Following America’s recent measles deaths, anti-vaccine activists have cast doubt on the virus as the culprit. They’ve pointed to a victim’s underlying health conditions or, as they did last year in Texas, blamed hospital error. But the two latest measles deaths in Pennsylvania—bringing the state’s total to four since mid-August—have made the United States’ measles crisis undeniable.
Last month, the Pennsylvania Department of Health announced two measles-associated deaths; both cases were later revealed to be infants too young to have been vaccinated. In response, Robert F. Kennedy Jr.—who was an anti-vaccine activist for decades before becoming health secretary—wrote on X that the deaths might have been “altogether fabricated.” (He later acknowledged a coroner’s conclusion that one of the deaths had been caused by measles.) Then, last weekend, an unvaccinated 40-year-old woman died in Jefferson County; immediately, people on Reddit and X insisted that her death wasn’t really caused by measles, because she’d had asthma and chronic obstructive pulmonary disease, both of which can make breathing difficult. Yesterday, state officials revealed that an unvaccinated 18-year-old died from a rare inflammatory condition of the brain and spinal cord that can be triggered by measles. Some commenters online deemed that death suspicious too.
What the armchair epidemiologists miss is that vulnerability to the infection doesn’t make a death less real. The two infants both tested positive for measles. The Lancaster County coroner’s office determined that one infant died of a ruptured spleen; however, when I spoke with that child’s parents, they told me that the mother had been extremely ill with the disease when she gave birth, the baby was not breathing when he was born, and they believed measles had killed their son. The other infant was born with a rare neurological condition, but the coroner found that measles was ultimately the cause of death. Greg Furlong, the Jefferson County coroner who investigated the 40-year-old woman’s death, told me that although the woman had conditions that made her vulnerable to measles, and was on supplemental oxygen, she was active before she contracted the virus. She cooked for her family and cleaned the house. Measles killed her in about a week. “If she wouldn’t have got the measles, would she still be alive today? I say yes,” Furlong, a Republican who is also the mayor of Summerville, said.
[Read: The measles-stricken mother who lost her newborn son]
Four deaths in roughly four weeks suggest that the state is in the midst of an enormous outbreak. The Pennsylvania health department lists total cases at 693, with 99 in the past week. But considering that measles kills about one to three of every 1,000 children it infects, the actual number is likely much larger. Milder cases are going unreported. Many who fall ill, particularly in the Amish community, aren’t getting tested; the Amish parents of the infant who died with a ruptured spleen told me that their 13 living children had all caught the virus, but they never got swabbed.
These deaths are occurring after three unvaccinated people, including two young girls, died of measles in Texas and New Mexico last year. Those were the first measles deaths in the country in a decade. The last time the United States experienced four measles deaths in a calendar year was in 1992, at the tail end of a years-long outbreak that killed more than 100 Americans. That resurgence led to a recommendation that children receive two doses of the measles, mumps, and rubella vaccine, and prompted a nationwide push to increase vaccination rates. It worked, and measles was declared eliminated in the United States in 2000. But overall kindergarten vaccination rates started declining during the coronavirus pandemic, and some areas, including Lancaster County, have fallen well below the 95 percent needed to maintain herd immunity.
Now, in the face of a new increase in measles deaths, Kennedy appears more interested in scoring political points than boosting national vaccination rates. He has accused Pennsylvania’s governor, Josh Shapiro, of “the weaponization of infectious disease fears for political gain”; Shapiro, in turn, charged Kennedy with “playing games with public health” after the CDC declined to update its measles statistics to include the deaths in his state. Kennedy’s stated reason for the omission is that the agency is “applying a consistent national standard.” But the delay marks a shift in policy: Last year, the CDC counted both Texas girls’ deaths and the death of the adult in New Mexico after the states announced them. (In a post on X, Kennedy wrote that the National Center for Health Statistics will determine if measles is the true cause of the deaths in Pennsylvania after examining death records; a spokesperson for the Department of Health and Human Services did not respond to questions about that investigation. In a statement, Pennsylvania’s health department said that its investigation had determined that all four deaths met the criteria for measles-associated fatalities.)
Tomorrow, Kennedy is scheduled to be the keynote speaker at the annual conference for Children’s Health Defense, the anti-vaccine organization that he founded before becoming health secretary. Children’s Health Defense has a long history of ginning up fears about the vaccine for measles, mumps, and rubella while downplaying the seriousness of the diseases. Kennedy does, too. In July 2021, Kennedy told attendees at an Amish country fair in Pennsylvania, “The cure for measles is chicken soup and vitamin A.” In fact, no known cure for measles exists; vitamin A has shown some promise in people with severe vitamin A deficiency, which is exceedingly rare in the United States. Since becoming health secretary, he has stated publicly that vaccination is “the most effective way to prevent measles infection,” but as I’ve reported, he also undercut that message by telling the father of a girl who died in West Texas that “you don’t know what’s in the vaccine anymore.” Kennedy has been a stronger advocate for measles itself, which he’s falsely credited with boosting resistance to cancer and cardiac disease, than he has for the vaccine that prevents it.
[Read: What RFK Jr. told grieving Texas families about the measles vaccine]
As cases and deaths rise, the reality becomes harder to ignore: Measles, a disease the country seemingly overcame 30 years ago, is once again killing Americans.