Confirmed measles cases in the United States have reached a 35-year high, with July marking a grim milestone in what is increasingly being recognized as the dawn of a new era of resurgent vaccine-preventable diseases. The cumulative number of cases over the past two years has surpassed the combined total of the preceding quarter-century, signaling a significant public health setback. The vast majority of these outbreaks are rooted in domestic transmission, directly linked to declining vaccination rates, a trend that medical professionals and public health officials view with profound concern.
For the first time in a generation, the United States no longer meets a critical criterion for having eliminated measles as a public health threat. This status hinges on the ability of public health systems to contain outbreaks, ensuring they fizzle out within a year. However, the prolonged outbreak in Utah, which has persisted since June 2025, exemplifies the breakdown of this crucial benchmark. This extended period of transmission underscores the vulnerability of communities with insufficient herd immunity.
The human cost of this resurgence is stark. Nearly 400 individuals have been hospitalized with measles in the U.S. over the past two years. Tragically, three lives have been lost to the disease, and at least three others have suffered severe complications, including brain swelling, leading to lingering neurological symptoms. These figures represent not just statistics, but devastating personal tragedies and a stark reminder of measles’ formidable potential for severe morbidity.
In response to the escalating crisis, the Centers for Disease Control and Prevention (CDC) is on the verge of finalizing a comprehensive study examining the nation’s measles situation. This in-depth analysis will scrutinize data spanning from January 2025 through June 2026, providing a critical overview of transmission patterns, outbreak drivers, and vaccination coverage.
A CDC scientist, speaking on condition of anonymity due to concerns about professional repercussions, acknowledged the gravity of the situation. "I don’t think we could say with a straight face that there hasn’t been transmission over the past 12 months," the researcher stated, referencing the internal report. This report will undergo a rigorous review by a national committee of measles specialists before being submitted to the Pan American Health Organization (PAHO). PAHO is the designated body responsible for evaluating the measles elimination status of countries across North, South, and Central America, as well as the Caribbean.
While PAHO’s official decisions are slated for an annual meeting this fall, experts anticipate the outcome. "The assessment for elimination isn’t until November, but that is a scheduling issue, basically," commented Anne Schuchat, a former leader of the CDC’s immunization and respiratory disease group. Schuchat, who held the position from 2006 to 2015, expressed her dismay at the disease’s return. "It’s just so sad, because some people will get brutally ill," she said, emphasizing that the current situation serves as a crucial "wake-up call" for public health preparedness.
The Human Toll: Pediatricians on the Front Lines
Pediatricians in regions like Utah have found themselves at the vanguard of measles’ resurgence, grappling with the reality of treating children suffering from vaccine-preventable illnesses that were once considered relics of the past. In candid interviews with KFF Health News, six physicians shared their harrowing experiences and insights into the growing wave of vaccine hesitancy and its devastating consequences.
The Agony of Measles in Unvaccinated Children
Hospital pediatricians describe the clinical presentation of measles in unvaccinated children with a palpable sense of distress. Emilie Morris, a pediatrician serving Salt Lake and Utah Counties, painted a vivid picture: "When children come in, they’re often bent over. We call it tripoding, which is particular to upper respiratory infections and airway swelling. They have a rash – viruses cause rashes all the time – but in this context, the kid is hunched over, mouth open, drooling, crying, maybe not even producing tears, because they’re so dehydrated. Really labored breathing, kind of tugging in their belly, tugging between their ribs. Their eyes look kind of glazed over. It’s like they’re seeing through you."
Nathan Money, also a pediatrician in Salt Lake and Utah Counties, highlighted the increased medical vigilance required for unvaccinated children. "If the child has a fever or trouble breathing, and they’re unvaccinated, I have to be way more aggressive from a medical standpoint, because they are at higher risk of having life-threatening illnesses. I have to do more blood work, or lumbar punctures to rule out meningitis. I have to do things which are painful, and it’s traumatic for the families." He conveys to parents, "Because your child doesn’t have vaccines, I have to be more worried about conditions like sepsis or meningitis, so therefore I need to do more workup." The overriding concern, he stated, is the fear of missing a critical diagnosis. "These are parents who love their children. They always tell me, ‘Do what you need to do to make sure my child is safe.’"
The Trajectory of Illness and Parental Regret
Trahern W. Jones, a pediatric infectious disease specialist in Salt Lake City, recounted the profound suffering he witnesses. "I’m coming into a room and just hearing the most awful barking cough, just a cough and a high-pitch stridor as the child is trying to breathe. And he’s just coughing so hard it just makes you feel short of breath. He looks like he’s been beaten down for days, but he can’t rest, because the cough keeps him awake."
He described scenarios where parents, though not overtly anti-vaccine, had paused vaccinations due to a past perceived adverse reaction in someone they knew. Others, he noted, had limited understanding of measles, with their knowledge stemming from outdated accounts. "That’s something I’ve heard from other parents," Jones observed. "It’s such an awful illness. Even the best possible course is going to be one of the worst diseases most children ever go through." The impact extends beyond the physical, encompassing sleep deprivation for parents and profound emotional distress, often compounded by regret and shame.
Dr. Morris also detailed the financial burdens faced by some families. "One child was from a family that was uninsured because they didn’t feel that they would need to use the medical system. They were faced with the high burden of cost of our healthcare system. The cost was playing into the parents’ decision on whether or not their child should receive necessary medical care." She recounted intervening, saying, "Please don’t go home. Your child needs oxygen. She has pneumonia. We will figure out a way to pay for this, because we acknowledge what we do is expensive." The situation was further complicated by the presence of unvaccinated siblings, necessitating a stringent 21-day quarantine for the entire household. Dr. Morris expressed frustration at the breakdown of trust, stating, "It’s pretty indicative of the breakdown of trust between physicians and families." She emphasizes the gravity of the situation: "This is the gravity or severity of your child’s situation and how serious we need to be about protecting other people."
Dr. Money echoed this sentiment, describing the situation as "heartbreaking to see these children struggling to survive when measles could have been easily prevented by a safe mechanism that is readily available and well studied." He lamented the misinformation that influences parents, stating, "The saddest part to me is when I am caring for a child and the parent says, ‘I didn’t know that this could get so bad.’"
The Roots of Vaccine Hesitancy: Information, Mistrust, and Politics
The contributing factors to declining vaccination rates are multifaceted, ranging from misinformation gleaned from online sources to broader societal mistrust in institutions. Pediatricians are increasingly finding themselves in challenging conversations with parents who, while often not outright anti-vaccine, harbor significant hesitations.
Navigating Digital-Age "Research"
Tim Duffy, a pediatrician in Salt Lake County, observes that younger parents, having grown up in the digital age, often engage in extensive online "research" that paradoxically reinforces their concerns. "They think they’re doing what’s best for their child," Duffy explained. He uses a stark analogy to illustrate the collective impact of individual choices: "I’ve told families: ‘You could do nothing I say as a pediatrician. You could sleep your child on their stomach. You could not put them in a car seat or, when they’re older, not use seat belts. You could do nothing I say, and for your individual child, they will probably be okay. But from my standpoint, where I’m taking care of thousands of kids, within a system that takes care of hundreds of thousands of kids, we will have bad outcomes. These children will show up at our facilities, and it’s so sad.’"
A pediatrician in southern Utah, who requested anonymity due to past harassment from anti-vaccine activists, addressed the persistent concern about autism. "I’ve told them that I’d be very concerned if there was any evidence that what we’re doing is causing autism. But if vaccines were causing autism, we should see more cases of autism in vaccinated kids compared to unvaccinated kids, and we’re just not seeing that." When parents express a desire for a "natural" approach or question the ingredients in vaccines, this pediatrician offers a personal endorsement: "Did you vaccinate your children?" "I say that knowing what I know, I’m confident giving this to my kids. They’re all vaccinated."
The Politicization of Public Health
The once apolitical nature of vaccination has unfortunately given way to a politically charged landscape. Trahern W. Jones noted, "Vaccines have become a political football. That wasn’t true 20 years ago. But now it’s used to drive a wedge between groups of people, which is unfortunate. Vaccines are one of the main reasons why we don’t have to worry about losing our kids."
The southern Utah pediatrician also pointed to recent controversial recommendations regarding vaccine schedules as a source of parental concern. They clarified that the Advisory Committee on Immunization Practices (ACIP), composed of scientists and public health experts, undergoes a rigorous, evidence-based process for evaluating vaccines. However, recent shifts in recommendations, influenced by new panels and outside of established timelines, have raised questions. "That raises concerns for me as a doctor," the pediatrician stated, noting that professional organizations like the American Academy of Pediatrics have publicly stated that these changes are not evidence-based.
Ellie Brownstein, a pediatrician and president-elect of the Utah chapter of the American Academy of Pediatrics, navigates these complexities by focusing on transparency and the scientific rationale behind established vaccine schedules. "Instead of just telling them what immunizations are due, I talk with them about why physicians and researchers have followed a different schedule for years, about the reasoning and the science behind it. I explain that I trust these experts over someone without a lot of experience."
Nathan Money emphasized the critical need for rebuilding trust, which he believes requires a unified and consistent message from all levels of leadership. "We need consistent messaging from state leadership, which has been pretty absent," he asserted. He envisions public health campaigns akin to those for other critical issues, with messages about vaccine safety and disease dangers displayed on billboards, in schools, and at public events. "Right now, people have to go out of their way to find information from reputable sources," Money concluded, adding that policy changes are also essential to reverse the current trend.
Strategies for Rebuilding Trust and Encouraging Vaccination
Pediatricians are developing and refining approaches to engage with parents who express hesitancy or outright refuse vaccination, recognizing that empathy and open dialogue are paramount.
Compassionate Engagement and Relationship Building
Trahern W. Jones advocates for a compassionate approach. "Approach them with as much compassion as you possibly can. Ask open-ended questions to learn about their experiences that led them to have these concerns," he advised. He stresses the importance of personal connection: "I point out to families that I have my own kids, and I would never recommend something for your kids that I wouldn’t do for mine."
The southern Utah pediatrician believes in building bridges, even with highly skeptical parents. "My number one goal now is to build bridges and maintain a relationship with families, because that’s what’s going to allow me to convince some of them." They engage parents by asking about their reasoning, even if it leads to a brief conversation. "It’s a good day if I can have a conversation with someone who doesn’t want to vaccinate, even if I don’t convince them," they stated, focusing on helping parents think through their decisions rather than imposing information.
Ellie Brownstein prefers not to exclude unvaccinated children from her practice, believing that maintaining a relationship offers continued opportunities for dialogue. "I know some do that. But what that does is it ends any future discussion," she explained.
A Frontline Perspective: The Unseen Reality of Measles
The physicians on the front lines offer a visceral account of the consequences of declining vaccination rates, urging the public to consider the reality beyond anecdotal evidence or social media narratives.
Nathan Money implores, "I wish that people could see what I see. Everyone else sees what people post on Instagram. Or they think, ‘Someone I know had measles when they were a kid and they were fine.’ But as a hospital-based pediatrician, I see what happens when things go poorly." He describes the terrifying sight of children struggling to breathe, reliant on oxygen, and the profound fear of parents watching their children battle a preventable disease. "It’s heartbreaking as a pediatrician and as a father to know that the entire situation could have been easily prevented."
Tim Duffy carries a personal sense of responsibility, feeling compelled to ensure he’s communicated effectively. "Even though parents say vaccination is their choice, I still feel personally responsible if something bad happens that’s preventable, because I feel like I didn’t say the right thing, I didn’t ask the right questions."
Emilie Morris highlights the human element of healthcare: "Every pediatrician I know cares so deeply about what they do. Sometimes people forget that we are human beings practicing this discipline, and we bring all our concerns for our community into this space." She speaks of the emotional toll of sharing grief with families over preventable tragedies.
Trahern W. Jones foresees a broader trend: "I think we’ll see more diseases start coming back that we thought we had gotten rid of." He expresses a concern that the necessary systemic changes are not yet being implemented by those in power. Drawing inspiration from literature, he concludes, "You don’t get to choose the time that you’re born into, but you get to choose what you’re going to do about it. And if there’s any comfort that I have, it’s in knowing that there are right decisions to make and that I’m going to make them, and I’m going to help others make them, too."
