Pennsylvania Confirms First Measles Deaths in 35 Years as US Case Count Tops 2900

Two unvaccinated residents of Lancaster County, Pennsylvania, died from measles-associated illness, marking the state’s first measles fatalities in 35 years and the first measles-related deaths reported in the United States in 2026. The Pennsylvania Department of Health (DOH) confirmed the deaths on August 25, 2026, but withheld further identifying details to protect the privacy of the individuals and their families.^1,2

DOH officials said both individuals lived in Lancaster County, where 185 measles cases have been reported so far this year, making it one of the largest single-county outbreaks in the country. Statewide, Pennsylvania has logged 393 cases across 28 counties in 2026, the third-highest total of any state.^1,2

As of August 27, 2026, the CDC reported 2903 confirmed measles cases, already exceeding the 2289 cases recorded for all of 2025 and the highest annual total since the disease was declared eliminated in the US in 2000. The CDC’s national tally has not yet incorporated the 2 Pennsylvania deaths, as the agency said it is still reviewing whether measles caused or contributed to the fatalities or whether the individuals died of other causes while infected.^1-3

Reaction From the Pediatric and Public Health Community

American Academy of Pediatrics (AAP) President Andrew Racine, MD, PhD, called the deaths a stark reminder of measles' potential severity. “In 2026, decades after measles was eliminated in the United States, it is heartbreaking to witness deaths from a disease that is preventable with a vaccine that has been widely used since the 1970s,” Racine said, urging pediatricians nationwide to “encourage MMR vaccination to stop the spread of measles.”⁴

The CDC and the US Department of Health and Human Services (HHS) also issued condolences, noting the agency is working with state and local health departments “to strengthen response efforts, rapidly support affected communities across the state, and communicate the steps [individuals] can take to slow the spread of measles.”²

CDC Breaks With Pennsylvania Over Death Classification

The story took a contentious turn in the days following DOH’s announcement. HHS Secretary Robert F. Kennedy, Jr. publicly questioned whether the 2 deaths were properly attributed to measles, and Pennsylvania’s Lancaster County Coroner's Office subsequently disclosed that one of the deceased was a newborn whose primary cause of death was a lacerated spleen, though the infant also tested positive for measles.⁵

Governor Josh Shapiro accused Kennedy of spreading vaccine misinformation, touching off a public dispute between the two officials over the circumstances of the deaths and the state's handling of the announcement.⁵

That dispute escalated further when the CDC’s newly installed director, Erica Schwartz, MD, ordered the agency to exclude the 2 Pennsylvania deaths from its official weekly measles death count, breaking with the agency’s longstanding practice of accepting state and local health departments’ classifications.⁵

The CDC’s data page now carries a footnote stating that “available information does not establish whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles.” The agency states it will update its national count “as additional information becomes available.”^3,5

An HHS spokesperson said the delay reflects the agency's "commitment to transparency," while Pennsylvania officials have maintained that both deaths were thoroughly investigated and appropriately classified as measles-associated before being announced.⁵

Vaccination Remains the Best Defense

Two doses of the measles, mumps, and rubella (MMR) vaccine confer approximately 97% lifetime protection against infection, and even breakthrough cases in vaccinated individuals tend to be markedly milder.¹

The CDC recommends that infants living in or traveling to outbreak areas receive an early dose at 6 months, followed by the standard doses at 12 to 15 months and 4 to 6 years, since the early dose does not advise durable immunity on its own. National kindergarten MMR coverage has declined from 95.2% during the 2019 to 2020 school year to 92.4% in 2025 to 2026, leaving an estimated 280,000 kindergartners without documented protection and eroding the community immunity threshold—above 95% coverage—needed to prevent outbreaks.^1-3

What This Means for Pharmacy Practice

With measles activity accelerating in Pennsylvania, Maryland, New York, and other states, pharmacists should proactively assess MMR vaccination status during routine patient interactions, especially for children, international travelers, and adults born after 1957 who lack documented immunity. Pharmacy teams can also help counter vaccine misinformation by clearly and consistently communicating the vaccine’s safety and effectiveness data, reinforcing that the MMR series remains one of the most extensively studied and effective vaccines available.^1,2

REFERENCES

1. Pennsylvania Department of Health confirms two measles-associated deaths. Pennsylvania Department of Health. August 25, 2026. Accessed September 1, 2026. https://www.pa.gov/agencies/health/newsroom/pennsylvania-department-of-health-confirms-two-measles-associate

2. Szabo L, Boden S, Dall C. Measles-related deaths in Pennsylvania mark first 2 US fatalities this year. CIDRAP News. August 25, 2026. Accessed September 1, 2026. https://www.cidrap.umn.edu/measles/measles-related-deaths-pennsylvania-mark-first-2-us-fatalities-year

3. Measles cases and outbreaks. Centers for Disease Control and Prevention. Updated August 30, 2026. Accessed September 1, 2026. https://www.cdc.gov/measles/data-research/index.html

4. AAP statement on measles-associated deaths reported in Pennsylvania. American Academy of Pediatrics. August 25, 2026. Accessed September 1, 2026. https://www.aap.org/en/news-room/news-releases/aap/2026/aap-statement-on-measles-associated-deaths-reported-in-pennsylvania/

5. Weixel N. CDC, Pennsylvania clash over measles deaths. The Hill. Updated September 1, 2026. Accessed September 1, 2026. https://thehill.com/policy/healthcare/6063769-cdc-disputes-pennsylvania-measles-deaths