Dr. Ralph Abraham, pictured in December 2023 at the University of Louisiana’s Monroe Library, was named deputy director of the U.S. Centers for Disease Control and Prevention in November 2025. (Photo by Julie O’Donoghue/Louisiana Illuminator)
After a year of ongoing measles epidemics, which affected more than 2,400 peopleThe United States may lose its measles-free status. But the newly appointed principal deputy director at the Centers for Disease Control and Prevention, Ralph Abraham, said in a briefing to reporters that he was not concerned about that prospect.
“It’s just the cost of doing business because our borders are a bit porous for global and international travel,” Abraham said. “We have communities that choose not to vaccinate. That is their personal freedom.”
However, only infections from other countries were included about 10% measles cases detected since January 20, 2025, the official start of the deadly measles outbreak in West Texas that spread to other states and Mexico. The rest was purchased in the country. This marks a change since the United States eliminated measles in 2000. Measles has occasionally appeared in the U.S. from people infected abroad, but these cases rarely caused outbreaks because of extremely high vaccination rates. Two doses of the measles, mumps and rubella vaccine strongly prevent infection and stop the spread of the virus.
To maintain measles elimination status, the United States must prove that the virus was not circulating in the country continuously for one year, between January 20, 2025 and January 20, 2026. To answer the question, scientists are investigating whether the major outbreaks in South Carolina, Utah, Arizona and Texas are related.
Health officials have confirmed that the main strain of measles virus in each of these outbreaks is D8-9171. But because the strain also occurs in Canada and Mexico, CDC scientists are now analyzing the entire genomes of measles viruses – about 16,000 genetic letters long – to see whether viruses found in the United States are more closely related to each other than viruses from other countries.
The CDC expects to complete the study within a few months and make the data public. Then the Pan American Health Organization, which oversees the Americas in cooperation with the World Health Organization, will decide whether the United States will lose its measles-free status. And that would mean it pricey, potentially fatal, and preventable measles outbreaks may become common again.
“When you hear someone like Abraham talk about the ‘cost of doing business,’ how could you be more callous,” said pediatrician and vaccine specialist Paul Offit in discussion on the Internet run by a health blog Inside Medicine January 20. “Last year, three people died of measles in this country,” Offit added. “We eliminated this virus in the year 2000 – we eliminated it. We eliminated the spread of the most contagious infection in humans. That was a reason to be proud.”
Abraham said vaccination remains the most effective method of preventing measles, but parents must have the freedom to decide whether to vaccinate their children. Since 2020, several states have loosened school vaccine requirements and vaccination rates fell. A record number of preschoolers, constituting approx 138,000 children, have been granted vaccine exemptions for the 2024–25 school year.
Information about vaccines was blacked out by Secretary of Health and Human Services Robert F. Kennedy Jr., who previously founded an anti-vaccine organization. Throughout his term, he questioned the effectiveness of vaccines. On national television, he repeated scientifically debunked rumors that vaccines may cause autism, brain swelling and death.
Jennifer Nuzzo, director of the Pandemic Center at Brown University, criticized the Trump administration’s focus on finding technical genetic details that could spare the country’s measles-free status. “This is the wrong thing to be paying attention to. We need to focus on containing the epidemic,” she said.
“If we maintain our status, it should be the result of stopping the spread of measles,” she said. “It’s like they’re trying to be graded on a curve.”
Trump administration hampered the CDC’s operation to facilitate West Texas in the critical first weeks of its outbreak and slowed down the release from federal emergency funds, according to a KFF Health News investigation. But the agency stepped up its work last year, providing local health departments with measles vaccines, communications materials and tests. Abraham said HHS will provide $1.5 million to South Carolina in response to the outbreak, which began nearly four months ago and has reached 646 cases as of Jan. 20.
If CDC genomic analyzes show that last year’s outbreaks resulted from a separate introduction of the virus from abroad, political appointees will likely credit Kennedy with saving the country’s status, said Demetre Daskalakis, former director of the CDC’s national vaccination center, who resigned in August in protest of Kennedy’s actions.
And if studies show that the disease outbreaks are linked, Daskalakis predicts, the administration will cast doubt on the findings and downplay the reversal in the country’s status: “They’ll say who cares.”
Indeed, at the briefing Abraham said: Reporter Stat that the reversal of the nation’s status would not be significant: “Losing elimination status does not mean that measles will be common.”
The data shows otherwise. The number of cases last year was the highest since 1991, before the government introduced its vaccination policy to ensure all children are protected by vaccination against measles.
Lauren Sausser contributed reporting.
This article appeared for the first time KFF Health News and is republished here under a Creative Commons Attribution-NoDerivs 4.0 International License. KFF Health News is a nationwide newsroom dealing with broadly understood journalism about health issues and is one of the main operational programs of KFF – an independent source of research, surveys and journalism in the field of health policy. Find out more about KFF. Subscribe to the free morning KFF Health News briefing.
This story was originally produced by Highlighter from Louisianawhich is part of States Newsroom, a nonprofit news network that includes the Ohio Capital Journal and is supported by grants and a coalition of donors as a 501c(3) public charity.
