The United States has lost its measles elimination status, held since 2000. The Wall Street Journal reported the loss on Nov. 13, citing people familiar with the matter. The Pan American Health Organization revoked the label after finding the country failed to stop continuous transmission for more than a year.
PAHO itself has published nothing. It did not immediately respond to Reuters, which matched the report the same day. PAHO officials told the Associated Press they are scheduling an announcement for next week.
So the news rests on reporting, not on a published decision. The finding itself is narrow: one chain of the same virus ran uninterrupted in the US for a year or more.
We asked a week ago whether the US would lose the label. This is what it means now that it is gone.
The test is one unbroken chain, and the US failed it
PAHO states the rule as a negative. A country re-establishes endemic transmission, its October notice says, when evidence shows “a chain of transmission” “involving a viral strain with an identical genotype and lineage has continued uninterrupted for 12 months or longer.”
KFF states the positive version as “interruption of endemic measles virus transmission for a period greater than or equal to 12 months.”
Case counts alone never decided this. A country can record thousands of imported cases and short outbreaks and keep the label. It cannot let one lineage circulate for a year.
Amesh Adalja of the Johns Hopkins Center for Health Security told AP the assessment is “solely based on genetics.” A source familiar with the CDC’s findings told Reuters the agency reached the same conclusion. That report stays confidential.
The ruling came from PAHO’s Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission. It is an independent panel of epidemiologists, virologists and public health experts, set up in 2019.
It met behind closed doors in Washington from Nov. 10 to 13 and reviewed reports from all 35 PAHO member states, Al Jazeera reported.
Noel Brewer chairs an independent measles advisory panel and teaches public health at the University of North Carolina. He presented the CDC’s status report to the commission on Nov. 10, Reuters reported. The commission recommends; PAHO Director Jarbas Barbosa signs off.
Mexico sits in the same position, alongside Guatemala, Peru and Bolivia, Al Jazeera reported. Researchers trace Mexico’s Chihuahua outbreak to an unvaccinated Mennonite child who traveled to Gaines County, Texas, and came home infected, AP reported.
The CDC’s own numbers, year by year
The CDC’s measles page, updated Nov. 13, counts 5,412 confirmed cases in 2026 as of Nov. 12. That is 5,394 cases across 47 jurisdictions, plus 18 among international visitors.
We pulled every annual total the CDC publishes.
| Year | Confirmed US cases |
|---|---|
| 2018 | 381 |
| 2019 | 1,274 |
| 2020 | 13 |
| 2021 | 49 |
| 2022 | 121 |
| 2023 | 59 |
| 2024 | 285 |
| 2025 | 2,289 |
| 2026 (to Nov. 12) | 5,412 |
By our arithmetic, this year runs to 2.4 times the 2025 total, and more than four times 2019, when the US came within days of losing the label the first time.
Outbreaks account for 96% of this year’s cases, or 5,216 of them, across 43 new outbreaks. Another 1,385 cases this year belong to outbreaks that began in 2025. That carry-over is the statistical shape of an unbroken chain.
Pennsylvania has the country’s largest outbreak and six measles-associated deaths, Contagion Live reported on Nov. 6. Wisconsin has logged 431 cases in 13 counties, its worst in three decades.
New York has 178 cases. It declared a state disaster emergency in October, shortly before a child in Lewis County died.
The death toll depends on who counts. The CDC lists six and calls that subject to change, while KFF notes that states have reported eight. Reuters puts the US at roughly 7,500 infections and 13 deaths since the start of 2025.
For schools, travel and insurance, almost nothing changes
Losing elimination status carries no penalty and no automatic policy change. School vaccination rules, insurance coverage of the MMR shot and the CDC’s outbreak playbook all sit outside PAHO’s reach. Al Jazeera reported that the loss brings no immediate consequences, and that experts call it an embarrassment.
CDC Director Erica Schwartz spoke to Reuters before the decision. The agency would be doing “the same exact thing” either way, she said: working with states on immunization.
Travel advice does not change. The CDC’s Global Measles notice has sat at Level 1, practice usual precautions, since May 28, 2025. It tells all international travelers to get fully vaccinated.
One thing does change, quietly. The CDC’s page still explains US cases by saying measles “is brought into the United States by travelers who get measles while they are in other countries.” On the commission’s finding, that no longer covers it. The virus now circulates at home.
The regional label was already gone. PAHO stripped the Americas of measles-free status on Nov. 10, 2025, after ruling Canada endemic. Reuters notes that Spain and the UK also lost elimination status recently.
The US left the WHO but remains a PAHO member.
Why the chain held: coverage slipped below 95%
Elimination needs roughly 95% two-dose coverage, the figure PAHO cites for “high and homogeneous” vaccination. Kindergarten coverage sits under that.
KFF puts two-dose MMR coverage at 92.4% in 2025-26, down from 95.2% in 2019-20. Only 10 states reach 95%, and coverage ranges from 75.2% in Idaho to 98.9% in West Virginia. AP reported the national childhood rate topped 97% when the US won elimination in 2000.
The vaccine’s performance is not in question. The CDC says two doses are 97% effective against measles, and one dose 93%. It calls the shot “very safe” and says “there is no link between the MMR vaccine and autism.” KFF says 96% of this year’s cases involved people who were unvaccinated or whose status nobody knew.
The same slide runs through routine childhood care, including the doubling of newborn vitamin K shot refusals we reported this month.
What the named critics are saying
Brewer did not soften it. “It is a fully preventable disease. It is unconscionable that we have this amount of measles,” he told Reuters.
David Margolius, who directs Cleveland’s health department, told AP the decision means the US is “moving backwards.” Matt Ferrari of Penn State’s Center for Infectious Disease Dynamics called a loss “a disappointment, not a shock.” He told Al Jazeera it could at least give state and local officials common language. Edwin Asturias of the University of Colorado told Al Jazeera it would be “a stain on your health programme.”
Criticism of the federal response has a named target. AP reported that public health experts call the response under Health Secretary Robert F. Kennedy Jr. muted. He has moved to shrink the childhood vaccine schedule and backed a Trump executive order on spacing out MMR doses, AP said.
Reuters wrote that Kennedy “has for years spread doubts, without scientific evidence, about the safety of measles vaccines.” HHS did not respond to Reuters.
Getting the label back means another clean year
The route back runs the same test forward. The country has to interrupt transmission, go 12 months without it, and then satisfy the commission. Brazil lost elimination in 2019 and won it back in 2024 after a targeted vaccination campaign, Al Jazeera reported.
That puts the earliest US recovery a year after the last case in the current chain, and nobody has declared that chain over. The clock has not started.
PAHO expects to announce the decision next week, with the commission’s final report to follow.