking about measles in the U.S., elimination means that measles virus introduced from a single case does not continue to spread from one person to another in the U.S. continuously over a period of at least 12 months.
Measles was declared eliminated from the U.S. in 2000, and even though the Americas has lost its elimination status, for now, the U.S. is still considered to have eliminated measles. However, if you have been listening to the news over the last year, you are likely aware that measles is very much present in the U.S. By late December 2025, more than 2,000 confirmed cases and three deaths had been recorded. Two points about these numbers are important. First, because not every case is confirmed, the actual number of cases is likely much higher. Second, the deaths in children from measles are the first child deaths to occur in the U.S. in the last 20 years.
Because the first cases occurred in late January 2025, the U.S. could lose its elimination status in 2026. So, what does this mean for families?
First: The status is a formality, but it results from an established surveillance system that involves an intentional and thorough process of which most people are unaware.
Measles elimination status is based on an extensive annual review of measles cases. Throughout the year, public health officials collect information and data related to each measles case, including tracing lines of spread; genetic typing of the virus; vaccination status, age and travel history of affected individuals; and other details. In the U.S. an independent committee of scientists and public health officials reviews these data in the form of a report prepared by the Centers for Disease Control and Prevention (CDC). The committee, known as the National Sustainability Committee for the Elimination of Measles, Rubella, and Congenital Rubella Syndrome (NSC), meets with CDC officials to ask questions or request additional information, and then they interpret the data and create recommendations for the U.S. to maintain its status.
The CDC report and the NSC interpretation and recommendations are submitted to the regional office of the World Health Organization (WHO), which for the U.S. is the Pan-American Health Organization, or PAHO. Within PAHO, the Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission (RVC) reviews the materials, asks follow-up questions, and ultimately determines whether the country maintains its status.
The important points about this process for families are three-fold:
- An understanding that groups are monitoring the spread of measles and determining whether the virus is changing as well as ensuring the vaccine remains effective.
- While the CDC is involved in this effort, the interpretation of data, recommendations, and assignment of elimination status are independent of the CDC.
- For a family making decisions about their health, this formal process is worth knowing about, but the reality is that even if measles “remains eliminated” based on the formal review of data, at this moment, it’s important to listen to the steady drumbeat of cases occurring in the U.S. Measles is present— cases were reported in 44 of 50 states in 2025— and the best protection is prevention through vaccination.
Second: Loss of measles elimination status is a warning about our systems.
Measles has been eliminated from this country for 25 years. If the U.S. loses its measles elimination status, it is an important warning for all of us because it means the public health infrastructure in the U.S. is not functioning effectively. Most people don’t pay attention to public health efforts. The absence of disease in communities is not something that people notice, but communities free of infectious disease outbreaks don’t happen by chance. They happen through a lot of behind-the-scenes work, including disease surveillance; vaccine infrastructure, including ensuring that people who couldn’t otherwise afford vaccines can get them (so we can all benefit from community immunity); and education about the ways to protect ourselves and our families.
The current breakdown in community immunity related to measles tells us enough children are not being vaccinated that a protection enjoyed by previous generations no longer extends to babies born today. We should all heed the warning of a few thousand measles cases and a handful of deaths before the situation worsens, and we start seeing tens of thousands of measles cases and tens or hundreds of deaths from a disease that was once eliminated.
We can all contribute not only by personally seeking out and following science-based recommendations but also by advocating for a fully funded and staffed public health infrastructure and strong, science-based public health policies. Public health has been weakened under the current administration, and while some celebrate this as “payback” for mistakes made during the COVID-19 pandemic, it is important to realize that we will all suffer the effects of the “break-it-rather-than-learn-from-it" approach that has been taken.
Third: Measles is no joke, and it is usually the first, but not the only, pathogen to show itself.
Regardless of whether PAHO determines that the U.S. has lost its measles elimination status, we know that measles outbreaks have been occurring in states throughout the U.S., and because measles is one of the most contagious diseases, it is the first to return when immunization rates drop.
Measles is a nasty virus. While most people survive a measles infection, some characteristics of measles make it uniquely dangerous:
- The virus hangs in the air for a couple of hours, so people can be exposed without even coming into contact with a measles-infected person. This is why we hear community alerts when someone with measles was in a public setting, like a store, airport or healthcare office.
- Measles can cause many different complications; about 3 of every 10 people with measles will have at least one complication. Some of the scarier complications can include blood clotting problems and suppression of a person’s immune system, increasing their chance of getting another infection just when they seem to be recovering from measles. Measles can also cause problems during pregnancy, including miscarriage. In rare instances, it can cause a condition called hemorrhagic measles, which is characterized by bleeding from openings on the body or under the skin, delirium, and difficulty breathing. (Find a more comprehensive list of symptoms and complications on the VEC’s “Vaccines & Diseases” webpage related to measles.)
- After a person recovers from measles, they can still suffer effects, like immune amnesia in which they lose immunity to other pathogens that they were previously protected against. It can take several years to recover or regenerate this protection. Likewise, a small number of people, particularly children who had measles in the first year of life, can also develop a fatal disease called subacute sclerosing panencephalitis, or SSPE. SSPE occurs when the virus continues to replicate in the person’s brain even after they have recovered from the initial infection. Years later, these individuals experience neurological deterioration that worsens over time. Early symptoms can include loss of vocabulary or personality changes; the condition ultimately culminates in death.
The increasing presence of measles in communities throughout the U.S. means three things for families. First, being exposed to measles in the community is more likely than it was even a year ago. Second, measles is usually the first infectious disease to return, but if vaccines are cast aside, it will not be the only disease to return. Third, it’s important to make sure everyone in your family who can be is protected against measles, and if someone can’t get vaccinated against measles for some reason (e.g., health conditions or age), you should monitor reports of the disease in your area or where you are going if you are traveling.
If you are interested in learning more about measles, check our webpage or “VEC Vaccine Notes” video or podcast.