Pennsylvania Measles Deaths Collide With Falling MMR Coverage

Pennsylvania health officials confirmed two measles-associated deaths in Lancaster County on August 25, 2026, both in unvaccinated people, the state’s first such deaths since 1991. The Centers for Disease Control and Prevention is not adding those deaths to its national count this week while it reviews whether measles caused them.

Health secretary Robert F. Kennedy Jr. called Gov. Josh Shapiro to offer federal help, then spent the next days attacking the announcement on his personal X account. The argument is loud. The coverage numbers underneath it are quieter, and they are the ones that will still be sitting in classrooms this fall.

The CDC Left Pennsylvania’s Two Deaths Off Its Tally

The Pennsylvania Department of Health said both people lived in Lancaster County and that it would not release further details that could identify their families. Secretary of Health Dr. Debra Bogen said the measles virus “spreads quickly and easily to anyone who is not immune.” Shapiro, speaking in Lancaster that afternoon, called illness and death from measles “completely preventable.”

Kennedy wrote that the announcement appeared premature and that the deaths “may even have been altogether fabricated by one of the Governor’s hopeful staffers.” On August 26, Shapiro answered that Kennedy had asked whether the state needed more federal support, then “launched into a tirade” about fetal tissue and the Biden administration. Shapiro wrote that Kennedy “even told me it would be better if we went back to ‘natural measles.’”

THE WEEK THE DEATH TALLY SPLIT

1. August 25, 2026: Pennsylvania confirms two measles-associated deaths in Lancaster County and records 393 measles cases across 29 counties.
2. August 26, 2026: Kennedy disputes the deaths on X. The state says “measles-associated” covers lab or epidemiologic evidence even when measles is not listed as the immediate cause. Lancaster County Coroner Dr. Stephen Diamantoni describes a newborn who died of a lacerated spleen with a postmortem measles test.
3. August 27, 2026: Diamantoni says the forensic pathologist, Dr. Wayne Ross, did not treat measles as a contributing factor because the spleen was not enlarged and the infant had massive blood loss. Measles still appears under Part II of the death certificate, for other contributing conditions.
4. August 30, 2026: CDC updates its outbreak page and holds the two deaths out of the national total while it reviews “whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles.”

CDC director Erica Schwartz has not issued a public comment on the Pennsylvania deaths. The agency’s own footnote is the record: this week’s update will not include them, and CDC “will update the national count as additional information becomes available.”

The United States Has Logged 2,903 Measles Cases

Whatever the death certificates finally say, the case curve is not in dispute. CDC, in an update posted August 30, reports 2,903 confirmed measles cases in 2026 as of August 27, across 47 jurisdictions plus 16 infections in international visitors. That already passes the 2,289 cases logged in all of 2025, which had been the highest full-year total in more than three decades.

THE 2026 MEASLES COUNT

Nearly half of this year’s cases, 1,351 people, are ages 5 to 19. Another 541 are under 5. CDC counts 37 outbreaks in 2026, and 94 percent of confirmed cases are outbreak-associated. South Carolina (670), Utah (526), Pennsylvania (371 on CDC’s August 21 state map), Texas (190), and Virginia (176) lead the state list. Pennsylvania’s own August 25 count was higher, at 393.

In 2025 the country recorded three measles deaths, two in unvaccinated school-age children in Texas and one in an unvaccinated adult in New Mexico. Before those, CDC had not counted a measles death since 2015. The 2024 total was 285 cases. The load-bearing comparison is that 2024-to-2026 jump, not the argument over two certificates in Lancaster.

What Measles-Associated Means for the Two Deaths

The state’s language did a lot of work. “Associated” is the word epidemiologists use when measles is present on lab or epidemiologic evidence but a coroner or attending physician may not list it as the immediate cause. Immediate cause on a death certificate is often the last mechanical event, such as blood loss or respiratory failure, not the infection that set that event in motion.

One of the two people is a newborn boy who died on August 14 at a birthing center in Strasburg Township. Diamantoni said the infant acquired measles before birth, tested positive on postmortem lung tissue, and died of a traumatic laceration of the spleen. The likely parents later told interviewers that the mother fell ill with measles after other children in the family got sick, went into labor a month early, and delivered a baby who was not breathing. The father was the only person in the household who had been vaccinated. A newborn is not yet eligible for a routine MMR dose, which starts at 12 months.

Paul Offit, a pediatrician at Children’s Hospital of Philadelphia, wrote that congenital measles can enlarge the spleen and thin its capsule, which can make rupture during birth more likely. Diamantoni said the pathologist found no swelling “whatsoever” and still does not believe measles contributed, even though the disease is listed on Part II of the certificate. The second death has not been described at all.

WHAT WE KNOW

• The setting: Both people the state counted were unvaccinated Lancaster County residents, and Pennsylvania had not recorded a measles-associated death since 1991.
• The infant: A newborn died August 14 of a lacerated spleen, with a postmortem measles test and measles listed under other contributing conditions.
• The outbreak: The state’s August 25 figure was 393 confirmed cases in 29 counties, with more than half in Lancaster County at the time of the announcement.

WHAT IS UNCONFIRMED

• The second death: The state has released no age, setting, or immediate cause for the other person it counted.
• CDC’s final call: The national death tally still does not include either case while the agency reviews the files.
• How much measles did: Diamantoni and the state are answering different questions, and they have not published a shared case summary.

Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and an infectious-diseases physician in Pittsburgh, said the coroner’s account and the state’s account are not necessarily in conflict because the two offices are answering two different questions. “Pennsylvania created its own information vacuum and then seemed surprised when someone else filled it,” he said.

Pennsylvania created its own information vacuum and then seemed surprised when someone else filled it. The coroner’s account and the state’s account are not necessarily in conflict, they are two offices answering two different questions, but nobody in Harrisburg explained that, so the public was left to choose between fraud and incompetence.

Amesh Adalja, senior scholar, Johns Hopkins Center for Health Security

That vacuum is now the political story. It is a poor substitute for the 223 people CDC says have already been hospitalized with confirmed measles this year.

Kindergarten MMR Coverage Sat at 92.4 Percent

The deaths landed in the same month CDC posted kindergarten shots data for the 2025-2026 school year. MMR coverage fell to 92.4 percent, down from 92.5 percent the year before and from about 95 percent in 2019-2020, before the pandemic. The Healthy People 2030 target is 95 percent, the level used to keep measles from circulating in a community. KFF, reading the same CDC files, estimates that leaves about 280,000 kindergarteners without MMR protection.

Exemptions from one or more required shots rose to 4.2 percent, the highest national rate on the series, up from 3.6 percent a year earlier and from 2.5 percent in 2019-2020. Nonmedical exemptions did the climbing, from 2.2 percent to 4.0 percent; medical exemptions slipped from 0.3 percent to 0.2 percent. Thirty-nine states sat below the 95 percent MMR line. Eighteen reported rates below 90 percent. Coverage ranged from 75.2 percent in Idaho to 98.9 percent in West Virginia. Twenty-four states now have exemption rates above 5 percent, which makes the 95 percent target unreachable even if every non-exempt child is vaccinated.

Those figures live in the CDC school vaccination coverage files that state immunization programs send in each year. They moved before Kennedy took over HHS, and they kept moving after. Shapiro told Kennedy that Pennsylvania’s kindergarten MMR rate had fallen from 97 percent to 93.2 percent; Kennedy wrote that Shapiro then agreed most of that drop happened under the prior administration. The state’s own 2025-2026 school survey puts two-dose MMR at 93.2 percent of kindergarteners, 94.6 percent of seventh graders, and 96.9 percent of twelfth graders, with a “significant number” of schools still under 95 percent.

Parents sending children back this week are walking into that gap, not into a cable-news segment. A cluster of unvaccinated families inside one county, one church, or one school is enough for measles to run, even when a statewide average looks only a few points off the old target.

Ninety-One Clinics and a School-Year Deadline

Pennsylvania has been treating the outbreak as a clinic-and-school problem since April, which is when the state says the current wave began. Shapiro’s August 25 briefing was as much an operations update as a death announcement.

WHAT PENNSYLVANIA HAS STOOD UP SINCE APRIL

• Pop-up shots: Health staff have given more than 4,100 MMR shots at pop-up clinics, with 91 sites so far and 40 more planned.
• July volume: Together with regular providers, more than 35,000 Pennsylvanians received an MMR dose in July 2026, about 10,000 more than a typical month.
• Early doses: The state told clinicians they may give MMR to infants as young as 6 months, following American Academy of Pediatrics outbreak guidance; those children still need two more doses after age 1.
• School paperwork: The health and education secretaries reminded administrators that immunization data is due to the health department by December 31, and nearly 1,000 school nurses sat through measles briefings as classrooms reopened.

More than 1,000 clinicians joined medical briefings because most practicing doctors in the state have never treated measles. The virus stays infectious in air and on surfaces for up to two hours after an infected person leaves. Symptoms start with fever, cough, runny nose, and red eyes, then a rash that begins on the head and moves down, 7 to 21 days after exposure. The state says nearly 20 percent of people who get measles are hospitalized, and death, though uncommon, occurs in one to three patients per 1,000 cases.

Shapiro, a father of four, put the pitch in county-fair English: “measles does not care about your county, your faith, or your social circle.” Michael D. Barber, CEO of Penn Medicine Lancaster General Health, named the people the clinics are trying to wrap around: newborns, pregnant women, and patients already under hospital care. The hotline is 877-PA-HEALTH.

Two Doses Still Stop 97 Percent of Measles

The shot at the center of the fight has not changed. Two MMR doses give about 97 percent lifetime protection against measles, the figure Pennsylvania printed on its own release and the figure CDC has used for years. One dose is about 93 percent effective. The first routine dose is at 12 to 15 months, the second at 4 to 6 years. During a community outbreak that reaches infants, a dose at 6 to 11 months can be given, then the regular two-dose series still follows after the first birthday.

Kennedy, speaking the next day in Tampa at a children’s health and nutrition event, did urge people to get vaccinated against measles and said, “We are actually restoring faith in the public health agencies.” He added that CDC is looking into the circumstances surrounding the deaths. He did not post that Tampa line on X. The official CDC account did post condolences to the families and called the MMR vaccine the “most effective protection against measles.”

HHS and CDC extend their condolences to the families and communities affected by two measles-associated deaths in Lancaster County, Pennsylvania. CDC is working closely with state and local health departments to strengthen response efforts, rapidly support affected communities…

— CDC (@CDCgov) August 25, 2026

The fetal-cell argument Kennedy pressed on Shapiro is the one that keeps getting treated as a new finding. Rubella virus for MMR-II is grown on the WI-38 cell line, which started from lung tissue of a fetus aborted in the 1960s. Those cells have been grown in labs for decades; no new abortion is required to make today’s doses. The American Academy of Pediatrics’ language, which Shapiro quoted, is that vaccines do not contain fetal cells, purification filters the product, and “no fetal tissue remains.” Residual DNA from the cell line is listed on the package insert. That is a manufacturing history. It is not fetal tissue in the vial, and it is not a reason the 97 percent figure moves.

Senate health chair Bill Cassidy, a Louisiana Republican, put the clinical point without the cell-line detour: “No one needs to die from measles in 2026.” He added that “misinformation and misguided policies are leaving children unprotected against a disease we know how to prevent.”

Parents Get Two Scripts From Washington

The second-order problem is the inbox a parent opens on a Sunday night. On one channel, CDC’s own account and Cassidy tell them to get the shot. On another, the health secretary spends the hours after a death announcement amplifying Del Bigtree’s HighWire site, arguing with former Surgeon General Jerome Adams about Pfizer’s Covid-19 vaccine, and accusing a governor of gaslighting over two local deaths. Adams wrote that the first Pennsylvania measles deaths in 35 years had just been announced and asked why Kennedy was spending his influence on “THIS nonsense.”

At his press conference today, Pennsylvania Governor Josh Shapiro accused me of promoting conspiracy theories because I told him, during an earlier telephone conversation, that some Americans had religious objections to the MMR vaccine because it contained fetal tissue. “There is…

— Robert F. Kennedy Jr (@RobertKennedyJr) August 26, 2026

Kennedy has also said the United States is “doing better at handling” an international outbreak “than any country in the world.” CDC’s table does not support a victory lap. Cases are already above 2025. Hospitalizations are in the hundreds. Kindergarten MMR is below the line that used to keep chains of transmission from taking root. Elimination, declared in 2000 after a year with no continuous domestic spread, is now discussed as a status the country could lose if transmission runs past 12 months.

Let’s set the record straight because @RobertKennedyJr’s post is inaccurate and misleading and he is making claims that have been debunked repeatedly by actual scientists and doctors.

Josh Shapiro, governor of Pennsylvania, on X, August 26, 2026

Shapiro asked parents to take vaccine claims to a trusted clinician before they decide. That is a reasonable instruction, and it is also an admission that the federal health department is no longer a single voice. Calley Means, a senior White House adviser, has spent the same stretch promoting nutrition and fitness and shifting blame onto the Biden years. A senior administration official said reexamining vaccine side effects remains a top Kennedy priority. That does not change how measles moves through an unvaccinated classroom.

The classification fight may end with CDC adding the deaths, leaving them off, or splitting them. School nurses still have to log shots by December 31. The 91 clinics are still booking the next 40. And 2,903 confirmed cases are already on the federal ledger, with 94 percent of them in people who were unvaccinated or whose status no one could find.

Disclaimer: This article is news reporting and analysis of public health data and official statements, and it is for information only. It is not medical advice, a vaccination recommendation for any individual, or a diagnosis of measles or any other illness. Readers should talk with a qualified physician, pediatrician, or other licensed clinician about their own shots, exposures, and symptoms before making a health decision. Case counts, death classifications, and school coverage figures reflect the CDC, Pennsylvania, and KFF sources cited here as of September 2, 2026, and those figures can change as investigations close and states send in new reports.