On August 25, 2026, the . Both people were unvaccinated residents of Lancaster County. The department has not released their names, ages, or other personal details out of respect for their privacy and that of their families.
So, before discussing case counts, vaccination rates, or , we should pause on what this announcement means. Two people have died. Two families are grieving. Their loved ones are not cautionary tales, and their deaths should not become an excuse for speculation, judgment, or cruelty.
They do, however, deserve honesty.
Measles is not just a fever and a rash. It is not a harmless childhood illness that modern society has somehow become too afraid to tolerate. It is a highly contagious infection that can cause pneumonia, swelling of the brain, permanent disability, and death. Vaccination made those outcomes so uncommon in the United States that several generations grew up without seeing them. That success changed our perception of the disease, but it did not change the virus.
A rare event that was becoming less rare
These are Pennsylvania’s first measles-associated deaths since 1991 and the first reported in the United States in 2026. They come amid the country’s largest number of measles cases in 35 years.
Pennsylvania has confirmed 393 cases across the Commonwealth this year, including 185 in Lancaster County, according to the state and . Nationally, the as of August 20. That is already more than the 2,289 cases reported during all of 2025. Most of this year’s cases are connected to outbreaks, and 169 people had been hospitalized before the two Pennsylvania deaths were announced.
The comparison with the rest of the post-elimination era is sobering: Three (3) measles deaths in the 23 years between 2001 and 2024. Then came three (3) measles deaths just in 2025. And now, two (2) measles deaths in 2026, with the Lancaster County coroner’s office saying
The three deaths between 2001 and 2024 occurred in 2003 and 2015. According to a , the people who died in 2003 were a 13-year-old with chronic granulomatous disease and a 75-year-old adult. The person who died in 2015 was a 28-year-old adult whose immune system was weakened.
Then came 2025. Two unvaccinated school-aged children in Texas, neither of whom had a known underlying medical condition, died during the large outbreak there. An unvaccinated adult in New Mexico also died. With the two deaths announced in Lancaster County, the United States has now recorded five measles deaths in less than two years, compared with three during the preceding 24 years.
Five is a small number only when the people inside it are strangers.
What “eliminated” actually meant
The United States declared measles eliminated in 2000. Elimination is a public-health term with a specific meaning: the country had stopped continuous, homegrown transmission of the virus for at least 12 months while maintaining a strong surveillance system. It did not mean measles had been eradicated from the world, nor did it mean another case could never arrive.
Measles continued circulating in other countries. Travelers occasionally brought it into the United States. For many years, however, those sparks usually failed to become large fires because enough people were immune, mostly through vaccination.
That protective barrier has weakened. . Pennsylvania’s two-dose coverage among kindergarten students is 93.2 percent. The statewide average also blurs the fact that there are schools and communities with much lower protection.
Those few percentage points matter because . Up to 9 out of 10 susceptible people who have close contact with someone with measles will become infected. The virus can remain infectious in the air for up to 2 hours after the infected person leaves. When a virus spreads that easily, vaccination gaps that look modest on a statewide chart can sustain a major local outbreak.
This is why public health experts aim for about 95 percent coverage with two doses of the measles-containing vaccine. That level makes it much harder for the virus to find its next susceptible person and helps protect babies who are too young for routine vaccination and people who cannot safely receive a live vaccine.
Why measles can be deadly
The rash is the part of measles people recognize, but it is not the part that makes the disease dangerous.
. The fever may rise above 104 degrees Fahrenheit. A few days later, the rash appears on the face and spreads downward. Meanwhile, the infection can damage the lungs, the brain, and the immune system.
According to the :
- About one in five unvaccinated people in the United States who develop measles is hospitalized.
- As many as one in 20 children with measles develops pneumonia, the most common cause of measles death in young children.
- About one in 1,000 children with measles develops encephalitis, or swelling of the brain. It can cause seizures, hearing loss, intellectual disability, or permanent brain damage.
- About one to three of every 1,000 children who become infected will die from respiratory or neurologic complications.
Measles can also impair the immune system in less visible ways. The virus can damage some of the cells that remember past infections and vaccines. Researchers call this “.” After recovering from measles, a person may be more vulnerable to other infections for months or even years.
There is also a very rare but fatal complication called , or SSPE. It usually appears seven to ten years after the original measles infection, when a person who seemed to have recovered begins to experience changes in behavior and thinking, followed by seizures and progressive neurologic decline.
Children younger than five, adults older than 20, pregnant people, and people with weakened immune systems face a higher risk of serious complications. But higher risk does not mean exclusive risk. Previously healthy children can become critically ill and die, as the 2025 deaths in Texas made painfully clear.
There is no specific antiviral medicine approved to cure measles. Clinicians provide fluids, manage fever, support breathing, and treat complications such as pneumonia or secondary bacterial infections. Vitamin A may be used under medical supervision for some children who already have measles, but it does not prevent the disease and is not a substitute for vaccination. Large doses can also be toxic.
What vaccination changed
The history helps explain why many Americans no longer recognize the danger.
In the decade before the first measles vaccine was licensed in 1963, the United States recorded an average of about 549,000 reported cases and 495 deaths every year. Because most cases were never formally reported, the . About 48,000 people were hospitalized annually, and roughly 1,000 developed lasting disability from measles encephalitis.
Then vaccination changed the country’s relationship with measles. . Deaths became so uncommon that a measles fatality made national news. Eventually, many people came to see the absence of measles as evidence that the vaccine was no longer necessary rather than evidence that it had worked.
That is one of the recurring problems of prevention: when it succeeds, the disaster that did not happen is invisible.
Two doses of the MMR vaccine are about 97 percent effective at preventing measles; one dose is about 93 percent effective. No vaccine is perfect, but a highly effective vaccine given throughout a community leaves the virus very few places to go. It also creates a shield around people whose age or medical condition leaves them especially vulnerable.
Compassion, clarity, and what comes next
The fact that both Lancaster County residents who died were unvaccinated is medically relevant. It is not a moral verdict, and it should not be used to attack their families or their community.
People make health decisions within families, cultures, faith communities, health systems, and information environments. Some face practical barriers to care. Some have questions that were never answered respectfully. Some have been repeatedly exposed to frightening claims about vaccines that are unsupported by evidence. Public health cannot answer those challenges with contempt. It must answer them by listening, building trusted local partnerships, ensuring convenient access to vaccination, and clearly correcting misinformation.
Compassion does not require us to soften the facts. The MMR vaccine is safe and highly effective. Measles can cause severe illness and death. There is no credible evidence that the MMR vaccine causes autism. And no vitamin, supplement, or wellness product can replace vaccination.
If you are unsure whether you or your children are protected, check your vaccination records or speak with a health care professional. Children routinely receive a first MMR dose at 12 to 15 months of age and a second at 4 to 6 years of age, although public health officials may recommend an earlier dose during an outbreak or before international travel. Adults without evidence of immunity should also ask a clinician whether they need vaccination.
If you think you have been exposed to measles and develop fever, cough, runny nose, red eyes, or a rash, call a health care provider before arriving at a clinic or emergency department. Calling ahead allows staff to protect other patients. Pennsylvanians can also call the Department of Health at 877-PA-HEALTH (877-724-3258).
Public health often speaks in rates and trends because that is how we see danger moving through a population. Grief arrives differently. It arrives one household at a time.
The two people who died in Lancaster County deserve to be remembered first as people, not as evidence in an argument. But we should also honor their lives by refusing to look away from what their deaths tell us. Measles did not become harmless just because it was absent from everyday American life. Vaccination made its consequences rare.
We know how to make them rare again.
Sources and Additional Reading
- Pennsylvania Department of Health — Official announcement confirming the two measles-associated deaths, their vaccination status, statewide case count, symptoms, and public-health guidance.
- Shapiro Administration — Overview of Pennsylvania’s outbreak response, vaccination clinics, provider and school outreach, and current student vaccination coverage.
- Centers for Disease Control and Prevention — Current national measles case and outbreak data, vaccination coverage trends, surveillance definitions, and historical comparisons.
- Centers for Disease Control and Prevention — History of measles in the United States, including the pre-vaccine burden, vaccine development, and the achievement of elimination.
- CDC’s Morbidity and Mortality Weekly Report — Epidemiologic review of the 2025 resurgence, including the three deaths reported before publication and details about earlier post-elimination deaths.
- Centers for Disease Control and Prevention — Plain-language explanation of measles symptoms, hospitalization, pneumonia, encephalitis, immune amnesia, SSPE, and the risk of death.
- Centers for Disease Control and Prevention — Clinical overview covering transmission, severe complications, high-risk groups, historical disease rates, and supportive treatment.
- Centers for Disease Control and Prevention — MMR vaccination schedule, effectiveness, safety, and recommendations for routine vaccination, travel, and some recent exposures.
- Reuters — National reporting on the Lancaster County deaths, Pennsylvania’s outbreak, national case totals, hospitalizations, and falling vaccination coverage.
- Associated Press — National context for the Pennsylvania deaths, including the comparison between the five U.S. measles deaths reported since 2025 and the three reported during the preceding decades.