On August 25, 2026, the Pennsylvania Department of Health (DOH) reported 393 cases of measles in 28 counties. The outbreak centered on Lancaster County, home to a large Mennonite community. The DOH also confirmed two measles-associated deaths in individuals who were unvaccinated. Unfortunately, the DOH didn’t state the ages of the two people who died, the reason that they were unvaccinated, or the cause of death.
This would have been helpful, as the anti-vaccine community, including Secretary of Health and Human Services Robert F. Kennedy Jr., have been quick to claim that these two measles deaths were fabricated. RFK Jr.’s claims were ironic given that on July 28, 2021, in front of more than 1,500 people in Lancaster County, RFK Jr. said that measles infections were no big deal and were easily treated with “chicken soup and vitamin A.”
Subsequently, we have learned that one of the two measles deaths was an infant who died shortly after birth due to splenic rupture. The coroner reported detecting measles virus in lung tissue. Given that congenital measles infection can cause splenic enlargement and thinning of the splenic capsule, it is likely that the child ruptured the spleen during birth.
The PA measles outbreak is particularly worrisome for several reasons:
First, the PA DOH issued its report in August. Measles is typically a late winter, early spring disease. It is likely that this outbreak will only worsen as we approach the winter months.
Second, two deaths among about 400 cases represents a mortality rate of 1 per 200 for a virus that typically has a mortality rate of 1 per 1,000. This suggests that the outbreak is much worse than is claimed. Many more people, possibly hundreds more, have been infected but not reported.
Third, children in PA are about to return to school, where they will share their viruses more easily. School vaccine mandates, which have been around for decades, were put in place because outbreaks often center on schools. Indeed, a measles outbreak in Philadelphia in 1991, which involved 1,400 cases and nine deaths, centered on two religious schools where children were unvaccinated.
Fourth, PA has both a religious and philosophical exemption to vaccination for school entry. It’s easy for PA’s children to enter school without proof of having received a measles-mumps-rubella (MMR) vaccine.
Fifth, President Donald Trump recently held a press conference warning against the MMR vaccine, claiming that the combination was “quite lethal.” Some people might have been influenced by his false claims.
In short, I think that the measles epidemic in Pennsylvania is about to get much worse. Because of cutbacks in our ability to monitor these outbreaks, I also worry that we might not know exactly how many more people are really suffering from this disease. I hope I’m wrong.
Paul A. Offit, MD, is director of the Vaccine Education Center and professor of pediatrics in the Division of Infectious Diseases at Children’s Hospital of Philadelphia. This piece originally ran on his Substack, Beyond the Noise!
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