The United States crossed the 5,000 measles threshold in 2026, the first since 1991. The review published on 6 November by the Centers for Disease Control and Prevention, CDC, reached 5,182 confirmed cases as of 5 November. Several deaths have been reported. This resurgence puts Robert F. Kennedy Jr., Secretary of Health, in front of a overwhelming political record: fragile prevention, shuffled expertise and recommendations that have become a judicial battlefield.
Criticism, however, requires an essential distinction. The decline in immunization began before its arrival in the government in February 2025. The figures available do not allow each contamination or death to be attributed to a Kennedy decision. On the other hand, they make it possible to judge its response to a known threat. The federal health officer had to restore confidence and strengthen collective protection. His choices increased the number of breaches with the institutions responsible for this mission.
Rougeole in the United States: a record and several deaths
The new total far exceeds the 2,289 cases recorded throughout 2025. The historical comparison is accurate: the country recorded 9,643 cases in 1991. The level of 2026 is the highest since that year, not an absolute record. The United States reported measles elimination in 2000. This qualification refers to the interruption of endemic transmission, not the permanent disappearance of the virus.
Human performance requires more precautions than an isolated figure. The federal CDC table shows four deaths for 2026, a provisional total that could be reviewed. Local ads are higher. On November 4, Pennsylvania’s Department of Health confirmed a sixth measles-related death in Pennsylvania. On November 2, New York health authorities announced the death of a child in Lewis County.
Wisconsin then announced the death of an infant on 5 November. His department of health stated that the medical examiner had retained measles as an immediate cause. These announcements should not be added to the federal total, which may already include some. However, they show that talking about one death would be false. CDCs report working on a harmonized definition of disease-related deaths to improve reporting consistency.
The problem goes beyond statistics. A preventable infection regains a significant spread capacity in the country, which has made its elimination a health success. Children too young to be vaccinated and some immunocompromised people are particularly dependent on the protection of their environment. For them, the weakening of this protection is not an abstract debate.
Already eroded vaccination coverage
School data show an old deterioration. Coverage by the combined measles, mumps and rubella vaccine, called ROR in French and MMR in the United States, reached 95.2% at kindergarten entry in 2019-2020. It dropped to 92.4% in 2025-2026. The national average masks much less protected communities. A virus introduced into these groups can circulate quickly.
The CDC also recall the increasing global circulation of measles. Travel promotes introductions, while under-vaccination pockets make large outbreaks possible. This finding prohibits an explanation entirely centred on one man. States, care systems and access barriers to vaccines also have their share in the situation.
He doesn’t exonerate Kennedy. A health policy also finds itself able to correct an unfavourable trend. In the face of insufficient coverage, federal responsibility is to provide understandable means, information and recommendations. However, several decisions taken since 2025 have placed the health authorities in a series of conflicts, revisions and appeals.
Eviction of 17 experts from ACIP
June 9, 2025 was a major breakdown. Kennedy has 17 members of the Advisory Committee on Vaccine Practices, ACIP, ousted. This body advises the CDC on the safety, efficacy and use of vaccines. The department announces their full replacement, in the name of restoring confidence and fighting conflicts of interest.
These arguments must be presented for what they are: the political justification of the secretary. They do not demonstrate that each of the excluded experts was compromised. An administration may control declarations of interest and modify a procedure. Simultaneously replacing an entire expert committee is a choice of another magnitude.
The result was a crisis of institutional legitimacy. On March 16, 2026, federal judge Brian Murphy suspended the appointments of 13 members of the recomposed committee and the votes of this new body. It considered that challenges to its composition and certain procedures were likely to succeed. This is a provisional decision, not a final decision on the whole health policy.
The coalition of medical societies at the origin of the appeal, including the American Academy of Pediatrics, denounces a disorganization of practices and an erosion of trust. This opposition is therefore not limited to partisan quarrel. It concerns the way in which medical recommendations are developed and the place left to expertise.
Amended and then suspended recommendations
On 27 May 2025 Kennedy had already announced the withdrawal of the Covid-19 vaccination recommendation for pregnant women and healthy children. The American Academy of Pediatrics had challenged this decision and its process. For children, the translation into the calendar was the use of a shared clinical decision. This was not a ban on the vaccine.
A new stage took place on 16 December 2025. CDCs adopt an individualized decision for vaccination against hepatitis B at birth in infants whose mothers have been tested negative. The provisions concerning positive mothers or mothers of unknown status remain separate. The department emphasizes parental choice and individual risk assessment.
On January 5, 2026, the federal calendar was then revised under the direction of Jim O的Neill, then acting Director of the CDC. Supported by Kennedy and following a presidential directive, the reform limits universal recommendations to 11 diseases. Other vaccinations are referred to populations at risk or to a shared decision. The government promises to maintain access and coverage.
Measles remains in the universal recommendations. It would therefore be incorrect to claim that Kennedy had deleted the ROR recommendation. The criticism relates to the general instability of the system and the method used. A policy of prevention must remain legible for both families and professionals.
The judgment of 16 March also suspends the January memorandum. The votes of the recomposed committee, including the one on hepatitis B, are affected by this suspension. As of November 6, the paediatric calendar published by the CDC remains updated on July 2, 2025. It displays a first dose against hepatitis B at birth. Not all the reforms announced have therefore become long-term rules.
ROR vaccine placed under suspicion again
On August 10, 2026, Donald Trump signed a new decree on paediatric vaccine recommendations. The text maintains measles as one of the diseases against which all children must be protected. But when these products are available in the United States, he recommends replacing the ROR combined vaccine with three separate injections. It also recommends, as far as possible, separate appointments for all paediatric vaccinations.
The decree also reaffirms the universal recommendations limited to eleven diseases, while the CDC continues to publish its paediatric calendar of July 2025. The presidential orientation and the clinical calendar should therefore be distinguished.
This decision belongs to the president, not Kennedy alone. However, she entrusts the Secretary of Health with the preparation of new options. The decree also guarantees the availability of combined vaccines. It therefore does not mean that they have already been withdrawn.
Scientific contrast is important. The CDC indicates that no published scientific evidence shows any benefit in separating the three components of the ORR. In an undervaccinated population, suggesting a preference for products still unavailable poses an immediate communication problem. The message can divert attention from the existing tool, whose effectiveness against measles reaches approximately 97% after two doses.
Nearly $500 million of affected mRNA projects
On August 5, 2025, the HHS announced a shutdown or reduction of 22 investments in messenger RNA vaccines for nearly $500 million. The decision concerns the BARDA agency, which is responsible in particular for developing means of responding to health threats. Contracts are terminated, some areas are reduced and several calls for projects are abandoned.
Kennedy explains that he wants to move the means to other platforms, which he presents as safer and more efficient. The press release allows some very advanced contracts to be completed. It also states that other uses of mRNA within the Ministry are not affected. It would therefore be wrong to talk about a general ban on this research.
The choice remains heavy: closing projects reduces the ways explored to prepare future vaccines. The criticism here is about research and preparedness capacity, not a direct cause of the current epidemic. The ORR vaccine is not a messenger RNA vaccine. Consolidating the two technologies would weaken the scientific requirement against Kennedy.
Reduce administration during a prevention crisis
On 27 March 2025, HHS submitted a reorganization plan for approximately 10,000 additional positions. By integrating voluntary departures and early retirements, the target was to increase from 82,000 to 62,000 staff. The department was also expected to consolidate 28 divisions into 15 and divide by two regional offices.
Kennedy promised $1.8 billion in annual savings without compromising essential services. This promise is not enough to demonstrate the health neutrality of such a broad restructuring. On the other hand, the figures announced should not be presented as permanent redundancies. Litigation and amendments affected the implementation of the plan.
Another confrontation involved nearly $11 billion in health funding for States. Twenty-four Attorneys General challenged their withdrawal in the spring of 2025. They obtained a preliminary injunction on 16 May. These funds cannot therefore be described as fully and definitively abolished.
The attempt remains part of the balance sheet. According to the complainant States, the funds supported, inter alia, disease surveillance, vaccination and health response capacity. Removing such means suddenly exposes local governments to a break in continuity. The use of courts has slowed down this operation, without removing the uncertainty created for the services concerned.
A federal response exists, but does not resolve the contradiction
It would also be incorrect to say that Washington did nothing against measles. The Congressional Research Service reported that, in September 2026, the CDC had provided an additional $50 million to respond to outbreaks. The Agency also provides epidemiological support, laboratory capacity and immunization resources. Local authorities remain on the front line.
These measures must be included in the balance sheet. They do not remove the contradiction between operational support to territories and decisions that have destabilized vaccine expertise. The restoration of trust, invoked by Kennedy, presupposes that families can distinguish a medical recommendation from political change. Successive reorganizations and judicial suspensions have made this exercise more difficult.
The massive return of measles alone does not constitute causal evidence against the secretary. However, it makes its priorities questionable and its obligation to achieve results more pressing. The magnitude of the outbreaks requires that the economies announced be judged on the basis of the truly preserved capabilities, and the promises of freedom of choice for the most vulnerable.
On the ground, the answer remains concrete. In Pennsylvania, professionals administered more than 61,000 doses of ORR in October, compared to about 25,000 in the usual month. The state is continuing its outreach campaigns while the CDCs still need to update and harmonize their death record. It is this increase in effective protection, rather than breaking announcements, that will measure the aftermath of the crisis.
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