Measles cases in the United States have reached their highest level in 35 years. Data from this year and last exceed the combined total of the previous 25 years. The Centers for Disease Control and Prevention is completing a study on the outbreak, which has hospitalized nearly 400 people, caused three deaths, and left at least three others with brain swelling and lasting symptoms.
The country may soon lose its measles elimination status. A key requirement for maintaining that designation is containing outbreaks within a year. Utah’s outbreak, ongoing since June 2025, has already surpassed that limit. A CDC scientist, who spoke anonymously due to concerns about retaliation, said sustained transmission over the past year makes the loss likely.
A national committee of specialists will review the agency’s internal report before it’s sent to the Pan American Health Organization, which evaluates elimination status for countries in the Americas. The final decision will come at PAHO’s annual meeting this fall, though experts say the outcome is nearly certain. Former CDC immunization director Anne Schuchat called the situation a scheduling issue. “It’s just so sad, because some people will get brutally ill,” she said. “This should serve as a warning.”
Vaccination rates have declined, with most cases tied to domestic outbreaks among unvaccinated groups. The resurgence has forced pediatricians to address both the medical and emotional consequences of preventable illness. In Utah, where the outbreak has been severe, doctors describe a crisis affecting homes, schools, and communities where trust in vaccines has weakened.
Hospital pediatrician Emilie Morris in Salt Lake County said children with measles often arrive in severe distress. “They’re bent over, mouth open, drooling, crying, maybe not even producing tears because they’re so dehydrated,” she said. “Their eyes look kind of glazed over. It’s like they’re seeing through you.” The rash, labored breathing, and dehydration signal a virus that has pushed their bodies to the limit.
Nathan Money, another pediatrician in the region, said unvaccinated children require more aggressive treatment. “I have to do more blood work, or lumbar punctures to rule out meningitis,” he said. “I have to do things which are painful, and it’s traumatic for the families.” Parents, he added, are almost always well-intentioned. “They always tell me, ‘Do what you need to do to make sure my child is safe.’”
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Trahern W. Jones, a pediatric infectious disease specialist based in Salt Lake City: So I’m coming to grips with the fact that we’re in a new era. “It’s such an awful illness. Even the best possible course is one of the worst diseases most children ever go through.”
The emotional toll extends beyond the child. Parents often struggle with regret, shame, and strained relationships with family members who had urged vaccination. Morris described families with multiple unvaccinated children at home, requiring a 21-day quarantine to prevent further spread. “Don’t interact with anybody else in your community,” she told them. “Don’t go to the grocery store, even with a mask.”
Rebuilding trust between doctors and families has become a major challenge. Morris said some parents don’t realize the severity of their child’s condition until it’s too late. “It reflects the breakdown of trust between physicians and families,” she said. “How can I make people understand I have a genuine concern for their child?”
Tim Duffy, a pediatrician in Salt Lake County, said many parents aren’t firmly opposed to vaccines but hesitate after months of online research. “They think they’re doing what’s best for their child,” he said. He compares it to other safety measures: “You could ignore everything I say as a pediatrician. You could sleep your child on their stomach. You could skip the car seat. For your individual child, they might be fine. But from my perspective, caring for thousands of kids, we will see bad outcomes.”
One unnamed pediatrician in southern Utah, who has faced harassment from activists, said autism concerns remain a hurdle. “If vaccines caused autism, we’d see more cases in vaccinated kids compared to unvaccinated ones, and we don’t,” they said. Others cite a preference for “natural” approaches or question vaccine ingredients. When asked if they vaccinated their own children, the doctor said yes. “Knowing what I know, I’m confident giving this to my kids.”
Vaccines have also become politicized in ways they weren’t two decades ago. Jones called it a divisive issue. “Vaccines are one of the main reasons we don’t have to worry about losing our kids,” he said. The southern Utah pediatrician noted that recent federal changes to vaccine recommendations—later blocked by a judge—have added confusion. “A couple of individuals altered the recommendation outside the usual evidence-based process,” they said. “That raises concerns for me as a doctor.”
Ellie Brownstein, president-elect of the Utah chapter of the American Academy of Pediatrics, said she now spends more time explaining the science behind vaccine schedules. “I trust these experts over someone without much experience,” she tells parents. Money said inconsistent messaging from state leaders has worsened the problem. “I want to see commercials on TV about the safety of the MMR vaccine and the dangers of measles,” he said. “I want to see this on billboards, in schools, in public buildings. Right now, people have to seek out information from reliable sources.”
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Jones said compassion is key. “Ask open-ended questions to learn about their experiences,” he said. “Don’t overwhelm them with facts. Try to show that you’re a real person with your own experiences.” He often mentions his children. “I would never recommend something for your kids that I wouldn’t do for mine.”
The southern Utah pediatrician takes a similar approach. “If you push too hard, you’ll lose people who need care,” they said. “My main goal is to build relationships.” Some parents refuse outright, but others are open to discussion. “It’s a good day if I can talk with someone who doesn’t want to vaccinate, even if I don’t change their mind,” they said. For hesitant parents, the doctor addresses specific concerns, like explaining that a fever after vaccination is normal and harmless.
Brownstein opposes excluding unvaccinated children from medical practices. “That shuts down any future conversation,” she said. “If these parents find like-minded doctors, the situation will worsen.”
Money said he wishes more people could witness what he sees in the hospital. “I see what happens when children with measles can’t breathe on their own,” he said. “The child is terrified, and the parents are scared their child might die. It’s heartbreaking as a pediatrician and as a father to know the situation could have been easily prevented.”
Duffy said he still feels responsible when preventable illnesses turn serious. “Maybe I didn’t say the right thing or ask the right questions,” he said. “Maybe I let it go because of the look on a parent’s face.” Morris described the grief of watching a family suffer through a preventable tragedy. “Holding grief with a family when something bad happens that was preventable—that’s the worst,” she said. “You wonder if you could have done something differently.”
Jones expects more vaccine-preventable diseases to return unless major changes occur. “I’m not seeing those changes from leaders,” he said. For now, he focuses on what he can control. “You don’t choose the time you’re born into, but you choose what to do about it,” he said. “I’m going to help others make those choices too.”
