Two unvaccinated Lancaster County residents died from measles Tuesday, marking Pennsylvania's first measles-associated deaths in 35 years and the first reported U.S. measles fatalities of 2026, according to the Pennsylvania Department of Health. The deaths come as the state battles its largest outbreak in decades, with 393 confirmed cases across 29 counties and 70 hospitalizations.
The fatalities are drawing attention to a steep decline in childhood vaccination in Lancaster County, where kindergarten coverage for the measles, mumps and rubella vaccine fell to 87.6% in the 2025-26 school year from 95.5% in 2017. Public-health authorities generally target vaccination coverage of about 95% to prevent sustained measles transmission because the virus is extraordinarily contagious.
"My deepest sympathies are with the loved ones who are facing this unimaginable loss," Pennsylvania Secretary of Health Dr. Debra Bogen said in a written statement. "Because measles was largely eliminated in the Commonwealth for more than three decades, people are not familiar with this disease and don't fully understand the potential severity of the illness."
About one in five of Pennsylvania's confirmed measles patients this year has been hospitalized, according to the figures in the supplied article, and none of the cases involved people who were fully vaccinated. Children account for roughly one-third of infections.
Dr. Fahmida McGann, an infectious-disease specialist at Penn State Health Lancaster Medical Center, said during a state press conference in June that hospitalized patients had suffered complications including kidney and liver dysfunction, abnormal blood counts and electrolyte problems, leaving them "exposed to serious organ failures, secondary infections, as well as bleeding."
The outbreak is part of a broader national resurgence. The Centers for Disease Control and Prevention had recorded 2,777 U.S. measles cases as of Aug. 20, according to the supplied figures, already exceeding the 2,289 cases reported during all of 2025. Pennsylvania ranked behind Utah and South Carolina in total cases.
Three people died from measles in the U.S. in 2025-two children in Texas and an adult in New Mexico. All were unvaccinated, according to the supplied article. The latest Pennsylvania deaths underscore the potential consequences as vaccination coverage declines in communities that had gone decades without confronting widespread transmission.
Nationally, MMR coverage among kindergartners stood at 92.4% for the 2025-26 school year, while 4.2%, or about 155,000 children, had an exemption from at least one required vaccine. Exemptions increased in 41 states and the District of Columbia, according to CDC data cited in the article.
Pennsylvania permits school-vaccine exemptions for religious objections or a "strong moral or ethical conviction similar to a religious belief." Parents can invoke the exemption in writing without obtaining a physician's signature, a provision that has become increasingly consequential as unvaccinated children cluster in individual communities and schools.
At Ephrata Mennonite School in Lancaster County, fewer than half of kindergartners were immunized against measles last year, according to the supplied article. School administrator Joshua Good said resistance to vaccination had hardened over the past decade.
"The opposition to vaccination has become entrenched in a significant portion of parents, with concerns ranging from how vaccines are developed to their safety to resentment over the handling of immunizations and public restrictions during the COVID-19 pandemic," Good said. Referring to Health and Human Services Secretary Robert F. Kennedy Jr., he added: "And then you throw in messaging from key health people like RFK Jr."
The outbreak has also collided with a national fight over childhood-vaccine policy. President Trump signed an executive order Aug. 10 calling for a narrower universally recommended childhood vaccination schedule and directing the administration to pursue separate injections for measles, mumps and rubella rather than the long-established combination MMR vaccine, according to the supplied article.
Pennsylvania Gov. Josh Shapiro rejected changes to the state's vaccination recommendations and sharply criticized the federal approach. "President Donald Trump and [Health and Human Services Secretary Robert F. Kennedy Jr.] are screwing around with the childhood vaccine schedule - ignoring decades of science, sowing chaos and confusion, and spreading dangerous misinformation that puts kids and families at risk," Shapiro said.
Dr. Andrew Racine, president of the American Academy of Pediatrics, described the executive order as "not only disheartening but dangerous." Johns Hopkins Bloomberg School of Public Health, according to the article, has said there is no scientific evidence of a health benefit from separating the MMR vaccine into three injections.
Beyond the immediate illness, measles can have lasting effects on immune defenses. Research led by Michael Mina and published in Science in 2019 found that measles infection can erase part of the body's preexisting immune memory, a phenomenon known as "immune amnesia." Researchers found that infected unvaccinated children lost between 11% and 73% of their existing antibody repertoire.
The two-dose MMR regimen is about 97% effective against measles and doesn't cause the immune-amnesia effect associated with infection. Pennsylvania health authorities are urging residents with uncertain vaccination histories to check their records and contact healthcare providers, particularly in communities experiencing active transmission.
