By Nicholas Piretto and Matthew Fisher
Editor’s note: Part four in an investigative series on the recent measles outbreak in the United States.
The federal Centers for Disease Control and Prevention declared measles was eliminated in 2000. Twenty-five years later, an unvaccinated child in Suffolk County recently tested positive for measles and became one of the more recent local cases in a resurgence of the communicable disease across the country.
In May, the number of confirmed national cases reached 935, according to the CDC. This 16.9% rise coincided with outbreaks spreading to new states, including Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, New Jersey, Ohio, Pennsylvania, Rhode Island, Tennessee, Vermont, Virginia and Washington.
A total of 12 outbreaks were reported across the country in the first five months of 2025, with 93% of confirmed cases stemming from community outbreaks. By contrast, just 16 outbreaks were recorded in all of 2024, with only 69% of cases linked to outbreaks. The country has already seen 75% as many outbreaks in less than half the time, suggesting a sharp increase in frequency.
“I’m certainly concerned about larger outbreaks because the reality is that we’ve now seen up to three children who have died of a totally vaccine-preventable illness,” said Dr. Matthew Harris, medical director of emergency preparedness at Cohen Children’s Medical Center in New Hyde Park. “For me, one of these deaths was too many, and three are almost unspeakable.”
With measles on the rise in the United States, it is important to understand this contagious disease and how its significance may be undermined by the public. Vaccines have been at the forefront of public discussion in recent years, especially throughout the coronavirus global pandemic, which affected both how the public views vaccines and, potentially, the resurgence in measles.
Measles brings high fever—often 104 degrees Fahrenheit—cough, runny nose, watery eyes and a red rash that covers much of the body. Tiny white spots inside the mouth, called Koplik spots, often form on the inner cheek. From the mouth, the rash usually spreads to the entire body.
Before the measles vaccine was introduced in 1963, 3 million to 4 million Americans annually tested positive for measles, resulting in hundreds of deaths and thousands of hospitalizations, according to the CDC. This first vaccine against measles was known as the Edmonston-B strain vaccine. In 1971, the MMR (measles, mumps and rubella) vaccine was introduced.
Despite the success of the MMR vaccine, there has been a slow, but steady decline in the vaccination rate against measles in recent years. MMR vaccination rates among U.S. kindergarteners dropped to 92.7% in 2023–24—below the 95% herd immunity threshold—according to the CDC’s “SchoolVaxView” report.
Experts cite several key reasons for the recent decline in vaccination rates in the U.S., including apathy. Susan Lee Dupree, a nurse practitioner at Northside Hospital in Atlanta, Ga., said, “We’ve had two to three generations of people that have never seen measles. They’ve never seen how they can devastate a population. They’ve never seen children dying of these things, and so it doesn’t really seem real when you talk about vaccinating your kid.”
In effect, the idea of fighting off measles becomes an abstract thought, like battling the boogeyman, she said.
More recent issues like the coronavirus pandemic have played a role. The COVID-19 vaccine had to be developed rapidly, and so many people distrusted it, leading to a more general sense of vaccine hesitancy or mistrust, experts contend. Anti-vaccine narratives, fueled by social media, only compounded the problem.
Religious beliefs against vaccines, which were heightened during the pandemic, also caused vaccination rates to dip. Maria Iler, another nurse practitioner in Atlanta, said, “I believe some people choose to not vaccinate because there is a history of false information about some vaccines and their side effects, and some people have religious beliefs.”
Some health professionals, like Dupree, suggest immigration may play a role. However, the CDC has stated that most measles cases originate with unvaccinated U.S. residents returning from travel abroad. Legally admitted immigrants and refugees are required to undergo medical exams and receive vaccinations before entry. While isolated cases have emerged in migrant shelters, these have been contained, and there is no strong evidence connecting undocumented immigration to current national outbreaks, federal health officials say.
“I’m certainly concerned about larger outbreaks because the reality is that we’ve now seen up to three children who have died of a totally vaccine-preventable illness.”
Dr. Matthew Harris, Medical Director, Cohen Children’s Medical Center
In the end, the measles outbreak may be a question of misunderstanding on many fronts. Deann Hansen, another nurse practitioner at Northside Hospital, said she believes it’s a travesty that a disease that was nearly eradicated by 2000 is now on the rise owing to ignorance.
“I feel that one of the major reasons why people don’t vaccinate against measles is a misunderstanding of how severe measles can be,” she said. There’s “a general misguided lack of trust in vaccines and a fear of unsubstantiated consequences.”
“There is zero scientific evidence around most of the big conspiracies between vaccines and things like autism,” Harris noted. “These have been fully scientifically disproven, despite what people see in the external media. Measles can cause a devastating pneumonia or infection of the lungs and a devastating encephalitis, or in very rare cases a subacute infection of the brain that’s irreversible.”
Encephalitis is an inflammation of the brain tissue.
If you think you or a loved one are showing symptoms of or have been exposed to measles, call your doctor or a nearby health department immediately.
Visit the CDC’s measles page for more on outbreaks, safety protocols, and symptoms.
