The United States has recorded more than 2,000 confirmed measles cases so far this year, approaching the total of 2,228 cases recorded in all of 2025. This puts the country on track to experience its worst measles year in decades, as states grapple with the loss of federal funding for public health initiatives.
The virus continues to spread in unvaccinated and under-vaccinated communities, including among infants who are too young to receive the vaccine. This outbreak highlights the twin crises of misinformation and public health in the US.
On 4 June, the US recorded 2,030 cases, though experts believe the actual number is approximately three times higher. Cases in Utah appear to be declining, while outbreaks in Virginia and Pennsylvania are escalating.
"I think it's going to be a busy summer," said Andrew Pavia, a George and Esther presidential professor and infectious disease expert speaking in his personal capacity.
Utah has presented a unique aspect of the outbreak. "What makes Utah different than South Carolina and Texas is that it spread throughout the entire state and became much more widely distributed," Pavia noted.
Two factors determined whether cases were contained: "It hit hardest in communities that had relatively low vaccination rates and relatively limited public health departments," Pavia explained.
The Utah cluster began in a community with weak connections to public health, making case tracking difficult. It quickly spread to other areas. "With immunization rates having fallen off for 15 to 20 years in some places, there are young adults who are susceptible, who grew up in otherwise typical middle-class settings," Pavia added.
Controlling measles requires robust public health measures: vigorous contact tracing, isolation for the sick, and quarantine for the exposed. These tasks have become increasingly politicized following the Covid-19 pandemic. Utah's decentralized public health system meant that most of the response came from local health departments.
"Some of these small health departments are very stressed for personnel, funds, and training, particularly after the massive cuts that the administration made to pass-through money that went to state and local health departments – I think it was $11 billion they took away," Pavia said.
Utah Governor Spencer Cox "has not uttered the word 'measles' since 2024," and the health department had to clear all announcements through political leadership, making it less visible and vocal than other states, according to Pavia. He contrasted this with South Carolina, where the governor and health department director gave regular updates and "spoke with one voice about the need for containment."
The measles outbreak in South Carolina is officially contained, and there was a 162% increase in vaccinations in Spartanburg County in January. However, the response was still challenging, said Annie Andrews, a pediatrician in South Carolina. Before the outbreak ended, it climbed to nearly 1,000 documented cases – probably 2,000 to 3,000 cases in reality – with at least one young boy hospitalized with measles encephalitis.
Watching it unfold was "incredibly frustrating," Andrews said. "None of this had to happen. This was entirely preventable, and this is a direct result of decades' worth of vaccine misinformation and disinformation."
In early 2025, US poison control centers reported a 38.7% increase in exposures to vitamin A, while internet searches surged for the unproven treatment touted by Robert F Kennedy Jr, the secretary of the US Department of Health and Human Services (HHS) and a longtime vaccine critic, according to a new analysis. Kennedy has also framed measles vaccination as a personal choice as the outbreak continues to spiral.
High vaccination levels can prevent outbreaks from growing and protect those who cannot be vaccinated or do not respond to vaccines. Babies under one year of age are not usually vaccinated and cannot receive shots before six months, making them particularly vulnerable. In Texas, a baby born to a measles-positive mother required hospitalization for acute measles meningoencephalitis, according to a new report from the US Centers for Disease Control and Prevention (CDC) in the Morbidity and Mortality Weekly Report (MMWR).
When Pavia was a child, every parent feared measles outbreaks. "Everyone knew a child who had a bad outcome from measles, and they didn't take measles for granted. That's no longer true," Pavia said. Now, when patients report even uncomplicated symptoms – intense light sensitivity, painful diarrhea, high fevers – he and his colleagues hear the same refrain: "This was worse than anybody told me it was going to be." Parents say they have never seen their children so sick.
"We are nowhere out of the woods from this anti-science era we find ourselves in here in South Carolina and in other places across the country, and that environment just made us really vulnerable to this measles outbreak," Andrews said. "RFK Jr has been one of the figures leading that spread of disinformation."
Misinformation from top health leaders has made it more difficult to combat the outbreak on the ground, Pavia said. "When you have the situation we have now with the secretary of HHS, who is a longstanding vaccine critic, who did not do anything proactively nationally to help change the attitudes towards measles – you're dependent on local officials standing up, and that's been variable."
Andrews has known she wanted to be a doctor since age four and knew she wanted to be a pediatrician from her first time in a children's hospital over 20 years ago. But now, she finds herself taking on new roles she never imagined: she has become a social media influencer, explaining why vaccination is important and addressing common health misconceptions.
"Pediatricians and other physicians created a vacuum in social media spaces that allowed RFK Jr and other anti-science, anti-vaccine influencers to fill that void," Andrews said. "I think pediatricians and physicians just never understood the importance of engaging in those spaces. That's where real people are, that's where our patients are getting their information, and because we didn't engage there, the disinformation took over, and it's going to take us so long to claw back at that, to regain the trust."
Offering accessible and engaging information is a key part of being a medical professional, she added. "Until we accept that, we're going to continue to get outflanked in these spaces and end up right back where we are today."
Now, Andrews is aiming for an even bigger platform, running for US Senate in South Carolina. If elected, she would be the first woman physician in the Senate and the first pediatrician senator ever. "There's never been a more urgent need for scientifically literate, data-driven lawmakers to be in the rooms where these conversations are happening," she said.
It will take decades to counter the distrust that permeates public health and medical systems in the US, she said. "It's so pervasive now, this distrust in vaccines, this misunderstanding of the safety and efficacy of vaccines," Andrews said. "It's so heartbreaking to watch patients suffer as a result."
