One year after a measles outbreak erupted in West Texas, the virus is still moving steadily across the country — and health officials are growing increasingly alarmed. The US just recorded its worst year for measles, raising fears of a dangerous resurgence, a reality that many experts say reflects deeper cracks in the nation’s public health defenses.
Texas alone logged more than 760 cases before finally declaring its outbreak over in August. Two children died. It was the largest outbreak the country had seen in decades. Yet instead of fading, measles continued to spread. New clusters emerged in upstate South Carolina and along the Utah–Arizona border, each racking up hundreds of cases that are still rising.
The first weeks of 2026 have only intensified the concern. Exposure alerts have surfaced in schools, churches, restaurants, airports and shops. With cases appearing week after week, the United States now risks losing its measles elimination status — a distinction it has held since 2000.
“It’s startling,” said Dr. Caitlin Rivers of Johns Hopkins Bloomberg School of Public Health. “Just a few years ago, measles was extremely rare here. Now we’re seeing in a single week what once took a year.”
In 2025, the US reported more than 2,200 confirmed measles cases — more than any year since elimination was declared. The opening weeks of 2026 have already brought at least 171 new cases, nearly matching the average annual totals of the past quarter-century.
More than 95% of infections have occurred in people who never received the recommended two doses of the MMR vaccine.
For many experts, the numbers point to a sobering reality: the country may need to confront an even worse situation before it improves.
“This is devastating because it’s almost entirely preventable,” Rivers said. “But lagging vaccination coverage has left too many people exposed.”
In April, the Pan American Health Organization will review whether the US can keep its elimination status. The decision will depend on whether recent outbreaks can be traced back to a single chain of transmission — or whether measles has re-established itself in the country.
Yet some believe the label itself matters less than what it represents.
“Measles elimination is a vital sign of public health,” said Dr. Demetre Daskalakis, former CDC official who resigned last year. “And right now, that system is not healthy. I don’t need to check its pulse to know that.”
One troubling indicator is vaccination coverage among children. A record share of US kindergartners claimed exemptions from required vaccines last year. For the fifth year in a row, MMR coverage fell below the federal target of 95%.
The CDC says philosophical and personal objections now account for more than a third of exemptions, with missed deadlines and claimed medical concerns also playing roles. While most parents still support school vaccine rules, hesitancy continues to grow.
“Vaccines are victims of their own success,” said Dr. Paul Offit of the Children’s Hospital of Philadelphia. “We eliminated measles — and with it, the memory of how dangerous it was.”
Offit recalls asking vaccine pioneer Dr. Maurice Hilleman years ago whether education alone could sustain vaccination rates. Hilleman believed the virus would have to return to remind people what was at stake.
“Seeing children once again exposed to something that can kill them — when it didn’t have to happen — that’s an enormous defeat,” Offit said.
Yet even tragedy has not fully shifted behavior. Last year’s three measles deaths equaled the total from the previous 25 years combined. Still, vaccination uptake remains slow in many affected communities.
In South Carolina, mobile clinics were deployed early in the outbreak, but participation has been “disappointing,” state epidemiologist Dr. Linda Bell said.
Outbreaks often begin in under-vaccinated pockets — tight-knit religious or cultural communities — but Daskalakis says a new kind of network now plays a role: online communities bound together by anti-vaccine messaging.
Despite official statements from federal health leaders supporting vaccination, recent changes to the childhood vaccine schedule and mixed messaging have fueled broader doubts.
Experts warn that without swift action, larger outbreaks — and more deaths — are inevitable. At least one in every 1,000 measles patients may die. In South Carolina alone, cases have already surpassed 550.
“The more cases there are, the more chances for severe illness,” Rivers said.
Raising vaccination rates remains the clearest solution. Past outbreaks have been stopped within months when coverage improved. Stronger school requirements and renewed public messaging could quickly reverse the trend.
“We already have everything we need,” Rivers said. “What we’re missing is the understanding of how urgent this is.”
For Daskalakis, the challenge ahead is familiar — and relentless.
“Public health is never static,” he said. “There’s always a new threat, new misinformation, new challenges. The question is whether we meet them in time.”
For now, measles continues its slow march across the country, testing whether the nation can reclaim the protection it once took for granted.
