Health and Human Services Secretary Robert F. Kennedy Jr. said this week that parents should vaccinate their children against measles, a direct endorsement delivered as the United States records its highest annual case count in 35 years.
Speaking on CNN's "State of the Union," Kennedy was pressed by host Dana Bash to look into the camera and tell unvaccinated families to get the shot. He responded that parents should get their children vaccinated for measles, that the vaccine is effective, and that it stops measles in about 97 percent of cases. That figure matches CDC guidance: two doses of MMR are about 97 percent effective, and one dose about 93 percent. Kennedy also said he has never questioned the efficacy of the MMR vaccine.
The statement matters for a practical reason rather than a political one. About 93 percent of confirmed cases this year have occurred in people who were unvaccinated or whose vaccination status was unknown. For families still deciding, the federal government's most senior health official has now stated a position on the record, weeks before most US school districts open.
The Surveillance Numbers Behind the Statement
The CDC has confirmed 2,371 measles cases this year. That surpasses the 2,289 cases recorded for all of last year, which was itself the highest annual total in more than three decades. The last year with a larger count was 1991, when the agency confirmed 9,643 cases.
Of this year's total, 16 cases were among international visitors to the United States; the rest were reported by 45 jurisdictions. The CDC has logged 37 new outbreaks, compared with 48 across all of last year, and 94 percent of cases are outbreak-associated, meaning linked to a cluster of three or more connected infections rather than to isolated importations.
Two figures cut against the alarm. No measles deaths have been reported in the United States this year, compared with three last year — two unvaccinated children in West Texas and one unvaccinated adult in New Mexico. The hospitalization rate has also fallen, to about 7 percent of confirmed cases from 11 percent. Neither figure means the outbreak is mild. Measles can cause pneumonia and encephalitis, and last year's deaths were the first US measles deaths in a decade.
The largest clusters this year have centered on South Carolina, Utah and Arizona, with Pennsylvania and Virginia among the more recent hot spots. The Spartanburg County, South Carolina outbreak reached 997 cases before it was declared over in late April — the largest US measles outbreak since 1991. About 95 percent of patients were unvaccinated, most were school-age children, and at least 21 people were hospitalized. Spartanburg County's school MMR coverage was 88.9 percent, against a state average of 93.7 percent.
Coverage Gaps Are Concentrated, Not National
National vaccination statistics understate the actual risk because the gaps are local. Kindergarten MMR coverage fell to 92.5 percent in the most recent school year, down from 95.2 percent before the pandemic. That left roughly 286,000 kindergartners without MMR documentation.
The threshold that matters is 95 percent, the level generally required to interrupt community transmission. A state can sit near that average while individual school districts fall far below it, and it is those districts where a single imported case turns into an outbreak. Florida illustrates the pattern: the state has reported 141 cases against eight last year, with kindergarten MMR coverage at 88.8 percent and the majority of cases in Collier County, where an outbreak at Ave Maria University began in the winter.
For parents in major metro areas, the relevant question is not the state figure but the local one. The CDC publishes only national and state estimates, but many state health departments publish school- or district-level immunization data, and checking a specific school's coverage rate is a more useful exercise than reading a national average.
The Elimination Review Coming in November
The United States has held measles elimination status since 2000. Elimination means no single chain of domestic transmission has continued uninterrupted for 12 months. The Pan American Health Organization has confirmed that its regional commission will review US status in November, at its regular annual meeting; the review was moved from the spring at the request of US health authorities, who cited ongoing whole-genome sequencing work.
That sequencing is the crux. The commission's test is not case counts but whether genomic evidence shows uninterrupted domestic transmission for 12 or more consecutive months. Analyses have traced a continuous lineage from the West Texas outbreak through the ongoing Utah and Arizona outbreak, and several infectious disease researchers have said the threshold has already been crossed in practice. The region as a whole lost its measles-free designation after PAHO determined that endemic transmission had been re-established in Canada.
Losing elimination status would not change any clinical recommendation. It would change how the US is classified internationally, and it could affect travel health guidance issued by other countries and prompt US clinicians to consider measles earlier in patients with fever and rash.
Dr. Richard Besser, a pediatrician and former acting CDC director, told ABC News that crossing this threshold is a reminder of how far measles has come back in the United States, and called the resurgence a failure of national health leadership. Kennedy, asked whether he accepted responsibility for the rise, said he did not, describing the surge as part of an international outbreak and attributing US cases largely to religious communities that decline vaccination.
Public health researchers point to a different combination: falling coverage, rising nonmedical exemptions, and reduced familiarity with a disease most parents under 45 have never seen. William Moss of the Johns Hopkins Bloomberg School of Public Health has noted that the age distribution of this year's cases reflects years of undervaccination rather than a single outbreak. In the same interview, Kennedy repeated several claims about other vaccines and about RSV that infectious disease specialists have rejected. His measles endorsement and his statements on other vaccines should be evaluated separately, on separate evidence.
Practical Checks Before the School Year Starts
The MMR schedule has not changed. The CDC and the American Academy of Pediatrics continue to recommend two doses, the first at 12 to 15 months and the second at four to six years. One dose provides about 93 percent protection; two provide about 97 percent.
Families can request an immunization record from a pediatrician's office or from their state immunization registry. Adults born in or after 1957 who are unsure of their status can ask a clinician about a blood test or an additional dose, because an extra MMR dose is not harmful for most people. Anyone who is pregnant or significantly immunocompromised should not receive MMR and should discuss exposure precautions with a clinician instead.
Cost is rarely the barrier it once was. The federal Vaccines for Children program covers MMR at no cost for children who are uninsured, underinsured, Medicaid-enrolled, or American Indian or Alaska Native, and county health departments in most major metro areas administer it. Insured adults generally receive MMR as a no-cost preventive service.
Anyone who develops fever with a rash after a possible exposure should call ahead before arriving at a clinic or emergency department. Measles is among the most contagious diseases known — the CDC estimates up to nine in 10 unprotected people nearby will become infected — and calling first allows staff to route the patient away from waiting rooms. This is general information and not a substitute for a clinician's advice.
The CDC posts updated national case counts weekly. The PAHO review is scheduled for November.
Frequently Asked Questions
What did the Health Secretary actually say? During a CNN interview, Kennedy said parents should get their children vaccinated for measles, described the vaccine as stopping measles in about 97 percent of cases, and said he has never questioned MMR's efficacy.
How many measles cases has the United States recorded this year? The CDC has confirmed 2,371 cases across 45 jurisdictions, with 37 new outbreaks. That exceeds the 2,289 cases recorded for all of last year and is the highest annual total since 1991.
Have there been any measles deaths this year? No measles deaths have been reported in the United States this year. Three were recorded last year: two unvaccinated children in West Texas and one unvaccinated adult in New Mexico.
Who is getting sick? About 93 percent of confirmed cases involve people who were unvaccinated or whose vaccination status was unknown. The remainder had documented MMR doses; breakthrough infections remain uncommon and are consistent with prior years.
What does losing elimination status mean for families? It would not change vaccination recommendations or clinical care. It is an international classification reflecting sustained domestic transmission, and PAHO's regional commission reviews US status in November.
Where can families get the MMR vaccine at low or no cost? The federal Vaccines for Children program covers MMR for eligible children at no cost through participating providers and county health departments. Most insured adults receive MMR as a no-cost preventive service.
How can parents check their own school district's vaccination rate? The CDC publishes only national and state figures, but many state health departments publish school- or district-level coverage data. Because coverage varies sharply within states, the local figure is more informative.
