PENNSYLVANIA — The Centers for Disease Control and Prevention is excluding two measles-associated deaths reported by Pennsylvania from its national count, citing insufficient evidence that the virus caused or contributed to the fatalities. The agency delayed its weekly measles update to keep the national death tally at zero while it reviews additional information regarding the circumstances of the cases.

Pennsylvania Governor Josh Shapiro announced the two measles-associated deaths on August 28, marking the first such fatalities in the state in 35 years. The CDC stated that available information does not establish whether measles caused the deaths or whether the individuals died from other causes while infected with the virus.

The CDC measles landing page was updated twice on Sunday, first reporting the two deaths and then replacing them with an asterisk. This action diverges from standard procedure, as states usually notify the CDC of reportable cases such as measles without federal review or adjudication unless a state requests additional assistance.

Robert F. Kennedy Jr. the US Secretary of Health and Human Services, questioned the validity of the reports during an interview. "We're trying to figure out.. who are those deaths, whether they actually happened we can't figure that out yet," Kennedy said.

Shapiro accused Kennedy of going down a rabbit hole of conspiracy theories and false claims. The governor stated there has been regular communication with the CDC and other federal agencies. Shapiro added that Pennsylvania has received the support needed from the federal government.

The Pennsylvania Department of Health reported a total of 497 measles cases in the state. At least one of the Pennsylvania measles deaths was a newborn who died soon after birth. The Lancaster County coroner said a case referred to his office involved a newborn who died shortly after birth and tested positive for measles.

The newborn was born with a pulse but was not breathing. Paramedics were unable to resuscitate the newborn. The mother said she was unable to get vaccinated because she was pregnant. The father of the deceased newborn said he received a voicemail asking him to get in touch with Kennedy.

The father said he had not responded to the voicemail from Kennedy. In 2021, Kennedy praised the Amish of Lancaster County for not vaccinating their children. Kennedy was the leader of the anti-vaccine organization Children’s Health Defense in 2021. The Amish do not have any formal religious objection to vaccines, but they are frequently disconnected from the healthcare system.

Debra Houry, former chief medical officer of the CDC, criticized the federal response in an interview. "This is highly unusual," Houry said. She noted that the "CDC and states usually work collaboratively together." "This will undermine that relationship," she said.

Houry added that the communication coming from the CDC’s official channel on Friday was political and not focused on what should be done during an outbreak. An HHS spokesperson stated via X that the agency is "working to determine what actually occurred". Shapiro stated the measles situation in Pennsylvania has gotten much worse since his comments on Tuesday.

The CDC included the measles deaths reported by Texas and New Mexico in its national tally. There were three deaths associated with measles in the US last year, which were the first from the virus in a decade. The US has recently fallen below the threshold to keep measles outbreaks in check. Measles cases were reported in Montgomery, Berks, and Northampton counties in Pennsylvania, with fifty cases in Chester County.

Timeline

Pennsylvania Governor Shapiro announced two measles-associated deaths on August 28.

What's New

The Pennsylvania Department of Health states that there were two recent measles-associated deaths in Lancaster County, and that the term 'measles-associated' is used when laboratory or epidemiologic evidence of measles is present, but the disease may not be assessed by the medical certifier or coroner to be the immediate cause of death.

Kennedy accused Pennsylvania Governor Shapiro of fearmongering. Kennedy claimed Pennsylvania was not cooperating as federal officials sought information about the deaths.

The two measles-associated deaths in Pennsylvania are directly affected, but no specific number of people impacted beyond the deceased individuals is provided.

Why It Matters

The exclusion of these deaths affects the national measles mortality statistics and the public health response. The CDC requires stronger evidence to classify deaths as measles-caused for national counts, distinguishing between association and causation. This distinction impacts how the scale of the outbreak is perceived federally compared to state-level reporting.

The disagreement shows a shift in the relationship between federal health agencies and state governments. Usually, states notify the CDC of reportable cases, and the agency does not review or adjudicate these cases unless asked. The current dispute over verification processes and the public questioning of state-reported data represents a departure from established collaborative norms.