Measles is undeniably back. The disease, which was declared eliminated in the United States in 2000, is once again endemic, the Pan American Health Organization reportedly decided at a meeting this week.
PAHO made that determination based on a set of technical standards, and its official declaration is expected early next week. Those criteria say that measles is endemic when the same strain of the virus causes continuous infections for a year straight; even before this week’s meeting, publicly available data indicated that this was likely the case. But really, the evidence has been clear for some time now: The U.S. is in the midst of a measles crisis unlike any it’s faced in decades. More than 5,000 cases in 45 states have been confirmed this year. Pennsylvania started reporting measles deaths this August; its count is now up to seven. New York has had one death. Wisconsin reported its second yesterday.
This is already America’s worst year for measles since 1991, which marked the end of a three-year epidemic in which 123 people died. That surge helped spur a national vaccination push. This time, the outbreak has unfolded on the watch of a health secretary who has declined to accept responsibility for its ongoing spread.
Robert F. Kennedy Jr. has dismissed Democrats’ attempts to blame him for measles’ return. In April, he told a Senate committee that “the measles epidemic began before I came into office.” That’s true: Measles had already begun to spread in West Texas by January 2025, before Kennedy became health secretary. And routine childhood-vaccination rates, including the measles immunization, have declined since the coronavirus pandemic, which disrupted doctor appointments around the country. The U.S. isn’t alone in seeing cases rise. In January, six other countries—including Austria, Spain, and the United Kingdom—lost their elimination status. Measles was declared endemic in Canada again last year.
But this is Kennedy’s crisis now. He’s been the nation’s top public-health official for nearly two years, and the country’s predicament has only deepened under his leadership. The number of measles cases in the U.S. in the first 10 months of the year is more than double the total for 2025. Meanwhile, Kennedy and the Department of Health and Human Services have failed to send a clear message to Americans about the importance of curbing the virus’s spread. As one CDC official, whose name I’m withholding to protect them from professional repercussions, recently told me, “The response has lacked a clear strategy and support from the top.”
Kennedy’s CDC has offered help to states dealing with outbreaks. Recently, it’s sent staff to Pennsylvania, New York, and Wisconsin to assist with tasks such as contact tracing and surveillance. (In an emailed statement earlier this week, an HHS spokesperson cited that assistance and $100 million the CDC has recently sent to states as evidence of the department’s “aggressive” response to measles.) But under Kennedy, the CDC’s response has also at times appeared constrained. The Washington Post reported that an alert that CDC scientists wanted to send regarding the risks of measles during pregnancy was not approved for unclear reasons. Meanwhile, at least some of the assistance the CDC has offered hasn’t been welcome. As Nicholas Florko reported in The Atlantic last year, Kennedy planned to send vitamin A to Texas, but health officials in the state never requested any. (Vitamin A can help treat measles in children who have a severe deficiency but has not been shown to be effective for most Americans.)
Perhaps most dramatically, Kennedy and his HHS have fought with states over the precise toll that measles has taken. In August, after two infants died in Pennsylvania, Kennedy and Governor Josh Shapiro got into a public dispute over whether measles contributed to those children’s deaths. As the number of deaths reported by states has continued to rise, the CDC has so far declined to attribute some of them to measles; its dashboard currently lists only six fatalities.
Kennedy doesn’t talk about measles often. When he does, he tends to offer a tepid endorsement of the vaccine or downplay the seriousness of the disease. In 2024, during his failed presidential run, Kennedy—a longtime anti-vaccine activist—told an interviewer that he wouldn’t give his children the measles, mumps, and rubella vaccine if they were born today. (Last year, he said he would “probably” do so.) He also claimed at the time that “kids who get the measles as a child are much healthier when they grow up,” which is not true. Last year, during an outbreak in Texas in which two young girls died, he offered only half-hearted support for vaccination while pushing vitamin A. As I reported at the time, Kennedy privately told the father of one young girl who had died of measles, “You don’t know what’s in the vaccine anymore.”
This August, in the midst of a rapidly growing outbreak in Lancaster County, Pennsylvania, Kennedy said on CNN that “parents should get their children vaccinated for measles”—but only after the host, Dana Bash, asked him to encourage parents to vaccinate their children. (The HHS spokesperson wrote that Kennedy and CDC Director Erica Schwartz “continue to recommend MMR vaccination as the most effective way to prevent measles.”) Such a statement would be entirely unremarkable for any previous health secretary, but it felt notable coming from Kennedy. Since that CNN interview, Kennedy has devoted few words to measles and far more to mocking Shapiro and promoting other projects, such as his cooking show. One recent episode explored how to make a chickpea salad.
Kennedy has also kept mum on the many false statements about measles and vaccination from his allies and supporters. The anti-vaccine nonprofit Kennedy founded, Children’s Health Defense, published an article in September saying that “parents don’t need to be afraid of the measles” and asserting incorrectly that the virus can make children stronger. A week later, after four people had died in Pennsylvania, Kennedy told attendees at a Children’s Health Defense conference, “You have a strong and steadfast friend at the White House.”
None of this reflects well on the health secretary, but he has shown no sign that he’ll change course. (HHS did not immediately respond this morning to a request for comment on PAHO’s reported decision.) President Trump has been supportive of Kennedy’s vaccine agenda, and combatting measles was never a focus of Kennedy’s Make America Healthy Again movement.
In recent months, that movement has seemed to fray: One of the health secretary’s closest allies, Calley Means, quit his White House post in late October and then went on Joe Rogan’s podcast to complain about the influence of industry lobbyists in the federal government. The much-ballyhooed boost that MAHA would supposedly give Republicans in the midterms never materialized, either. Two of the movement’s most prominent candidates—the Texas Senate nominee Ken Paxton and Zach Lahn, a candidate for governor in Iowa—lost their races by wide margins.
But MAHA, and Kennedy, may not be chastened. The new White House chief of staff, Stephen Miller, appears to be anti-vaccine curious. He has echoed President Trump’s call to split the MMR into separate shots; the vaccines are not currently available separately, and experts say splitting them up is unnecessary. And he’s complained, without citing any particular evidence, that pressure to “pump your kids full of shots days after birth” is a “medical travesty.” (The White House declined to comment on Miller’s vaccine beliefs.) Kennedy cheered Miller’s promotion and wrote on X that it was time to “unleash the Kraken.” What, exactly, he means by that is unclear. But a disease that’s arguably the most contagious in history has already been unleashed on the United States, and Kennedy hasn’t shown nearly enough interest in reining it in.
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