US Measles Cases Climb, Raising Questions About Preparedness and Prevention

Measles cases in the United States are nearing 2000—the highest number of confirmed diagnoses in more than 2 decades. Most recently, reports from South Carolina have revealed outbreaks necessitating quarantine measures following exposure in public schools, raising concerns that sustained transmission could threaten the country’s measles elimination status.¹

As vaccination rates continue to decline and outbreaks persist, questions about how best to respond—and whether the United States is adequately prepared—are becoming increasingly urgent.

How Many Cases of Measles Are There in the US?

As of December 10, 2025, the CDC reports a total of 1912 cases of measles spread across the country, with high rates concentrated in states including Texas (n = 805), South Carolina (n = 129), New Mexico (n = 100), Arizona (n = 169), and Utah (n = 115). Most cases are in unvaccinated persons or those with unknown vaccination histories, affecting those between the ages of 5 and 19.²

The spike in cases in a South Carolina public school has revitalized the conversation around the measles outbreak. According to reporting, an estimated 250 people were exposed, with most confirmed measles cases centralized in Spartanburg County. In response, the school issued a quarantine, and students have transitioned to temporary remote learning.³

In response to the event, South Carolina Governor Henry McMaster highlighted personal choice over vaccine mandates⁴:

"There are some people who don't want to do it, and that's up to them," McMaster said. "People need to understand it's dangerous just like a lot of other diseases. If there's some way to prevent it, you ought to do it."

The return of quarantines and remote learning evokes memories of the COVID-19 pandemic and raises broader questions about how the public, policymakers, and health care institutions will respond to ongoing—and potentially worsening—measles outbreaks. Addressing challenges such as the spread of misinformation, strengthening health literacy, and supporting vaccination efforts is more important than ever.

What Is Measles—And Is It Really That Bad?

Measles is among the most highly transmissible infectious diseases characterized by high fevers and the distinctive splotchy, red rash that spreads across the body. Although most patients recover from measles in about 10 days, it can be serious—and even fatal—for children under the age of 5 or those who are immunocompromised.^1,5

In addition to acute complications, measles infection is associated with a rare but devastating long-term condition known as subacute sclerosing panencephalitis (SSPE), a progressive and fatal neurodegenerative disorder marked by worsening cognitive and motor decline. In September 2025, a child in Los Angeles passed from the rare complication.⁶

SSPE occurs in approximately 1 in 10,000 individuals infected with measles, with the risk rising to roughly 1 in 600 among those infected during infancy. It is a late complication of measles, typically occurring between 2 and 10 years following full recovery from measles. There is no cure for SSPE, and patients only survive for 2 to 3 years after diagnosis.⁶

The risk of severe, and potentially fatal, outcomes underscores the importance of prevention through vaccination—not only to protect individuals, but also to prevent measles-associated complications and limit transmission to vulnerable populations who cannot be vaccinated.

Is the MMR Vaccine Safe?

The measles, mumps, and rubella (MMR) vaccine is safe, well-studied, and highly effective at preventing measles infection and its complications. Two doses of the MMR vaccine provide approximately 97% protection against measles and have been instrumental in dramatically reducing measles-related morbidity and mortality worldwide.²

Serious adverse events associated with the MMR vaccine are rare, and extensive research has consistently shown no link between the vaccine and autism or other chronic conditions. Because the MMR vaccine is a live attenuated vaccine, it is not recommended for certain individuals, including those who are severely immunocompromised or pregnant—making community-wide vaccination coverage especially critical.²

“For herd immunity—or community immunity—we generally look for about a 95% vaccination rate,” Crystal Hodge, PharmD, BCIDP, BCPS, explained in an interview with Pharmacy Times. “We understand that not everyone can be vaccinated, since the MMR vaccine is a live vaccine and not appropriate for certain individuals. But to protect the greatest number of people, the community vaccination rate needs to be around 95%.”⁷

How Can Pharmacists Support Their Communities During Disease Outbreaks?

Pharmacists play a critical role in outbreak response and prevention. Key opportunities for impact include:

• educating patients about measles transmission, symptoms, complications, and the importance of vaccination;
• addressing misinformation and providing evidence-based counseling on vaccine safety and effectiveness;
• promoting vaccination access and identifying patients who may be overdue for immunization;
• staying informed about local and national measles outbreaks to support timely guidance and referrals; and
• reinforcing infection prevention measures, including isolation recommendations and when to seek medical care.

As trusted and accessible health care professionals, pharmacists are uniquely positioned to help strengthen community preparedness and mitigate the impact of vaccine-preventable disease outbreaks.

REFERENCES

1. Rohde R. Public Health Wake-Up Call: Will the US Lose Measles Elimination Status? ContagionLive. December 16, 2025. Accessed December 16, 2025. https://www.contagionlive.com/view/public-health-wake-up-call-will-the-us-lose-measles-elimination-status-

2. Measles Cases and Outbreaks. CDC. Updated December 10, 2025. Accessed December 16, 2025. https://www.cdc.gov/measles/data-research/index.html

3. Medina E, Madigan N. A Measles Outbreak Brings With It Echoes of the Pandemic. New York Times. December 13, 2025. Accessed December 16, 2025.

4. Bettelheim A. Measles response puts personal choice over orders. Axios. December 15, 2025. Accessed December 16, 2025. https://www.axios.com/2025/12/16/measles-outbreak-south-carolina-response

5. Measles. Mayo Clinic. Updated August 23, 2025. Accessed December 16, 2025. https://www.mayoclinic.org/diseases-conditions/measles/symptoms-causes/syc-20374857

6. Gerlach A. Los Angeles Reports Fatal Case of a Rare Measles Complication Years After Infection. Pharmacy Times. September 12, 2025. Accessed December 16, 2025. https://www.pharmacytimes.com/view/los-angeles-reports-fatal-case-of-a-rare-measles-complication-years-after-infection

7. Gerlach A. Measles Outbreak Update, Florida Surgeon General Announces Plan to Remove Vaccine Mandates in Schools. Pharmacy Times. September 10, 2025. Accessed December 16, 2025. https://www.pharmacytimes.com/view/measles-outbreak-update-florida-surgeon-general-announces-plan-to-remove-vaccine-mandates-in-schools