The United States is facing a significant public health crisis as confirmed measles cases have surged to a 35-year high, marking what experts fear is the beginning of a prolonged era of resurgent preventable diseases. With cases already exceeding previous annual totals by July, the current year, combined with the previous one, has seen more measles infections than in the preceding quarter-century. The overwhelming majority of these cases are attributed to domestic outbreaks, fueled by a concerning and persistent decline in vaccination rates across the nation.
For the first time in over two decades, the U.S. no longer meets a key criterion for measles elimination as a public health threat. This status hinges on the ability of public health systems to contain outbreaks, preventing them from spreading and persisting beyond a single year. The prolonged outbreak in Utah, which has been ongoing since June 2025, exemplifies this critical failure.
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, and at least three others have suffered severe complications, including brain swelling, leading to lingering neurological symptoms. These severe outcomes underscore the virulent nature of measles and the critical importance of widespread immunity.
The Centers for Disease Control and Prevention (CDC) is on the verge of finalizing a comprehensive study analyzing national measles data from January 2025 through June 2026. This report is expected to provide a definitive assessment of the situation and may formally signal the loss of the U.S. measles elimination status.
"I don’t think we could say with a straight face that there hasn’t been transmission over the past 12 months," stated a CDC scientist with direct knowledge of the agency’s forthcoming measles report, speaking on condition of anonymity due to concerns about professional repercussions. This internal report will undergo review by a national committee of measles specialists before being submitted to the Pan American Health Organization (PAHO). PAHO, responsible for evaluating measles elimination status across the Americas, will make its official determination at its annual meeting this fall. However, many scientists believe the evidence already points to a clear outcome.
"The assessment for elimination isn’t until November, but that is a scheduling issue, basically," commented Anne Schuchat, former head of the CDC’s immunization and respiratory disease group. "It’s just so sad, because some people will get brutally ill," she added, emphasizing that the resurgence of measles serves as a critical "wake-up call."
The Human Toll: Pediatricians on the Front Lines
Pediatricians in regions like Utah, which has been particularly hard-hit, are bearing witness to the devastating consequences of declining vaccination rates. Six doctors shared their experiences and insights with KFF Health News, offering a poignant look at the challenges posed by resurgent vaccine-preventable diseases and the growing epidemic of vaccine hesitancy. Their accounts paint a grim picture of children suffering from severe measles complications, parents grappling with misinformation, and healthcare providers facing immense emotional and professional strain.
The Grim Reality of Hospitalized Children
Emilie Morris, a hospital pediatrician in Salt Lake and Utah Counties, described the harrowing presentation of young patients suffering from measles. "When children come in, they’re often bent over," she explained, referencing a posture known as tripoding, often indicative of upper 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, another pediatrician in the same 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," he stated. This increased risk necessitates more invasive procedures, such as blood work and lumbar punctures to rule out meningitis, which are inherently painful and traumatic for both the child and the family.
Dr. Money further elaborated on the communication challenges: "I tell them, ‘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 last thing I want to do is miss something. These are parents who love their children. They always tell me, ‘Do what you need to do to make sure my child is safe.’"
Treating Measles: A Harrowing Experience
Trahern W. Jones, a pediatric infectious disease specialist in Salt Lake City, recounted a particularly distressing case. "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," he described. "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 noted that some parents, while not overtly anti-vaccine, delay immunizations due to past perceived negative experiences or misinformation. "The parents tell me they’re not anti-vaccine, but in the past, somebody they know had a reaction to a vaccine – or something they thought was a reaction to a vaccine – and so they paused vaccines when the child was a baby. They were planning to catch up later."
Another parent expressed profound shock at the severity of the illness, having relied on outdated information. "In another case, the parent was stunned by how awful it was. I asked them what they knew about measles before their child was sick, and they said the only person who’d ever taught them anything about measles was their grandmother who had taken care of her kids with measles ages ago," Dr. Jones said. "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 ordeal extends beyond the physical suffering of the child. "There are multiple facets to it," Dr. Jones explained. "Physically, the child has been beat down for multiple days by this virus. The parents don’t get to sleep, because they’re nursing their child. Then there’s the emotional component because the parent is regretting not getting the vaccine, not realizing how bad this was, and then feeling deeply ashamed, trying to reconcile with family members who are really upset at them for not getting their child vaccinated."
The economic burden of healthcare also emerged as a significant factor. Dr. Morris recounted a situation with an uninsured family facing mounting medical costs. "One child was from a family that was uninsured because they didn’t feel that they would need to use the medical system," she stated. "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. I said something like: ‘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.’"
This uninsured child also had unvaccinated siblings at home, necessitating a strict 21-day quarantine to prevent further spread. "On top of that, the parent had several other children in the home who weren’t vaccinated," Dr. Morris continued. "It was past the period where we could intervene with vaccines to try to prevent infection, so then our recommendation was to quarantine their children at home for 21 days: ‘Don’t interact with anybody else in your community. Don’t go to the grocery store, even with a mask. Please take this seriously.’"
Dr. Morris expressed the deep frustration physicians feel in bridging the trust deficit: "It takes time for parents to understand the level of concern I have, even when their child is physically ill in the hospital requiring ongoing care. It’s pretty indicative of the breakdown of trust between physicians and families. I say, ‘This is the gravity or severity of your child’s situation and how serious we need to be about protecting other people.’ It’s frustrating. How can I make people understand I have a very genuine concern for their child? And I know they share that concern, but maybe it’s not the same degree of concern, because they don’t understand the illness and how severe it can become."
Dr. Money echoed this sentiment, stating, "It’s 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. These are well-meaning parents who love their children, who have gotten bad information from federal leadership or from online sources. 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 Hesitancy: Navigating a Sea of Misinformation
Pediatricians are confronting a complex web of factors contributing to vaccine hesitancy, ranging from deeply ingrained fears about vaccine safety to the pervasive influence of social media and political polarization.
The Digital Echo Chamber
Tim Duffy, a pediatrician in Salt Lake County, observed that many parents are not overtly anti-vaccine but rather hesitant, influenced by extensive online "research." "A lot of families aren’t aggressively anti-vax, but they’re hesitant," he noted. "Younger parents who grew up in the digital age have done their research – ‘research’ in quotation marks – for months. And they keep getting confirmation of their concerns on social media. They think they’re doing what’s best for their child."
Dr. Duffy offered a stark analogy to illustrate the collective risk posed by individual decisions: "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.’"
Addressing Specific Concerns
Concerns about autism remain a significant driver of vaccine hesitancy. A pediatrician in southern Utah, who requested anonymity due to past harassment from anti-vaccine activists, addressed this directly. "A lot of parents are concerned about autism," they stated. "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."
Other parents express a desire for a "natural" approach or concerns about vaccine ingredients. The question, "Did you vaccinate your children?" is frequently posed. The pediatrician responded, "I say that knowing what I know, I’m confident giving this to my kids. They’re all vaccinated."
The Political Contagion: Vaccines as a Wedge Issue
The politicization of public health issues, particularly vaccination, has exacerbated the problem, creating a landscape where scientific consensus is challenged and trust in institutions erodes.
Shifting Political Tides
"Vaccines have become a political football. That wasn’t true 20 years ago," observed Dr. Jones. "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 recent controversial recommendation by the Department of Health and Human Services in January 2026 to reduce the number of childhood vaccines, which was subsequently blocked by a federal judge, has sown further confusion and distrust. A pediatrician in southern Utah noted, "People don’t know who to believe. If politics comes up, I tell parents that my messaging on vaccines is not politically motivated."
They elaborated on the process: "I’ve said there was a process for the approval of immunizations through ACIP [the Advisory Committee on Immunization Practices], which is made up of scientists, public health experts, and doctors, and all those people were let go, and a new panel was selected. A couple of individuals changed the recommendation outside of the time-tested, evidence-based process for evaluating vaccines. That raises concerns for me as a doctor. I tell parents that the American Academy of Pediatrics, the American Academy of Family Physicians, and several other professional organizations have issued statements saying that these changes are not based on evidence."
Ellie Brownstein, a pediatrician and president-elect of the Utah chapter of the American Academy of Pediatrics, acknowledged the added complexity. "I avoid talking about politics, but what’s being said has added another layer to our work," she said. When discussing vaccine schedules, she emphasizes the rationale and scientific evidence behind established practices, stating, "I explain that I trust these experts over someone without a lot of experience."
Rebuilding Trust: A Call for Consistent Messaging
Dr. Money highlighted the profound loss of trust in the medical community as a primary driver of decreased vaccination rates. "People are not vaccinated, because they’ve lost trust in the medical community. They’re placing trust elsewhere," he stated. "Rebuilding trust is a complicated process, but it comes from consistent messaging at every level, from the pediatrician to local health departments to community leaders, city leadership, district leadership, religious leadership, educational leadership."
He called for more proactive and visible public health campaigns. "We need consistent messaging from state leadership, which has been pretty absent," Dr. Money asserted. "I want to see commercials on TV about the safety of the MMR [measles, mumps, and rubella] vaccine and the dangers of the measles, sponsored by my state leadership. I’d like to see this on billboards and in schools, in public buildings and grocery stores. I want to go to a sports event and see messages about the measles and the MMR vaccine. Right now, people have to go out of their way to find information from reputable sources."
Policy changes are also deemed necessary. "We also need policy changes to support vaccination," he urged. "This train is going in the wrong direction, and it can feel like a helpless situation, because we’re just not seeing the public messaging and leadership that’s needed to turn this around."
Strategies for Engagement: Bridging the Divide
Healthcare providers are developing nuanced approaches to engage with parents who are hesitant or resistant to vaccination, prioritizing empathy and relationship-building over confrontation.
Compassionate Communication
"Approach them with as much compassion as you possibly can," advised Dr. Jones. "Ask open-ended questions to learn about their experiences that led them to have these concerns." He stressed the importance of avoiding a purely factual, directive approach. "I think it’s really important to not come down on them, citing facts and figures and pointing to guidelines on why they need to get their kids vaccinated. But try to direct their attention to the fact that you’re a real person with your own real experiences and knowledge. 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 shared a similar philosophy: "I’ve learned that if you come down hard, you’re going to lose people who need care. 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."
This approach involves understanding parental autonomy while still advocating for evidence-based care. "Parents who are very skeptical or anti-vax will say no when I tell them their child is due for immunizations," the pediatrician explained. "I’ll say: ‘Fine. You guys get to choose. You’re the parents. But I’m curious to know what your reasoning is.’ Sometimes they’re just like, ‘It’s something I’ve decided.’ They don’t want to have a conversation."
Even a conversation, regardless of immediate outcome, is considered a victory. "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. "I try to help them think through things rather than shoving anything down their throat. When they’re done talking, I’ll ask, ‘Can I share my perspectives on this?’ Some will say yes enthusiastically, and others will say yes because they’re being polite."
For parents who are uncertain, the focus shifts to addressing their specific anxieties. "A lot of parents aren’t sure what to do, and those are the people I focus most of my time on," the pediatrician continued. "I focus our conversation on their specific concerns, and I’m open about specific side effects that different immunizations can have. For example, I’ll tell them that some children get a fever after a vaccine, which is OK. The fever is not harmful, but it can make babies feel crummy as their body is building up antibodies against viruses and bacteria."
Dr. Brownstein expressed a commitment to inclusive care, even for unvaccinated children. "I don’t like the idea of excluding unvaccinated kids from my practice. I know some do that," she said. "But what that does is it ends any future discussion. I can’t keep talking with parents about vaccines if I kick them out of my practice, and if these parents find like-minded doctors, this situation will get worse."
The Long Shadow of Preventable Illness
The return of measles and other vaccine-preventable diseases is a stark reminder of the fragility of public health gains and the critical role of collective immunity.
A Pediatrician’s Plea
Dr. Money implored the public to understand the severity of what he witnesses daily. "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 stated. "I see what happens when children with measles aren’t able to breathe on their own, and they’re in a hospital bed with a cannula in their nose, struggling to breathe, an IV in their arm because they can’t drink on their own. And the child is terrified, and the parents are scared that their child might die. It’s heartbreaking as a pediatrician and as a father to know that the entire situation could have been easily prevented."
Dr. Duffy shared the personal burden of responsibility. "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. Maybe I let it drop because of the look on a parent’s face."
Dr. Morris emphasized the human element of medical practice. "Every pediatrician I know cares so deeply about what they do," she said. "Sometimes people forget that we are human beings practicing this discipline, and we bring all our concerns for our community into this space. I’m trying to navigate a lot of complex human emotions, like how it feels to hold grief with a family when something bad happens that was preventable – which is the worst situation, because you think, ‘Could I have done something differently?’"
A Glimmer of Hope in the Face of Adversity
Looking ahead, Dr. Jones expressed a somber prediction: "I think we’ll see more diseases start coming back that we thought we had gotten rid of. I think it’s going to take dramatic changes to actually prevent those outcomes. I’m not necessarily seeing those changes being done by those in power."
However, he found solace in the resolve of healthcare professionals. "I think of that quote from The Lord of the Rings. It’s something like, 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." The fight against resurgent infectious diseases requires not only robust public health infrastructure but also a recommitment to scientific literacy and collective responsibility.
