Measles cases in the United States reach highest point in 33 years: What you need to know

It is a worrying setback in the advances made in public health: the United States has recorded the highest number of annual measles cases in 33 years. By early July 2025, at least 1.281 confirmed cases had been reported in 38 states and the District of Columbia, according to the Johns Hopkins University Center for Innovation in Outbreak Response (CORI). The outbreak, which is the worst since 1992, has caused at least three deaths and more than 150 hospitalizations, almost all among unvaccinated people.

The epicenter of the crisis is Texas, particularly Gaines County, where 414 of the state’s 753 cases have been reported. Although authorities say the spread in that county has been stopped, transmission continues in Lamar County, located near the Oklahoma border. The Texas Department of State Health Services confirmed two new cases a few days ago that were not related to any known outbreak, indicating that the threat remains active.

A setback

Measles was officially declared eradicated in the United States in 2000 thanks to widespread vaccination and rapid response to outbreaks. Since then, occasional cases have typically been due to unvaccinated travelers returning from countries with active outbreaks. However, in recent years there has been an increase in vaccine skepticism, leading to larger and longer outbreaks.

Health experts also attribute the increase in cases to declining coverage of the MMR (measles, mumps, and rubella) vaccine. In 2019, the national vaccination rate among kindergarten children was just over 95%, the threshold for herd immunity. That figure has now fallen below 93% and continues to decline, leaving more Americans, especially children, vulnerable.

According to CDC data, approximately 92% of those infected in 2025 were unvaccinated or their vaccination status was unknown. Among those hospitalized were two children from Texas and a man from New Mexico, all of whom had not received the MMR vaccine.

Misinformation and RFK Jr.

Secretary of Health and Human Services Robert F. Kennedy Jr., a longtime vaccine skeptic, has sent mixed messages about the outbreak. While officially supporting vaccination, Kennedy has also promoted the arguments of vaccine opponents and praised alternative treatments that lack scientific backing.

In June, Kennedy dismissed the initial outbreak in Texas as normal and insignificant, raising concerns among public health experts. He later fired the 17 members of the CDC’s vaccine advisory committee and replaced them with well-known vaccine skeptics. The new committee members have since announced plans to reevaluate the childhood vaccination schedule.

Another factor complicating the situation is the influence of “health influencers” and anti-vaccine groups on the internet, many of whom have financial incentives to undermine trust in vaccines. Their messages have even reached communities that historically supported immunization, leading some parents to vaccinate their older children and refuse vaccines for their younger ones.

Canada and Mexico

In mid-June 2025, the Pan American Health Organization (PAHO) reported 7,132 confirmed cases of measles and 13 deaths across the Americas, a 29-fold increase compared to the same period in 2024. Most cases occurred in Canada (3,170), Mexico (2,597), and the United States (1,227 at the time of the PAHO report).

Children under five and adolescents between 10 and 19 are the most affected age groups. In response, PAHO has urged countries to intensify vaccination efforts, with the goal of restoring 95% coverage with two doses of measles-containing vaccines.

In Mexico, where most cases are concentrated in the state of Chihuahua, near the Texas border, Health Secretary David Kershenobich has expanded vaccination recommendations. In Ciudad Juárez alone, just across from El Paso, 65 confirmed cases have been reported. El Paso County has recorded 63 cases related to the Texas outbreak.

A burden on the public health system

According to official data, the 2019 outbreak in New York City, which affected fewer cases than the current outbreak in Texas, cost the city $8.4 billion and required the involvement of more than 550 employees. Federal funding cuts during the pandemic and tight budgets for public health agencies have made it difficult for many jurisdictions to deal with outbreaks.

Texas has had to divert staff from other health initiatives to focus on containing measles. In Dallas County, 16 immunization service employees were laid off due to budget constraints (driven by the Trump administration), even though the state is facing its worst year in more than three decades in terms of measles.

Despite the recent decline in new cases in Texas, public health officials such as Philip Huang, director of Health and Human Services for Dallas County, warn that the outbreak is far from over and stress that unless vaccination rates improve rapidly, the United States risks losing its measles elimination status, which would represent a profound shift in global health benchmarks.

Sign up for our weekly newsletter to get more English-language news coverage from EL PAÍS USA Edition