This fall in the U.S., as kids settle into a new school year, measles is spreading at a level not seen in 35 years. Children have died. And in just the past month, 10 children have been infected in an outbreak linked to a single daycare in Georgia. Far too many students are entering classrooms vulnerable to a highly contagious and dangerous virus.
Yet there has been relative silence from the U.S. Centers for Disease Control and Prevention (CDC), the agency where I once served as a senior leader, about measles. CDC’s back-to-school messages on X have advised families about sleep, physical activity, healthy lunches, and bullying. All are important. But one message emphasized in prior years at the start of school is noticeably absent and can now be found only in CDC’s online archives: Get your child up to date on routine vaccinations. During the country’s largest measles resurgence in decades, that should be the nation’s most urgent back-to-school message.
CDC’s reticence extends beyond social media. Four measles-associated deaths reported by Pennsylvania were initially absent from the agency’s national dashboard. In late August, CDC posted two of the Pennsylvania deaths, then added an asterisk and language that it was reviewing additional information. The deaths were later removed without a clear explanation. Now two deaths are reported on CDC’s dashboard as of September 28 without identifying the states. This is not transparency; it is silence at a moment when families need clear, accurate information to protect their children.
Why are these deaths being left off the official tally? There’s a disagreement between federal and state officials over how to count measles deaths—even though Pennsylvania investigated each death and reported them to CDC through the established nationally notifiable disease surveillance system that has been used by state and local health departments across the country for years. In late August, when officials from Pennsylvania announced the first two deaths there, Robert F. Kennedy Jr., Secretary of Health and Human Services (HHS), even questioned if the deaths were fabricated. But Pennsylvania’s definition of a measles-associated death ensures that deaths unrelated to underlying measles infection are not counted.
Leaders at HHS and CDC have said they are working to clearly define measles deaths and that it will update its counts as reviews are complete. But the agency has not explained which deaths they are currently counting, how these decisions are being made, why the data reporting system used by states was changed, and how they will account for the secondary infections and other complications caused by measles.Two former leaders of the National Center for Health Statistics have called this out publicly, writing in STAT that these changes will delay reporting and add to public confusion about the severity of measles.
An important question to ask is whether shifting explanations and new disease-classification systems are clarifying the outbreak or miring it in confusion and making it easier to minimize. A single measles case can expose dozens of classmates, teachers, and siblings, as well as infants too young to be vaccinated. Federal officials should be using their platforms to prevent the next case and not debating the numbers.
Meanwhile, the big picture is being missed: We know how to prevent this.
After the last significant measles surge in the late 1980s, the CDC Advisory Committee on Immunization Practices and the American Academy of Pediatrics recommended that all kids receive a second dose of the measles, mumps, and rubella (MMR) vaccine at age four to six. One dose is approximately 93% effective against measles; two doses are approximately 97% effective. But national MMR coverage among kindergartners fell again during the 2025-2026 school year, and approximately 280,000 kindergartners attended school without documentation that they had completed the MMR series. Vaccine exemptions in 24 states exceeded 5%, meaning these communities no longer have the 95% adequate protection to keep measles from spreading.
The impact extends beyond the child who becomes sick. When an unvaccinated student is exposed to measles, they will often be required to stay at home for at least 21 days. That means missed academics, missed social interactions, and missed work for parents. In addition to the impact on a child and their family, each case of measles costs the public-health system on average $58,600 to respond to, including the cost of contact tracing and quarantines. And measles isn’t over when the rash goes away. It can result in “immune amnesia,” meaning kids are more likely to get other infections over the next two to three years, and approximately one in 10,000 people who recovered from measles will die years later from the rare brain disease subacute sclerosing panencephalitis.
Amid the recent deadly outbreaks of measles, our federal health leaders have too often paired a lukewarm recommendation to vaccinate with insinuations and incorrect information about vaccine ingredients, fetal tissue, or waning immunity. The same week families needed clarity about a growing outbreak, Kennedy addressed a conference hosted by Children’s Health Defense, the anti-vaccine organization he once led.
In response to the outbreak, Pennsylvania has opened up nearly 150 pop-up vaccination clinics in homes and community centers, engaged health systems and local clinics across the state, requested federal support for additional vaccinations, developed a dashboard showing community transmission by county, and worked with coroners to investigate deaths. This is boots-on-the-ground public health.
Our federal health leaders should reinforce that work rather than cast doubt on it, giving parents and schools clear guidance and reporting cases consistently and transparently. Data and definitions matter, but we cannot lose sight of the people who are behind each of these data points. Each case number represents someone who became sick, and behind each death is a grieving family and a life that deserves to be counted. Now that children are back in school, our responsibility is both simple and urgent: to use the tools we know work to keep this preventable disease out of the classroom.
