On Tuesday, August 26, 2026, Pennsylvania announced the deaths of two unvaccinated Lancaster County residents, one a newborn, describing them as measles-associated. Health Secretary Debra Bogen said she “sadly can confirm” the two deaths. They were reported as the first measles deaths in Pennsylvania in 35 years.
There is a genuine classification dispute underneath the story, and it needs stating before the rest. The state health department reports deaths where measles is present as “measles-associated,” a category it says “may not be assessed by the medical examiner or coroner to be the immediate cause of death.” Lancaster County Coroner Stephen Diamantoni determined the newborn died shortly after birth from a laceration of the spleen, with measles antibodies present in postmortem testing; the forensic pathologist who performed the autopsy did not consider the death related to measles, the autopsy did not show an enlarged spleen, and the office is still investigating what caused the rupture.
So the question of whether these should be counted as measles deaths is contested on the record, and a health secretary challenging the classification would be defensible.
That is not what happened. Kennedy wrote on X that “the announcement appears to have been premature, and the deaths may even have been altogether fabricated by one of the Governor's hopeful staffers,” adding that officials “cannot find any measles deaths in Lancaster County” and claiming Shapiro was not cooperating with the CDC or the county.
An accusation that a named official's staff invented infant deaths is a fraud allegation. Kennedy offered no evidence for it, and the coroner's findings, which do complicate the classification, do not support a claim of fabrication.
Gov. Josh Shapiro said Kennedy was “spreading misinformation” about vaccine safety and urged him to stop.
The agency then acted on the secretary's public doubt. When the CDC published its next national measles count, the two Pennsylvania deaths were absent. The agency's measles page was updated twice, with the deaths appearing briefly before being replaced by a note saying they will not be included while the agency reviews additional information, and asserting that available data does not establish whether measles caused or contributed to them.
That departs from how the count normally works. State health departments, not the CDC, determine cases and deaths, and the CDC's practice has been to include what states report. A former CDC lead called the exclusion “highly unusual.”
Pennsylvania had confirmed both deaths, a newborn and a six-week-old infant, neither old enough to be vaccinated. They were the first U.S. measles deaths of 2026 and the first in Pennsylvania in 35 years. A postmortem test on the baby's lung tissue showed a measles infection acquired before birth. The effect of the exclusion is that the national tally the public and researchers rely on now omits two deaths the responsible state has confirmed, after the cabinet secretary suggested they were fabricated.
On September 3, 2026, Reuters reported who made the decision to take the deaths off the national tally. Citing three sources including a Pennsylvania official, it reported that Kennedy personally asked CDC Director Erica Schwartz to remove the reference to the two Pennsylvania deaths from the agency's online measles page, after questioning whether measles contributed to them. Schwartz agreed and implemented it without objection.
The sequence matters. According to the reporting, CDC staff had already accepted Pennsylvania's characterization of the deaths as measles-linked before Kennedy intervened. The CDC held its regular Friday measles update and published on Sunday instead, without the Pennsylvania fatalities, adding the note that “at this time, available information does not establish whether measles caused or contributed to the deaths.”
HHS disputes the account. A spokesperson called the Reuters report “false and misleading” and said CDC officials, not Kennedy or Schwartz, made the decision about the measles reporting.
The reporting is anonymously sourced and denied by the department, which is stated here rather than glossed. What is not in dispute is the outcome: as of early September the official United States measles death toll for 2026 stood at zero, in a year with roughly 3,000 recorded cases, and Pennsylvania's two deaths were not in it. (The CDC has since added two deaths; see the October 1 update.)
The record moved substantially in early September, and it did not move in one direction.
On Friday, September 4, 2026, Lancaster County Coroner Dr. Stephen Diamantoni ruled on both deaths, and he reached opposite conclusions. A girl born with Amish lethal microcephaly, a genetic condition that leaves infants with underdeveloped brains and typically kills them within about six months, died of measles at around six weeks old. “The condition is severe and predisposes those infants to respiratory infections that could ultimately lead to their death,” Diamantoni said. On the newborn, he did not change his finding: the cause was a laceration of the spleen, and his forensic pathologist “was quite adamant that it was not measles-related based on the size of the spleen, the lack of any inflammation, no fragility of the capsule around the spleen and the character of the laceration.”
So one death is now affirmatively attributed to measles by the county's own coroner, and one is not. Diamantoni also noted that “measles-associated,” the category Pennsylvania used, is not one his office recognizes; the state applies it when laboratory or epidemiologic evidence of measles is present while the official cause of death is still under investigation. The Atlantic interviewed the newborn's parents, who said the mother had a severe measles infection during the pregnancy and that she and the midwife believed measles killed the baby, and that no one had told them about the lacerated spleen.
Dr. Paul Offit of Children's Hospital of Philadelphia said the coroner made the right call on the six-week-old: “Even if the child had a condition that would have eventually proved fatal without the measles, she wouldn't have died when she did if not for the virus.” Offit also drew an inference from the arithmetic. Measles kills roughly 1 to 3 of every 1,000 people infected. Two infant deaths at a point when only about 400 infections had been reported suggests the true outbreak is far larger than the official count. “This outbreak is much bigger than people are claiming,” he said. Pennsylvania reported 577 cases as of September 4, every one of them in a person who had not received both recommended MMR doses.
What happened to the federal count is the part that turns a classification dispute into a data-integrity problem. On September 3, Reuters reported that Kennedy had asked for the two deaths to be removed from the CDC's public measles tracker, and that new CDC Director Dr. Erica Schwartz approved it. They were replaced with an asterisk. The agency's public position was that “available information does not establish whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles.”
Jeremy Faust, an emergency physician who publishes Inside Medicine, then found that the CDC's own internal system, the One CDC Data Platform used by state and local health officials, still counted both deaths as confirmed, even though the platform's documentation says its data “align with the data available on CDC's external web.” The agency was telling public health professionals one thing and the public another.
That gap was closed in the direction of the public number. Sometime on Friday, September 5, someone at the CDC's National Center for Immunization and Respiratory Diseases changed the internal site to match the public one. Both now show zero measles deaths for 2026. The asterisk was rewritten to read: “The National Center for Health Statistics (NCHS) does not currently have any death records from 2026 that indicate measles is the underlying cause.” Faust's assessment: “It is bad enough that the public was being misled about these deaths. Now, public health professionals with access to the CDC's internal system are being showed censored information, too.”
Kennedy's original claim, that the deaths “may even have been altogether fabricated,” remains unsupported by anything in this record. A coroner has now confirmed one of them (see The Worst U.S. Measles Year Since 1991, and an Elimination Status Now Under Review and Trump Fires CDC Director Monarez After She Declines Kennedy's Vaccine Demands, and Three Top Officials Quit in Protest).
The change was then made formal. According to a note published on the CDC's website on September 4 and reported by the Guardian, the agency now counts measles deaths using death-certificate data from the National Center for Health Statistics rather than its National Notifiable Diseases Surveillance System, which carries case reports from states. “CDC will report measles deaths if and when the National Center for Health Statistics reports measles as the underlying cause of death,” HHS spokesperson Emily Hilliard said. Debra Houry, a former CDC chief medical officer, called the move “puzzling.” The CDC's page says it is working with the Council of State and Territorial Epidemiologists “to develop a standardized case definition for deaths due to measles.”
On September 12, a 40-year-old woman in Jefferson County, Pennsylvania, died of probable measles, according to county coroner Greg Furlong; the Guardian reported she was unvaccinated and had underlying conditions. “I strongly 100% believe if this wouldn't have come into her life that she would be alive today,” Furlong said. Hilliard said “CDC's recommendation for the MMR vaccine has remained unchanged.”
On September 15, Pennsylvania announced a fourth measles-associated death: an unvaccinated 18-year-old in Mifflin County who died of acute disseminated encephalomyelitis, a rare neurological complication of measles. CNN reported it is the first year with four U.S. measles deaths since 1992. Pennsylvania has reported 693 cases in its outbreak. NBC News reported the CDC had not yet confirmed any of the deaths. Gov. Josh Shapiro said, “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 called that false, and CNN reported his position that the CDC “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.”
On September 16, Sen. Bill Cassidy (R-LA), who chairs the Senate health committee and voted to confirm Kennedy, opened a hearing by saying, “Now we have people dying from measles. That's going to be a terrible legacy for this administration.” He said, “Misinformation and misguided policies are leaving children and adults unprotected against disease that we know how to prevent,” and, on the CDC's count, “If people are dying from measles, the American people should know that.” HHS spokeswoman Emily Hilliard said “any notion that the Trump Administration is discouraging measles vaccination is absolutely fake news.”
Correction (September 15, 2026): an earlier version of this entry described Pennsylvania's first two measles deaths as an adult and an infant. They were a newborn and a six-week-old infant.
Update (September 17, 2026): Pennsylvania made its request for federal help conditional on the CDC acknowledging the deaths. Health Secretary Debra Bogen wrote to CDC Director Erica Schwartz on the evening of September 16 beginning the process of requesting an Epi-Aid, the agency's short-term emergency epidemiological assistance, while stating the state would withdraw the request if the agency would not publish the four measles-associated deaths it has reported.
“The CDC's choice not to publicly recognize the deaths undermines our response,” Bogen wrote. “For this reason, if CDC is unable to transparently and accurately communicate information about those measles-associated deaths, the Department will respectfully rescind our request for a CDC Epi-Aid.” She added that “While our professional teams have collaborated well on the measles outbreak response, including the identification and reporting of four measles-associated deaths, CDC's public communication about the deaths has not been reflective of our close collaboration.”
The CDC answered the next day: “CDC will not submit to political blackmail that conditions critical public health assistance. The people of Pennsylvania should never be used as leverage in a political dispute over how deaths are classified.” HHS press secretary Grace Davis Jamison said the agency “will not allow” Gov. Josh Shapiro “to politicize this process.”
As of September 16, Pennsylvania reported 731 cases, 117 of them in the previous week, just over 140 hospitalizations and four deaths. The CDC's dashboard carries an asterisk saying available information “does not establish whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles.”
Demetre Daskalakis, who ran the CDC's National Center for Immunization and Respiratory Diseases, said the agency's move to relitigate death-certificate data is unusual: “Generally, they are cleaning data to make sure it's coming in as quality data. They're not litigating the decisions on a death certificate. This relitigation is highly atypical.” He said he worries “the goal of the secretary is to say that measles doesn't kill anyone. And that's not true, but when you own the keys to the kingdom.”
The classification dispute remains genuinely contested, as this entry has noted throughout.
Update (October 1, 2026): The federal count has moved, but it still trails the state's. The CDC added its first 2026 measles death to its online tracker in late September, The Hill reported, without saying where or when it occurred, and on September 29 it confirmed a second, The Detroit News reported. The agency has not said which states the deaths were in. Its dashboard says the number “is subject to change; CDC will update its reporting as additional information becomes available and relevant reviews are completed.” The Hill also reported that earlier in September Kennedy acknowledged that measles caused the death of an infant in Pennsylvania after the Lancaster County coroner confirmed the cause, while accusing Shapiro of having “politicized” the deaths.
Pennsylvania's count kept rising. On September 30 the state Department of Health reported a fifth measles-associated death, an unvaccinated Lancaster County resident, with 943 cumulative cases across 39 counties and 176 hospitalizations since the outbreak began in April. The department said more than 53,000 MMR doses were given statewide in September, more than double a typical month. CNN noted that 1991 was the last year the United States recorded more than four measles deaths. HHS press secretary Emily Hilliard told CNN that “Secretary Kennedy and CDC Director Dr. Erica Schwartz continue to recommend the MMR vaccine as the most effective way to prevent measles infection,” and that the CDC “stands ready” to deploy epidemiologists if Pennsylvania formally requests an Epi-Aid. Nationally, the CDC counted 3,659 cases as of September 24.
Update (October 13, 2026): on October 12 the Franklin County coroner reported the death of an unvaccinated 39-year-old woman with underlying conditions, saying it “meets the definition set forth by the Pennsylvania Department of Health for a measles-associated death,” which would be the state's sixth, CIDRAP reported. The state health department said it is “conducting a thorough review of the reported death”; its dashboard, last updated October 9, showed five measles-associated deaths and 1,136 cases. The CDC's national page, as of October 8, listed two U.S. measles deaths in 2026, reflecting its policy of counting only deaths where the death certificate lists measles as the underlying cause.
Update (October 18, 2026): Pennsylvania formally requested CDC field help on October 7, the Philadelphia Inquirer reported, and on October 15 the CDC said it would send an officer from its Epidemic Intelligence Service and release nearly $4 million for the response, NBC News reported; the CDC has previously sent such teams to other states with large measles clusters, including Kansas, New Mexico, South Carolina, Texas, Virginia and Wisconsin. Kennedy said, “I am confident I will bring that outbreak to a quick close.” Pennsylvania's health secretary wrote on October 16, “By not acknowledging the deaths, the CDC obscures the seriousness of this disease.” The state counted more than 1,200 cases and five confirmed deaths, with a sixth under review; the CDC's national count was 4,410 cases, CIDRAP reported, and it still lists two U.S. measles deaths in 2026.