The United States has effectively lost its measles elimination status, according to data reviewed by The New York Times, 26 years after the country first earned the designation. Genetic evidence shows the virus is once again spreading without interruption inside the country, and an international panel is meeting this week to decide whether to strip the status formally.
The country achieved measles elimination in 2000, after decades of vaccination had driven measles down to a handful of imported cases each year. Losing the status would not mean the disease has returned to the levels of the past, but it would mark the end of a public health achievement that has stood for more than a quarter of a century.
The Pan American Health Organization’s verification commission is meeting in Washington from 10 to 13 November to assess the evidence, with a decision expected within a week. The panel will look at case counts, genetic data and vaccination rates before it rules.
How measles elimination is judged
Measles elimination does not mean the virus has vanished. It means there has been no continuous homegrown transmission of the disease for at least 12 months, under high-quality surveillance. A country loses the status when the same virus genotype and lineage circulates without a break for a year or more in a specific area.
For the United States, the review period starts on 20 January 2025, when the West Texas outbreak began. Outbreaks in Utah and Arizona since then can be traced back to that Texas outbreak, and the outbreak in Utah itself has continued without interruption for more than a year, according to the Times analysis.
Cases climb past 5,000
The Centers for Disease Control and Prevention reported 5,182 confirmed measles cases in 2026 as of 5 November, the first time the annual total has passed 5,000 since 1991, when 9,643 cases were recorded. The total is already more than double the 2,289 cases recorded in all of 2025, and far above the 285 cases in 2024. The surge put measles elimination in doubt months before the panel met.
Cases rose by 330 in a single week, the 13th week in a row in which the weekly increase passed 100, according to USA Today. The CDC has recorded 43 outbreaks in 2026, and 562 people, about 11 percent of all confirmed cases, have been admitted to hospital.
The death toll is disputed. The CDC’s national tally lists four measles deaths in 2026, while state health departments have reported at least eight: six in Pennsylvania, one in New York and one infant in Wisconsin. The gap arose after the CDC, under Health Secretary Robert F. Kennedy Jr., switched from state figures to mortality data from the National Center for Health Statistics, Reuters reported.
Vaccination rates fall below the threshold
Vaccination coverage among kindergartners has fallen below the level needed to keep measles elimination. Coverage with the measles, mumps and rubella vaccine stood at 92.4 percent in the 2025-26 school year, down from 95.2 percent in 2019-20 and below the 95 percent threshold. About 280,000 kindergartners were at risk during the school year as a result.
About 96 percent of the people infected with measles this year were either unvaccinated or had an unknown vaccination status, according to CDC data. That gap is the main reason measles elimination is now at risk. Pennsylvania has been hit hardest, with 140 cases in the last two weeks and more than 1,000 this year. New York recorded its first measles death in more than 30 years, a 7-month-old child, and the Times reported one death each in New York and Wisconsin last week.
What losing measles elimination would mean
“The U.S. is in the throes of the deadliest measles outbreak it has seen in decades,” Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University, told Scientific American earlier this year. She added that losing measles elimination status would be an official acknowledgement that the country is on the wrong path.
The Americas as a region already lost its own elimination status in November 2025, after Canada recorded 12 months of continuous transmission. For the United States, the formal decision on measles elimination now rests with the commission in Washington, but the genetic evidence it will weigh already points in one direction.