RFK Jr. and MAHA’s reckoning with measles

By most measures, measles in the United States is out of control. Last week alone, the number of cases increased by 8%, with 330 infections reported, exceeding the total number of cases in 2024 (the total number of cases in 2024 according to the U.S. Centers for Disease Control and Prevention was 285). Texas and South Carolina have experienced large outbreaks, but Pennsylvania has been particularly hard hit recently, with more than 1,300 cases and 250 hospitalizations so far this year. Due to under-reporting, public health officials have warned that the true number of cases may be higher, possibly as high as 6,000.

“We’re seeing more cases of measles in this report than we’ve seen in the past quarter century combined,” University of North Carolina public health professor Noel Brewer told POLITICO this week. Brewer served on a key CDC vaccine advisory group before Health and Human Services Secretary Robert F. Kennedy Jr., a well-known believer and propagandist of anti-vaccination conspiracy theories, overhauled the panel.

Measles is a highly contagious viral disease characterized by a visible rash. While most people recover, it can cause pneumonia, blindness and brain swelling, and erases the immune system’s memory, making secondary infections prone to secondary infections. About one to three people in 1,000 die from measles, with children most at risk. The measles vaccine is very effective and safe. According to the World Health Organization, an estimated 59 million deaths were prevented globally through measles vaccination between 2000 and 2024.

There have been 42 measles outbreaks this year, with at least 4,410 confirmed cases of measles as of Oct. 15, nearly double the 2025 total, according to CDC data. But critics say the CDC isn’t telling the full story. The agency’s measles dashboard lists three deaths, with one added Wednesday, but Pennsylvania alone has reported five deaths this year, with a sixth under investigation. The CDC has not released the names of the states where the latest deaths occurred, but health experts say there is no reason to withhold this information.

Why is there a difference? That’s what Pennsylvania Health Secretary Debra Bogen wants to know. Late last week, Bogen sent a letter to CDC Director Erica Schwartz asking for a death toll in the state and demanding answers about how the agency tracks measles deaths. “The CDC’s failure to acknowledge deaths obscures the severity of the disease and the toll of measles across the United States,” Bogen wrote. Schwartz has been CDC director since August, succeeding acting director Jay Bhattacharya.

This is not the first time Bogan has sent such a letter. In September, she asked Schwartz to acknowledge the death toll, which then stood at four. Later that month, Reuters reported that Kennedy asked Schwartz to remove two measles deaths from the CDC’s dashboard, which she did “without objection,” according to three people familiar with the matter. While the deaths have been added back to the tally, they are marked with an asterisk indicating “the numbers may change.”

Start your day with important news from the salon.
Sign up for our free morning newsletter, Crash Course.

Pennsylvania Gov. Josh Shapiro, a Democrat, has also raised questions about the CDC’s response, publicly accusing Kennedy and the Trump administration of sowing doubt about the vaccine. Kennedy denied any wrongdoing and regarded the epidemic as a global problem, saying: “We have done better, especially my government, in controlling the epidemic better than any other country in the world.”

Kennedy has made this statement before. Indeed, other countries have also seen surges in measles cases, notably Indonesia, Guatemala, India and Bangladesh, with the latter registering more than 65,000 infections in the past 12 months. But that doesn’t change the fact that the United States has failed miserably at protecting the population from measles, with vaccination rates continuing to decline. However, Kennedy has been reluctant to promote the vaccine, continuing to cast doubt on its safety and insisting on the use of unproven measles treatments such as vitamin A and cod liver oil. The recommendation comes amid growing calls to control vitamin A poisoning, according to research published online in June in the Journal of the American Medical Association.

Kennedy tried to turn the tables, accusing Shapiro of “politicizing” the pandemic and rejecting federal help. But that aid was initially denied because the CDC did not accurately count deaths, and Pennsylvania requested emergency aid in September. State and federal governments are currently working together. Last week, the CDC dispatched a “disease detective” from the agency’s Epidemic Intelligence Unit to Pennsylvania.

All of this comes as the World Health Organization will review the measles elimination status achieved in the United States in 2000, given when a country has gone a full 12 months without sustained transmission of the virus. But when the Pan American Health Organization, part of the World Health Organization, meets in November, they are expected to revoke the U.S. status, just as they did to Canada last November, 25 years after our northern neighbor eliminated the disease.

Measles is just one of seemingly countless self-inflicted crises at the heart of the Make America Healthy Again movement, which Kennedy spearheaded during his 2024 presidential campaign before endorsing Trump and joining the administration. As a result, Kennedy has been busy lately speaking to Republicans in the midterm elections, sometimes even hopping on military planes to do so, while MAHA-aligned groups have spent nearly $2 million supporting candidates associated with the health secretary. POLITICO reported last week that “MAHA PAC and MAHA Action PAC, two political action committees that support candidates committed to the health secretary’s agenda, announced they were donating a combined $1.65 million to support Republican Zach Lahn’s campaign for Iowa governor.”

Aside from the election, Kennedy’s main focus these days has been redefining junk food, but the public is clearly losing trust in the MAHA movement. New data from an Axios-Ipsos poll shows that only one in four people trust health information from Kennedy. While he has become a prime target of Democratic investigation and even impeachment if Democrats win a congressional majority, replacing the health secretary may not be enough to restore public health. As health care policy experts Steven Grossman and Michael Miller recently wrote in MedPage Today, “Even if the outcome brings more pro-vaccine lawmakers to Congress, vaccines will still face long-term existential threats at the federal and state levels from regulatory and legislative proposals and actions. Strong support from pro-vaccine policymakers and advocates will be critical over the next two years, but this need will likely extend into 2029 and beyond.”

Amid a backdrop of scandal-ridden Trump administration, corruption, wars and soaring costs of living, a resurgence of measles may not be top of mind for most voters. But every time public health leaders ignore an escalating crisis, it leads to more hospitalizations, disabilities and deaths. If the midterm elections fail to bring about some form of reckoning with MAHA and its assault on public health, we can expect to lose more than the World Health Organization eliminates its status.