Three-Quarters of U.S. Counties With Data Fall Below Measles Protection Threshold, NBC-Stanford Analysis Finds

Since the CDC's 5,182-case count as of Nov. 5 and the opening of the Pan American Health Organization's review this week, a county-level analysis has put numbers on where the country's measles defenses are weakest. The updated NBC News/Stanford University investigation finds that three-quarters of U.S. counties with recent kindergarten immunization data now sit below the recommended threshold for community measles protection.

More than half of those counties dropped further between the 2024-25 and 2025-26 school years. The analysis says the gaps are widest in the country's most vulnerable areas.

Where the gaps are

Measles is the most contagious virus known, and stopping its spread takes about 95 percent two-dose MMR coverage. National kindergarten coverage was 95.2 percent in 2019-20, the last school year to begin before the pandemic. It has fallen every year since and stood at 92.4 percent in 2025-26.

Kindergarten exemptions hit a record 4.2 percent, the fourth straight annual record.

The national average hides the local picture. Once a county slips under the threshold, one imported case can find enough unprotected children to spread. The CDC counts 43 outbreaks this year.

The scale of the comeback

In 2000, when the U.S. declared measles eliminated, the country recorded only about 100 confirmed cases. This year the CDC has counted 5,182, against 2,289 in all of 2025 and 285 in 2024.

Dr. Jeffrey Koplan, who became CDC director in 1998, said his team pledged to stop measles transmission within four years and did it in two. "We had a great vaccine," said Koplan, now vice president for global health at Emory University. "Everyone was on board." He credited bipartisan backing from the CDC, the FDA, pediatricians and state health departments.

That consensus is gone. Nearly all of the thousands of people infected over the past year and a half were unvaccinated, according to the NBC analysis.

Deaths

State health departments have reported eight measles-associated deaths in 2026: six in Pennsylvania, one in New York and one in Wisconsin. Four of the dead were babies too young to be vaccinated.

The CDC's own national tally is lower. The agency counts four deaths and does not name states, according to the World Socialist Web Site, which says the CDC has stopped adding state-confirmed deaths to its total. Our earlier coverage noted the same CDC-Pennsylvania disagreement.

From 2016 through 2024, no one in the U.S. died of measles. Three people died in 2025.

Who is blamed

NBC attributes the erosion to decades of scientifically dubious claims about childhood vaccines, followed by a surge of misinformation and interrupted routine shots during the pandemic shutdowns.

The World Socialist Web Site puts the blame elsewhere. It argues the resurgence follows what it calls the Trump administration's dismantling of public health, "spearheaded by anti-vaccine fanatic Robert F. Kennedy Jr.," and says the pandemic-era decline began under policies of both parties. That is the outlet's characterization. The documents here carry no response from HHS or Kennedy.

The facts both accounts share are plain. Coverage fell every year after 2019-20, a stretch that spans a pandemic, two administrations and a rise in exemptions.

What PAHO decides

A commission of eight epidemiologists, infectious disease specialists and vaccine experts from countries across the Americas, including the U.S., is meeting in Washington from Nov. 10 to 13. It is weighing whether the U.S. has lost its measles elimination status.

After PAHO officials make a final decision, they will inform the U.S. Department of Health and Human Services, possibly this week. NBC reports that public health experts expect the status to be revoked.

What follows a revocation is an open question. Elimination status can be regained only by stopping continuous transmission again, and with three-quarters of the counties in the new analysis below the protection threshold, the number of places where a single case can ignite an outbreak is growing.