Measles cases this year have surpassed all of 2025 to become the worst since the disease was declared eliminated in 2000, with cases now in 44 states and the District of Columbia, according to a federal report released Friday.
There were 2,318 confirmed cases as of July 23, compared with 2,289 in all of 2025, with 93% of cases for both years being among unvaccinated people, mostly younger than 20.
There have been fewer hospitalizations this year, 151 compared with 243 last year, and no deaths yet, compared with three in 2025. The highest number of new cases was in mid-January 2026, when there were almost 300 new cases.
The largest number of current cases are in South Carolina (670), Utah (522), Texas (188), Virginia (176) and Pennsylvania (134). Except for Virginia, all those states have childhood vaccination rates below the 95% level considered necessary to prevent outbreaks among unvaccinated people as of the 2024-25 school year.
Virginia’s statewide rate was 95.6%, but the measles outbreak was in two rural counties west of Richmond where measles vaccination rates are less than 75%.
The last time national cases were higher than 2025 and 2026 was in the 1990s as national vaccinations were still ramping up, with 9,643 cases in 1991 and almost 28,000 in 1990.
Most states now have childhood vaccination rates below the 95% level considered necessary to prevent outbreaks among unvaccinated people, including people who choose not to be vaccinated and small children too young for the shots.
Oklahoma has a low childhood vaccination rate of 88.7% and saw 20 cases last year, but only one so far this year. A foundation has sent a mobile health van around the state to vaccinate thousands of children.
Delaware declared a new outbreak this week. The state’s first measles cases in a decade climbed to five cases in a few days. The state’s child vaccination rate is 94.1%.
“High vaccination coverage has protected even the unvaccinated and undervaccinated because of herd protection, keeping measles at bay for the past few decades,” said Dr. William Moss, director of the International Vaccine Access Center at Johns Hopkins University, in a published statement.
“But in communities with pockets of susceptible individuals across a broad age range, measles has been able to take hold, infecting those who are susceptible and spreading rapidly,” he said.
The center used its own measles tracker to declare more cases in 2026 than last year as of July 21.
The Pan American Health Organization is scheduled to review the U.S. measles status in November and consider revoking “elimination” status as it did for Canada last year.
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