Pennsylvania has confirmed a fourth measles-related death this year, marking the highest annual toll in the United States since 1992. The latest victim, an unvaccinated 18-year-old from Mifflin County, died from acute disseminated encephalomyelitis, a rare neurological complication that can follow infection, according to County Coroner Andrea Alcalde.
The outbreak has now claimed lives across multiple age groups. Earlier fatalities included two infants in Lancaster County and a 40-year-old woman in Jefferson County, whose death was reported over the weekend. State health officials have documented 693 measles cases across 38 Pennsylvania counties so far this year, while the Centers for Disease Control and Prevention (CDC) reports more than 3,200 cases nationally.
Health Officials Emphasize Vaccine Effectiveness
“My thoughts are with the two families who lost loved ones to this highly-contagious virus, as Pennsylvania faces the worst measles outbreak in more than three decades,” Pennsylvania Secretary of Health Dr. Debra Bogen said in a statement Tuesday. “We remain committed to working with our partners across Pennsylvania to stem this outbreak and prevent more deaths. That means ensuring people have the facts about measles and access to the MMR vaccine – which kept measles outbreaks at bay for decades.”
The CDC states that two doses of the MMR vaccine provide 97% protection against measles. Approved in 1963, the vaccine is considered very safe, with side effects typically mild and self-resolving. However, declining vaccination rates have fueled a national resurgence of the once-eliminated disease.
Measles Complications and Risks
According to the CDC, approximately one in five unvaccinated people who contract measles requires hospitalization. As many as one in 20 children develops pneumonia, the leading cause of measles-related death in young children. Encephalitis, or brain swelling, occurs in one of every 1,000 pediatric cases. The virus kills one to three of every 1,000 infected children.
Political Conflict Intensifies Over Outbreak Response
The deaths have ignited a public dispute between Democratic Governor Josh Shapiro and U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr., a prominent vaccine skeptic.
In a post on X, Shapiro called the fatalities — the first measles deaths in Pennsylvania in 35 years — “tragedies.”
“Pennsylvania is experiencing the worst measles outbreak in the country,” he wrote. “This disease was declared eliminated in the United States in 2000 — yet decades later, we are seeing it surge due to lower vaccination rates.”
Dispute Over Death Counting and Federal Involvement
The CDC has not yet included any 2026 measles deaths in its official tally. The agency previously declined to count Pennsylvania’s first two reported deaths, citing insufficient information to determine whether measles caused or contributed to the fatalities. That decision came from CDC Director Dr. Erica Schwartz.
Shapiro revealed in late August that he had declined an offer of federal assistance from Kennedy, telling the secretary that his “actions and his rhetoric,” including spreading vaccine misinformation, were harming communities.
Kennedy responded on social media, accusing Shapiro of fearmongering and the “weaponization of infectious disease” for political gain. He suggested the deaths may have been “altogether fabricated” by one of Shapiro’s “hopeful staffers” to support a narrative that measles infection is more dangerous than it actually is.
Coroners Question Cause of Death in Infant Cases
The Lancaster County coroner, Dr. Stephen Diamantoni, disputed whether one infant death was caused by measles. A newborn died of a ruptured spleen, which Diamantoni said his forensic pathologist determined was not caused by the viral illness. A second death, in a six-week-old infant with a serious genetic condition called Amish lethal microcephaly, was attributed to measles, Diamantoni told CNN.
Following this week’s additional deaths, Shapiro again criticized Kennedy.
“This serious situation continues to be made worse by RFK Jr. playing games with public health and safety. It’s long past time for @SecKennedy to stop stoking vaccine skepticism and misinformation and compromising the serious mission of the nation’s public health agencies,” Shapiro posted on X. “It is also deeply concerning to learn that the Secretary personally intervened in an otherwise administrative process to direct the CDC to not report these Pennsylvania deaths, presumably because it doesn’t fit his phony narrative.”
Kennedy countered on X, stating Shapiro was politicizing the outbreak “instead of implementing a unified public health response. He continues to point the finger at me and the federal government and to malign the Amish while refusing the federal assistance that might help end the outbreak.”
Kennedy also denied directing the CDC to “suppress” Pennsylvania deaths, saying the agency “will report measles-caused deaths when the National Center for Health Statistics reports measles as the underlying cause based on death record information submitted by the states.”