Pennsylvania Conditions CDC Measles Help on Federal Recognition of Four Deaths, HHS Calls It 'Political Blackmail'

Since Pennsylvania confirmed its first two measles deaths in Lancaster County in August, the outbreak has grown to at least 731 confirmed cases across 38 counties, with two additional measles-associated deaths reported since, according to the state health department. That count now sits at four deaths total, and the state says 141 people have been hospitalized.

Pennsylvania Health Secretary Debra Bogen sent a letter to CDC Director Erica Schwartz on the evening of Wednesday, September 16, saying the state had begun the process of requesting emergency federal support known as an Epi-Aid, according to a document reviewed by Reuters and cited by CNBC, The Print and The Guardian. The catch: Bogen wrote that Pennsylvania will withdraw the request if the CDC won't publicly recognize the four deaths.

"The CDC's choice not to publicly recognize the deaths undermines our response," Bogen wrote. "For this reason, if CDC is unable to transparently and accurately communicate information about those measles-associated deaths, the Department will respectfully rescind our request for a CDC Epi-Aid."

HHS pushed back hard. Spokeswoman Emily Hilliard told The Hill that "CDC will not submit to political blackmail that conditions critical public health assistance," adding the agency "will not allow Governor Shapiro to politicize this process." Al Jazeera separately attributed nearly identical language, including the same "political blackmail" phrase, to HHS press secretary Grace Davis Jamison. Both outlets reported HHS's position that the CDC had not received Pennsylvania's Epi-Aid request "through its normal channels."

That procedural dispute matters because the CDC's own director, Erica Schwartz, told The Epoch Times in mid-September that Pennsylvania had not officially requested an Epi-Aid and had not accepted CDC assistance, unlike Texas, South Carolina, Virginia, Kansas, New Mexico and Wisconsin, which Schwartz said worked with federal teams during their own outbreaks. According to Ground News' aggregation of coverage, the CDC's national dashboard still lists zero measles deaths for Pennsylvania even as the state's own count stands at four.

Governor Josh Shapiro has escalated in response, saying Pennsylvania will not accept further federal funding to fight the outbreak until HHS acknowledges the four deaths on the CDC's website, per reporting aggregated by Ground News. Senator Bill Cassidy, the Republican chairman of the Senate health committee, also faulted the administration's handling of the dispute this week, according to The Guardian, putting a member of his own party on record against HHS's approach.

The underlying disagreement is about classification, not just politics. Pennsylvania's health department has said it uses the term "measles-associated" whenever lab or epidemiologic evidence links a death to the virus, even if a coroner doesn't list measles as the direct cause of death, according to Fox News. That standard applied to the state's first reported death, a newborn who died after birth from a lacerated spleen and had tested positive for measles acquired before birth, per Lancaster County findings cited by The Philadelphia Inquirer and reported by Fox News. Coroner Stephen Diamantoni said he was still investigating that death and was not aware of the state's second reported fatality at the time.

RFK Jr. has seized on those gaps. In a Wednesday post on X quoted by Fox News, Kennedy alleged Pennsylvania had withheld information from the CDC and suggested the deaths "may even have been altogether fabricated by one of the Governor's hopeful staffers." Kennedy has not presented evidence for it beyond questioning the coroner's process. Pennsylvania has not walked back its death count, and the fourth death, a 40-year-old unvaccinated woman in Jefferson County, was reported by the county coroner's office on September 12, according to The Epoch Times, with testing still pending to confirm measles as of that report. Coroner Greg Furlong said she developed symptoms after contact with a neighbor who had a lab-confirmed case.

A legitimate concern exists beneath the political dispute. HHS and Kennedy's allies argue that a broad "measles-associated" standard, one that can count deaths where measles wasn't the immediate listed cause, risks overstating the virus's lethality and that a health secretary asking pointed questions about classification isn't inherently illegitimate. Disease experts quoted by Reuters and The Guardian counter that the CDC excluding a state's own certified numbers from a national tally, something they call "highly unusual," is a bigger departure from normal practice than a governor asking questions about it.

The CDC says it hasn't received a formal Epi-Aid request through normal channels. Pennsylvania says it has started that process and is waiting on public recognition of the deaths before finishing it. Until one side moves, cases keep climbing, Jefferson County's fourth death remains pending lab confirmation, and the CDC's public dashboard keeps showing zero.