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U.S. Measles Cases Surge in 2026, Threatening Elimination Status Amidst Widespread Outbreaks

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Measles Resurgence in the United States: 2026 Crisis Overview

The United States is experiencing a significant resurgence of measles in 2026, with case numbers surpassing levels not seen in decades and threatening the nation's elimination status, which has been maintained since 2000.

Large and sustained outbreaks in multiple states, declining vaccination rates, and debates over public health policy and vaccine mandates are key features of the current situation.

The Pan American Health Organization (PAHO) is scheduled to review the U.S. elimination status in April and November 2026.

National Case Data and Trends

  • As of late February 2026, the U.S. has recorded at least 1,136 confirmed measles cases across over 28 states, with some reports citing figures as high as 1,281 by early March.
  • This number represents roughly half of the total 2,283–2,288 cases reported in all of 2025, which was the highest annual total since 1992.
  • In 2026, over 10% of cases have resulted in hospitalization, and 93-96% of cases are among unvaccinated individuals or those with unknown vaccination status.
  • Three measles-related deaths were reported last year: two unvaccinated school-age children in Texas and one unvaccinated adult in New Mexico. A Los Angeles County child also died in September 2025 from subacute sclerosing panencephalitis (SSPE), a rare and fatal complication arising from a measles infection contracted in infancy.

Major Outbreaks by State

South Carolina

South Carolina’s outbreak, centered in Spartanburg County, began in October 2025. By early March 2026, it had reached approximately 991 confirmed cases, making it the largest single U.S. measles outbreak in decades.

  • The outbreak has been slowing in recent weeks. The state administered nearly 17,000 MMR doses in January, and over 4,800 early doses were given to infants aged 6-11 months.
  • At least 20 hospitalizations have been reported, with complications including pneumonia and encephalitis. Infected individuals are predominantly unvaccinated children and teenagers.
  • Hundreds of people, including students, have been in quarantine.

Utah and Arizona

  • An outbreak along the Utah-Arizona border, which began in June 2025, has expanded. As of March 2026, Utah reported over 350 cases, 31 hospitalizations, and 3 intensive care unit admissions.
  • The outbreak was initially concentrated in southwestern Utah and has since spread northward, with spread linked to school athletic events.
  • Arizona has reported over 100 cases, concentrated in Mohave County and the Colorado City area.

Florida

  • Florida recorded approximately 130-134 cases in 2026, centered at Ave Maria University in Collier County and the surrounding community. At least 12 students tested positive, with three hospitalized.

California

  • California has reported at least 40 confirmed cases in 2026, the highest annual total since 2019. Three outbreaks have been identified: in Riverside County, Shasta County, and an ongoing outbreak in Sacramento and Placer counties linked to travel from South Carolina.

Other States

  • Pennsylvania: 84 cases were reported in 2025, concentrated in Lancaster and Lebanon Counties.
  • Oregon: Cases were confirmed in Linn and Clackamas counties, with potential exposure at multiple public sites in Portland and Keizer.
  • Texas: The 2025 outbreak in West Texas officially sickened over 760 people and resulted in two child deaths.
  • Additional cases have been reported in over 30 other states, including Colorado, Georgia, Maryland, North Carolina, Virginia, and Washington.

Confirmed Exposure Sites

Multiple public exposure sites have been identified across the country, including:

  • Portland, Oregon: Safeway, Gresham Winco, Lark Café, Pho.Com restaurant, Providence Portland Medical Center ER
  • Keizer, Oregon: Solar Nails, Pho Keizer
  • Asheville, North Carolina: Mission Hospital Emergency Department
  • Washington, D.C. : National Mall (March for Life), Basilica of the National Shrine of the Immaculate Conception, Catholic University, Reagan National Airport, Union Station, Metro transit lines, Children’s National Hospital
  • Broomfield/Littleton, Colorado: Broomfield High School, Broomfield Heights Middle School, Denver International Airport, a church service

Vaccination Rates and Exemptions

National MMR vaccination rates among kindergartners declined to 92.5% in the 2024-2025 school year, down from 95.2% in 2019-2020. The herd immunity threshold for measles is 95%.

  • A record 138,000 kindergartners obtained vaccine exemptions for the 2024-25 school year.
  • Religious and non-medical exemptions have increased in several states. In South Carolina’s outbreak epicenter, religious exemptions more than doubled since 2020. In Oregon, 9.7% of kindergartners had nonmedical exemptions in 2024-2025.
  • In Spartanburg County, less than 90% of students have received required vaccines, with one school reporting a 21% vaccination rate.

Federal Policy and Official Statements

  • Health and Human Services Secretary Robert F. Kennedy Jr. has characterized measles vaccination as a personal choice and has promoted unproven treatments. He has stated that the outbreaks have "nothing to do" with him.
  • Acting CDC Director Jay Bhattacharya has supported vaccines but has not held public briefings on the measles surge. The CDC reduced recommended childhood vaccines in a decision temporarily invalidated by a federal court.
  • CDC Principal Deputy Director Dr. Ralph Abraham described the potential loss of elimination status as "the cost of doing business" and framed unvaccinated communities as a matter of "personal freedom."
  • CMS Administrator Dr. Mehmet Oz has urged the public to "take the vaccine, please," and stated Medicare and Medicaid will cover it.
  • The CDC has provided support to current outbreak jurisdictions, including funding to South Carolina and staff deployments. The U.S. Department of Health and Human Services reported the CDC provided $8.5 million to seven areas affected by measles outbreaks over the past year.

Public Health Response and Costs

  • State and local health departments are leading outbreak response, including contact tracing, case investigation, and quarantine guidance.
  • A Johns Hopkins analysis estimates an initial financial impact of ~$244,480 to manage an outbreak, with each additional case costing ~$16,000. A Yale School of Public Health report projects annual costs could reach $1.5 billion if vaccination rates continue to decline.
  • Budget cuts to local health departments, including a reported $4 million loss in Dallas County, Texas, have reduced staff and community vaccination capacity.
  • The CDC's genomic analysis capacity was delayed due to staffing challenges; the agency began releasing advanced genetic data in late March after months of delay.

International Context

Canada lost its measles elimination status in November 2025 after a year-long outbreak. The Americas region lost its overall elimination status as a result.

  • Mexico reported over 17,000 cases and 40 deaths since early 2025, largely linked to the same Texas outbreak strain. The Jalisco state government mandated face masks in schools in February 2026.
  • PAHO issued an epidemiological alert in early 2026, noting a 43-fold increase in cases in the region compared to the same period in 2025.
  • The United Kingdom also lost its measles elimination status in 2025.
  • Mexico and the U.S. have requested a two-month extension from PAHO to manage outbreaks before a formal status review.

Clinical Information on Measles

  • Measles is a highly contagious airborne virus. Up to 90% of unvaccinated individuals exposed will contract the disease. The virus can remain airborne for up to two hours.
  • Symptoms appear 7-21 days after exposure and include high fever, cough, runny nose, conjunctivitis, Koplik spots (white lesions inside the mouth), and a red, blotchy rash starting on the face.
  • Common complications include ear infections and pneumonia. Severe complications include encephalitis (brain swelling), which occurs in approximately 1 in 1,000 cases, and subacute sclerosing panencephalitis (SSPE), a fatal neurological disease that can develop 7-10 years after infection.
  • Infants, children under 5, adults over 20, pregnant women, and immunocompromised individuals are at highest risk for severe outcomes.
  • The MMR vaccine is 97% effective after two doses and 93% effective after one dose. The CDC recommends the first dose between 12-15 months and the second between 4-6 years.

Legislative Context

  • At least 350 bills described as anti-vaccine have been introduced in state legislatures nationally, including at least eight in South Carolina.
  • A bill in South Carolina would prohibit requiring vaccines for children under 2 years old, which would remove daycare vaccine mandates. The bill was advanced by a Senate subcommittee.
  • The Medical Freedom Act Coalition is advocating for legislation modeled after an Idaho law prohibiting medical mandates, targeting 20 states.
  • Groups associated with Robert F. Kennedy Jr., including Children’s Health Defense and Maha Action, are actively lobbying to eliminate immunization requirements.
  • Michigan has shifted some counties to a hybrid vaccine waiver process after in-person sessions became hostile.