Inquirer.com – Zurich DR

Tag: Measles

A 20-year-old Amish woman with leukemia got measles and died in Pa.’s largest outbreak in three decades

The headstone had not yet been placed Thursday on the freshly dug grave where a 20-year-old Amish woman was buried this week amid the rolling clover fields and dairy farms at the edge of suburban Philadelphia.

Newly wed, and receiving treatment for blood cancer, she was the last of nine siblings sickened when measles swept through her unvaccinated family’s home on a one-lane road in Lancaster County.

At first, the home remedies that eased their symptoms seemed to help her, too: Soothing the fever with bath soaks. Calming the rash with coconut or olive oil. Cloistering in a dark room to ease light sensitivity.

Then her fever spiked. She struggled to breathe and had to sleep sitting up in a recliner in the living room, her maternal grandmother recalled.

Her family does not operate cars, in keeping with Amish beliefs, so they hired a driver to take her to the emergency department at Hershey Medical Center about an hour away. She died about two weeks later in the intensive care unit there, her grandmother said.

Speaking on the porch of her stone farmhouse, the grandmother described the family’s experience with Pennsylvania’s largest measles outbreak in three decades, now the nation’s largest. At her request, The Inquirer withheld her name and that of her deceased granddaughter to protect the family’s privacy.

She said her granddaughter ultimately developed double pneumonia and died after the family decided to discontinue use of a ventilator.

The cancer made her especially vulnerable to a virus as contagious as measles, which will infect 9 in 10 unvaccinated people who are exposed.

“Her immune system wasn’t built up,” the grandmother said. “She just couldn’t take it with the measles.”

The Lancaster County borough where a 20-year-old Amish young woman died from pneumonia caused by measles is dotted with diary farms and grain silos.Wendy Ruderman

Pennsylvania reported on Wednesday its fifth measles-related death, revealing only that the latest fatality was an unvaccinated Lancaster County resident. Health officials did not provide further details, citing privacy laws.

But it appears from the grandmother’s account, along with other records and news reports, that three of the five deaths occurred in adults with measles. Other reported deaths included an 18-year-old Amish woman from Mifflin County and a 40-year-old from Jefferson County with severe respiratory conditions. Two Amish infants in Lancaster County who had confirmed measles cases also died. All five cases involved people who were unvaccinated, either by choice or because they were too young to receive vaccines.

The number of deaths in adults is striking, said Paul Offit, who heads the Vaccine Education Center at the Children’s Hospital of Philadelphia. Widespread childhood vaccinations had eradicated the disease in the United States, leaving mostly children too young to be vaccinated at high risk in recent decades. Now multiple generations of unvaccinated children are adults, exposing wider vulnerabilities across the state, Offit said.

“We’re aging out a population that was never vaccinated,” he said.

After learning the details of the 20-year-old’s death from The Inquirer, Offit explained that measles commonly leads to pneumonia.

“The measles virus reproduces itself in the lungs and can cause severe and occasionally fatal infection,” he said.

The Amish cemetery where the 20-year-old woman is buried.Wendy Ruderman

Too late to get vaccinated

The young woman, the second oldest in a line of nine siblings, ages 6 to 22, feared getting measles in the outbreak in Lancaster County, her grandmother said.

About two years ago, she was diagnosed with leukemia, a blood cancer, and began medical treatment with the help of an “English” neighbor — as Amish call outsiders — to drive her to her medical appointments.

The treatment regimen of chemo and steroids further weakened her immune system. She knew she was at risk of more severe sickness from a viral infection like measles, which started spreading throughout her family in the late summer.

Her eight siblings, her parents, and her new husband all got sick, the grandmother said.

Along with home remedies, family members drank extra fluids to stay hydrated, the grandmother said.

“They weren’t worried,” the grandmother said. “Measles just has to take its course.”

Although no one in the household was vaccinated, they are not opposed to the vaccine based on Amish beliefs. They believe it’s an individual choice, she said, and many Amish people opt not to get vaccinated because they “don’t know what’s in it.”

“We wouldn’t tell people not to get vaccinated,” the grandmother said. “It’s up to each person.”

As illness spread in her household, her granddaughter grew more worried about getting the virus than about the vaccine that medical authorities have long considered safe and effective.

She asked her doctor if she could get a measles vaccination. Her doctor said no. “She wasn’t allowed to get the shot because she was on chemo,” the grandmother said.

The measles vaccine contains a live but weakened virus, and her granddaughter was already immunocompromised from the leukemia treatment.

After getting measles, her granddaughter began to feel better in early September. She picked vegetables from the family’s garden to make soup using tomato juice as the broth. She canned jars for the coming cold months, her grandmother said.

“She had good days,” the grandmother said.

Read more: A Pa. coroner doubted a measles-linked death, sparking anti-vaccine outcry. Records show the state tried to reach him.

Then, in mid-September, she spiked a high fever, and her breathing became labored.

“She could hardly breath. Her lungs were just in bad shape,” she said.

The Amish typically only seek emergency hospital treatment until “sometimes we’re dying,” the grandmother said, recalling how her husband got chided by a doctor in 2018 for waiting too long to get the heart surgery he desperately needed.

“We do what we can at home,” she said. “We have so many natural things we can do.”

By Sept. 11, the family knew it was time to take her granddaughter for emergency care at Hershey Medical Center.

At Hershey’s ER, doctors gave her a chest X-Ray, but sent her home before reading it, the grandmother said.

“They wouldn’t do anything for her. They didn’t want her there,” she said. (A Hershey spokesperson did not reply to a request for comment on Friday.)

A Hershey provider later called and left a voicemail message asking the family to bring her back. Although the family has a phone in their house, the grandmother said they rarely use it. With the ringer off, all calls go to voicemail, she said.

A driver took them back to the hospital, where she was admitted on Sept. 14. An ultrasound showed fluid between the lining of her lungs and in her lungs. She was diagnosed with double pneumonia, her grandmother said.

Hospital staff hooked her up to supplemental oxygen.

“They had the oxygen up as far as they could and she still had to work to breathe,” the grandmother said.

About a week later, they moved her to the intensive care unit, where they sedated her so they could put her on a ventilator while intubated.

The hospital allowed two family members at a time to sit by her bed. Her granddaughter’s young husband and the girl’s mother sat vigil, the grandmother said.

As she continued to deteriorate, life support was the only remaining option, and it carried the risk of neurological complications, including brain death.

The family didn’t want that, the grandmother said. “They couldn’t do anything more,” she said.

They turned off the oxygen and shut off the ventilator, Family members, including her new husband’s parents, gathered around her bed.

She died with a breathing tube still in her mouth, the grandmother said.

A happy first year of marriage

More than 300 people came to the family’s home on Monday for the funeral service and viewing. She was buried in a cemetery near the family’s home, about a month before what would have been her first wedding anniversary.

Despite being ill with leukemia, her granddaughter’s trademark “rosy pink cheeks” and “beautiful smile” beamed on her wedding day, her grandmother recalled.

The November 2025 wedding, held at the family home, was a festive affair, with plates loaded up with chicken and vegetables, chicken and filling, pickled cabbage, and cooked celery.

She feels sorry for her granddaughter’s husband, who declined to be interviewed. “They had a good year together,” she said.

At the young woman’s home, two black dogs, with hay in their matted curly hair, greeted an Inquirer reporter on Thursday. Some of her family members were outside, unloading cornstalks from a horse-drawn wagon and feeding them into a John Deere harvesting machine.

They stopped working and spoke to one another in Pennsylvania Dutch, a centuries-old German dialect, before fetching the young woman’s father, who declined to be interviewed.

Staff writers Aubrey Whelan and Sarah Gantz contributed to this article.

October 2, 2026
A Pa. coroner doubted a measles-linked death, sparking anti-vaccine outcry. Records show the state tried to reach him.

Over five days in August, Pennsylvania health officials called the Lancaster County Coroner’s Office at least three times and sent an email asking to discuss the death of an infant who had tested positive for measles.

They did not connect with coroner Stephen Diamantoni before Gov. Josh Shapiro came to the county to announce at an Aug. 25 news conference that two unvaccinated Lancaster residents had died in a growing measles outbreak, the state’s first measles-associated deaths in 35 years.

Soon after, the county coroner — an elected Republican who has presided over the office for nearly two decades — was telling reporters the state had not talked to him directly, raising questions about the state’s communications.

His comments, coupled with his position that he did not believe one of the two infants affected had died from measles, kicked off a viral exchange of misinformation cited by anti-vaccine activists — and spiraling up to federal health leaders — to discredit the dangers of Pennsylvania’s growing measles outbreak.

Now emails from the coroner’s office, obtained by The Inquirer through an open-records request, show that state officials made significant outreach to Diamantoni, far beyond his prior statements acknowledging only that his deputy spoke with state officials shortly before the news conference.

In fact, doctors from the state health department had tried to contact his office about the case for days, with increasing urgency. At one point, a doctor told one of Diamantoni’s staffers that they were ready “24/7” to speak with someone from the office.

Yet two weeks after the announcement, he continued to emphasize the state’s lacking communication in an in-person interview with The Inquirer. “I have not received any information directly from the state [health] department,” he said on Sept. 9.

By then, his statements had enabled President Donald Trump’s health secretary, Robert F. Kennedy Jr., to question whether the deaths reported in Pennsylvania were real.

The Centers for Disease Control and Prevention for weeks omitted the first two deaths and those subsequently reported by the state in its national reporting, marking an extraordinary departure from public health norms. As of Thursday, the agency had updated its tally to recognize two deaths nationally this year, while Pennsylvania has reported five measles-related deaths.

Lancaster County coroner Stephen Diamantoni poses for a photo in his office in September.Gillian McGoldrick

Asked to comment on the records, Diamantoni said he was not aware of the state’s outreach ahead of Shapiro’s announcement.

He said state officials should have been more explicit in the calls they made to his office staffers, who sent him and his deputy emails relaying messages. The communications did not make it clear that they needed to speak to him about a measles-associated death, Diamantoni said, adding that he is easy to reach.

“It didn’t sound like there was urgency. It didn’t sound like anyone indicated that there was a measles death that we want to talk to the coroner about,” he said.

Public officers like Diamantoni have an obligation to ensure staff can get timely messages to him, especially in a public health emergency like a measles outbreak, said Kathleen Hall Jamieson, director emerita of the Annenberg Public Policy Center at the University of Pennsylvania. Likewise, she noted, state officials must ensure communications with the public are transparent and easy to understand.

State officials did not immediately say how they define a “measles-associated death” and have provided few details on the deaths themselves, leaving county coroners to fill in the blanks.

Public health experts have noted that the politically charged back-and-forth and competing narratives around the deaths risks confusing the public at a time when clarity is crucial — amid the largest measles outbreak in the country, with state officials reporting nearly 1,000 cases and five measles-associated deaths.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

The contradictory communications from the state and the local coroner’s office around the initial Lancaster deaths set the stage for Kennedy to attack Shapiro in an X post, claiming the Democratic governor may have “fabricated” two of the deaths in Pennsylvania.

Shapiro has sharply criticized Kennedy, a longtime anti-vaccination advocate, for spreading misinformation about vaccine safety and Pennsylvania’s outbreak, now the largest in the nation this year, with the most deaths reported by any state since 1992.

Asked for comment on communications with Diamantoni, state officials provided a statement by email saying Pennsylvania law bars them from providing further information on the initial measles-associated deaths.

The health department’s epidemiology team “thoroughly investigates and verifies” measles-associated deaths to ensure that they meet the state’s definition, and does not announce deaths until they have finished an investigation, health department press secretary Neil Ruhland said in an email.

He said state law does not require the department to report deaths to a coroner’s office; rather, coroners and “other certifiers” report deaths to the state health department.

“PA DOH has followed this explicit process for all measles-associated deaths in Pennsylvania,” Ruhland wrote.

‘No one looks good’

News outlets began calling Diamantoni as soon as the first measles-related deaths were reported in Lancaster, where he is a family medicine doctor and former Lancaster City Council president. First elected to the coroner’s office in 2007, he said he views his duties as apolitical and describes himself as a strong advocate for vaccination.

He told media outlets he had been surprised by the state’s announcement, as his office had not identified any deaths from measles.

The office had investigated the death of an infant who tested positive for the disease, but Diamantoni has maintained that the child had died from a lacerated spleen, not the highly contagious illness.

As his claims were widely reshared on social media and in national media stories, state officials said they stood by their findings that both deaths were measles-related. They were not told that the infant’s death was not associated with measles, they said.

Diamantoni told The Inquirer repeatedly that state health officials had never spoken personally with him about the death of an infant later identified as Ivan Miller, who was hours old when he died on Aug. 14.

He said that state health officials had only reached out hours before their news conference, and that his deputy, Eric Bieber, had spoken to them.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

Internal office records reveal that five days before the news conference, a staffer in the coroner’s office e-mailed Diamantoni, saying that an infectious-disease doctor with the state health department was looking to speak to “one of you” about “the positive measles case with the infant we just had.”

The state health department followed up on its initial Aug. 20 call with subsequent emails and calls on Aug. 21, a Friday, and Aug. 24, the following Monday, records show.

One doctor included his state-issued cell phone number in an email to a coroner’s office staffer and Bieber and emphasized that he was available “24/7” to discuss the case.

When Bieber spoke to representatives from the state health department on Aug. 25, the office did not realize that the state was about to announce two measles-associated deaths, according to Diamantoni.

Diamantoni added that since he did not believe Ivan Miller’s death was caused by measles, he had not been expecting any outreach from the state.

“I don’t think it would have brought a red flag to me. It just looked like a request we usually receive from different individuals, different agencies, requesting cause and manner information,” Diamantoni said.

Yet it is the responsibility of public officials to establish communication procedures at their offices, especially when a contagious disease is spreading and the public needs clear information, according to Penn’s Jamieson.

In public offices, she said, “you shouldn’t be seeing a situation in which the person doesn’t get the information, or is able to say, ‘I didn’t get it.’”

State officials could have communicated more clearly in announcing the deaths as well, she said, noting that they did not immediately define “measles-associated death” in an initial news release.

Jamieson said it is important for health officials to explain “what we know, what we don’t know, and how we’re finding out what we don’t know” in terms the public can understand.

“Anytime the public is listening to voices that are supposed to be speaking with authority, and the public, instead of hearing a clear message, is confused, you have a problem,” she said. “No one looks good.”

Measles-associated deaths in Pennsylvania

State officials have repeatedly cited state privacy laws in response to criticism of their communications, saying they cannot provide detail about how they investigated the measles-associated deaths.

The state defines a measles-associated death as one that occurs within 30 days of symptom onset in a person with clinical evidence of infection and a positive laboratory test for measles, and who did not die of another unrelated cause, like a car crash.

Officials have provided little information beyond the fact that none of the five people who have died were vaccinated, and their county of residence.

Local coroners like Diamantoni have offered more details.

For example, in early September, Jefferson County’s coroner, also an elected Republican, confirmed the death of a 40-year-old woman from measles. He disclosed that the woman also had severe respiratory conditions, including chronic obstructive pulmonary disease, that made her vulnerable to serious complications from a respiratory illness like measles.

Later in the same week, the Mifflin County coroner, another Republican, confirmed that an unvaccinated 18-year-old had died from a rare neurological complication of measles.

Diamantoni has shared that Ivan Miller, who died at a birthing center in Lancaster County, tested positive for a measles infection acquired before birth. His family, who is Amish, told the Atlantic that his mother had a severe case of measles and gave birth early.

Although Diamantoni did not consider measles to have caused the death, he said, measles was included on the boy’s death certificate in a section that lists “significant conditions contributing to death but not resulting in the underlying cause.”

Physicians have noted that measles can weaken the spleen, putting it at risk of rupture. Diamantoni cited a lacerated spleen as the primary cause of death.

The second death, another Amish infant, was not initially reported to Diamantoni; Lancaster’s Clinic for Special Children, which treats Amish children with genetic conditions, had treated the baby until her death.

Diamantoni’s office investigated the death about a week after the state’s news conference; he later told reporters that the baby was 6 weeks old and had Amish lethal microcephaly, a fatal genetic condition that makes respiratory illnesses particularly risky. Diamantoni said measles caused the baby’s death.

On Wednesday, state health officials announced a fifth death, a Lancaster County resident who tested positive for measles and died. Diamantoni told The Inquirer that he had not handled that death, but that state health officials had informed him about it. He said they provided no further information.

State officials did not say whether the person, who was unvaccinated, died in Lancaster County.

Diamantoni told an Inquirer reporter in early September that he was proud that his office was one of the first in the country to be certified by the International Association of Coroners and Medical Examiners.

“People may not always agree with our findings, but they’re well investigated and well thought out,” he said.

Staff writer Gillian McGoldrick contributed to this article.

October 1, 2026
Pennsylvania confirms a fifth death associated with widening measles outbreak

A fifth person has died amid Pennsylvania’s growing measles outbreak, state health officials confirmed on Wednesday.

The Pennsylvania Department of Health said in a news release that an unvaccinated resident of Lancaster County tested positive for measles and has died.

Health officials said they would not release any additional identifying details about the person who died, citing state privacy laws.

The state has confirmed two other measles-associated deaths this year in Lancaster County residents, both involving infants in the Amish community.

Mifflin and Jefferson Counties have also reported two measles-associated deaths involving an 18-year-old and a 40-year-old, respectively.

The announcement came as confirmed measles cases in Pennsylvania reached 943 so far this year, the largest outbreak in the state in three decades and the highest case count nationwide this year. The state has confirmed 40 new cases in the last two days.

The outbreak is centered in Lancaster, where nearly 400 people have been sickened so far this year, but also expanding in other counties, including Chester County in suburban Philadelphia, which had reported 83 cases as of Wednesday, the third-highest countywide case count in the state.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

The death toll reported in Pennsylvania is also the nation’s highest since 1992, but state and federal officials have clashed over how to characterize the four previous deaths reported in the state, all in people who were unvaccinated and confirmed to have measles infections.

The CDC’s public tracking of the toll of measles outbreaks nationally currently only shows two deaths from measles, reflecting decisions made under the leadership of President Donald Trump’s Health Secretary Robert F. Kennedy, Jr., a longtime anti-vaccine activist. The CDC’s website does not say where the two deaths occurred.

Gov. Josh Shapiro, a Democrat, has accused Kennedy of spreading misinformation about the safety of the measles vaccine, contributing to declining vaccination rates statewide. Kennedy has faulted Shapiro for politicizing the deaths and initially said his administration may have “fabricated” two deaths.

Pennsylvania officials said the latest death also fits the criteria for the state’s definition of a measles-associated death: One that occurred within 30 days of symptom onset in a person with clinical evidence of a measles infection and a positive lab test, that wasn’t due to an unrelated cause, like a car crash.

In confirming measles-associated deaths, the state also considers medical records and whether the person was exposed to measles before their death.

Statewide, nearly one in five people with reported cases have been hospitalized.

About a third of confirmed measles cases have occurred in children under 18.

Physicians and local officials in affected counties have warned that there are likely far more cases than have been officially reported.

Nearly all of the confirmed cases of measles have been in unvaccinated people, state officials said. The state confirmed four cases involving extremely rare “breakthrough” infections in people who were vaccinated, less than 1% of the total cases reported.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

Lancaster County coroner Stephen Diamantoni said state officials called him Wednesday to inform him of the latest measles-associated death, but provided no additional information on the case.

He said his office had not handled any recent deaths involving a person who tested positive for measles.

State officials have noted that not all deaths are referred to a coroner. They did not specify whether the latest death occurred in Lancaster County.

Diamantoni, an elected Republican who is also a physician, had questioned the state’s conclusions about an earlier death in Lancaster County, in an infant who tested positive for a measles infection acquired before birth.

The baby died shortly after birth from a lacerated spleen, Diamantoni said, adding that he did not believe the child’s death was caused by measles.

State officials have said that the baby’s death fits their definition of a measles-associated death, and physicians have noted that measles can weaken the spleen, putting it at risk for rupture.

Diamantoni also investigated the death of a second infant, which was not initially reported to his office. The six-week-old had a fatal genetic condition that made her particularly vulnerable to respiratory illnesses. That death was caused by measles, Diamantoni said.

The other two deaths, in Mifflin and Jefferson Counties, involved an 18-year-old who died from a rare neurological complication of measles and a 40-year-old woman with serious respiratory issues that also put her at higher risk of death from measles.

September 30, 2026
CDC adds second measles death to official tally

The Centers for Disease Control and Prevention updated its national measles tally late Monday to include another death in 2026, bringing its total to two, after Pennsylvania reported four measles-associated deaths in a growing outbreak.

The CDC’s website did not identify the person who died or say where the death occurred, leaving unclear whether it was one of the four Pennsylvania cases. No other states have reported any measles-associated deaths. The agency updated its tally last week to include one death in 2026.

A spokesperson for the Department of Health and Human Services said Tuesday that the National Center for Health Statistics informed CDC that it had received another report from a state about a measles-related death. “Through its standard process, NCHS verified that the death occurred and that measles was listed as the underlying cause of death,” Emily Hilliard said. “This is now reflected on the CDC website.”

The deaths have become the center of a bitter political feud between Pennsylvania Gov. Josh Shapiro (D) and Health and Human Services Secretary Robert F. Kennedy Jr. that started when Pennsylvania announced two measles-associated deaths in Lancaster County last month. The outbreak has grown to 903 cases, including 114 in the past seven days, state health authorities reported Monday.

After Pennsylvania announced its first deaths, the CDC excluded them from its weekly measles case-and-death tally, a decision that came from the agency’s new director, Erica Schwartz, the Washington Post previously reported. The highly unusual decision is a departure from the CDC’s practice of including such data from state health departments, which historically make the determinations.

September 29, 2026
Pennsylvania tops 900 measles cases, as its largest outbreak in 30 years spreads

Measles cases in Pennsylvania topped 900 this week, as the state’s largest outbreak in three decades continues to spread from rural Lancaster County communities into Philadelphia’s suburbs.

The Pennsylvania Department of Health reported 114 new cases in the last week, reaching a total of 903 cases this year as of Monday. That includes 83 cases in Chester County, the only county in the Philadelphia region where the virus is actively spreading in an outbreak that is also the nation’s largest currently.

Chester County’s outbreak has emerged as the third largest in the state, having more than tripled in size since early August.

Physicians and local health officials say the current case count is likely an undercount, with many cases going unreported.

Cases in Chester County have largely been concentrated along its western border with Lancaster County. But health experts expect the virus to continue to spread statewide. More than half of Pennsylvania’s counties already are affected, as vaccination rates have declined in many communities.

Overall, Chester County has a 94.5% measles vaccination rate among kindergarten students, just below the 95% of people scientists say need to be vaccinated to prevent the virus from spreading within a community.

The so-called herd immunity threshold for measles is high because the virus is so contagious: Nine out of 10 unvaccinated people who come into contact with measles will get sick.

In response to the outbreak, the county’s health department has ramped up communications and outreach, sent nurses into schools and close-knit communities, and held pop-up clinics. The overarching goal of all these efforts: Get more people vaccinated.

Two doses of the measles vaccine offer 97% protection against the virus.

“We are working all the time with organizations, businesses, community leaders — whoever we can get the attention of in the communities impacted,” Jeanne Franklin, the county’s health director, said in an interview last week.

The county has administered 538 measles, mumps, and rubella (MMR) vaccines this year, most of them since the outbreak began in April, she said.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

Measles spreading in Pennsylvania

Across Pennsylvania, at least one measles case has been reported in 39 of 67 counties.

Almost all have been among unvaccinated individuals. The state reported four rare “breakthrough” cases of measles in vaccinated people earlier this month.

The virus’ most common symptoms include a fever, cough, runny nose, watery eyes, and a telltale splotchy red rash.

Most people recover, but rare complications can be deadly.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

Pennsylvania has reported four measles-associated deaths, all affecting people who were unvaccinated and confirmed to have measles infections.

The deceased include two infants from Amish families in Lancaster County, an 18-year-old in Mifflin County who died from a serious neurological complication of measles, and a 40-year-old woman in Jefferson County with severe respiratory conditions.

As of Monday, Lancaster County had the largest outbreak, with 363 cases. There have been 106 cases in Mifflin County.

September 28, 2026
Gov. Josh Shapiro’s administration will rescind Pa. disease-tracking proposal that reignited pandemic-era outrage

Gov. Josh Shapiro’s administration will rescind a series of proposed vaccination and disease-tracking regulations that reignited public outrage toward restrictive pandemic-era policies in Pennsylvania — a decision made after receiving more than 10,000 comments opposing the changes, the Pennsylvania Department of Health said Friday.

The department will withdraw the regulations, incorporate feedback, and resubmit the public health rules “once Pennsylvanians’ feedback has been adequately incorporated,” Neil Ruhland, a spokesperson for the department, said in a statement.

Shapiro’s administration earlier this year submitted the proposed regulations aimed at combating infectious diseases to the Independent Regulatory Review Commission, a little-known board that assesses and approves new state regulations, requiring public input before they can be implemented. These regulations had been in progress for years, but were not introduced to the public until June 4.

The public comment period coincided with a high-profile clash between Shapiro and U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. over two infant deaths that Pennsylvania attributed to measles — the first deaths from the highly contagious and preventable disease in the state in 35 years. And it quickly refueled public disapproval of government mandates enacted during the COVID-19 pandemic.

Josh Shapiro’s measles response — and its backlash — reignites COVID-19 fury

The 502-page proposed regulations would have expanded the state health department’s investigatory powers deemed necessary to track, prevent, contain, or mitigate a contagious disease. Republican state lawmakers and thousands of enraged constituents were especially concerned by a provision that would allow the state health department or local health authorities to enter schools or private properties to investigate alleged outbreaks or review vaccination records. They also criticized the health department’s effort to change references to a “pregnant woman” to a “pregnant individual” throughout the policy, claiming it was an effort to remove women from the state’s public health rules.

The pushback comes at a time when federal health officials, under Kennedy, who has a history of anti-vaccine activism, have worked to reduce the number of childhood vaccination recommendations — and as childhood vaccination rates hit new lows in Pennsylvania. The effort has prompted Shapiro and other Democratic governors to sign executive orders to protect vaccine access. Setting vaccination mandates for schoolchildren falls to the states, not the federal government.

The proposals rescinded Friday will not affect federal or state executive orders related to vaccination access.

State House Minority Leader Jesse Topper (R., Bedford) during a news conference at the Capitol in Harrisburg Feb. 3, 2026.Tom Gralish / Staff Photographer

House Minority Leader Jesse Topper (R., Bedford) was among the first officials last month to raise alarm about the proposed regulations. In a statement Friday, he said it was the “correct and logical conclusion” for the health department, following the outpouring of public opposition.

Senate Majority Leader Joe Pittman (R., Indiana) called Friday’s announcement “a tremendous victory for the grassroots efforts of Pennsylvanians.”

”This is a stark reminder that we must continue to be vigilant when the Executive Branch attempts overreach,” Pittman said in a statement. “We cannot and will not allow actions like we saw taken by the Executive Branch during the height of the COVID-19 pandemic to be put in place again.”

Nearly all of the members of the Republican caucuses in Pennsylvania’s Senate and House submitted letters in opposition to the proposed regulations, arguing they were more restrictive than the ones enacted during the COVID-19 public health emergency and would infringe on Pennsylvanians’ constitutional rights.

“The proposed regulations represent executive-branch overreach reminiscent of what we experienced during the COVID-19 pandemic — but this time, the rules would be permanent,” Senate President Pro Tempore Kim Ward (R., Westmoreland) said in a statement last week. “Every Pennsylvanian should understand these regulations and how they could impact their lives.”

At least one Democrat — State Rep. Dan Frankel (D., Allegheny), who chairs the House Health Committee — submitted his support during the public comment period for updating the state’s existing communicable disease rules. Even so, his remarks recommended several changes to the proposed regulations, including to how the state would evaluate some vaccination exemptions to consider how children will be affected if their parent forgoes the preventive measures.

Senate Minority Leader Jay Costa (D., Allegheny) said in a statement Friday he was looking forward to continuing the conversation about the regulations, adding that “public trust and buy-in is crucial to effective governance.”

Beth Rementer, a spokesperson for House Democrats, said Friday that Shapiro’s administration was “acting responsibly” by considering public opinion.

“After all, that’s how government is supposed to work,” Rementer said.

Shapiro’s administration has rescinded at least 11 other regulation proposals since taking office in 2023, according to administration officials. But a deluge of feedback is rare, and most proposed regulations receive around five public comment submissions, a Shapiro administration official said.

Monday was the final day for public comment submissions. As part of their opposition campaign, Republican lawmakers encouraged their constituents to voice their opinion as part of public comment. By the end of the day, the review commission had received more than 10,000 comments opposing the regulations.

“The Department of Health received a historically high volume of feedback during the public commentary period, and it is clear additional stakeholder input is needed,” Ruhland said in the statement.

Shapiro, a Democrat, is seeking reelection in November. His GOP challenger, State Treasurer Stacy Garrity, has criticized Shapiro over the proposed regulations, calling them “mandates that would make draconian COVID-era restrictions blush.”

On Friday, Garrity celebrated the regulation withdrawal, and in a statement called Shapiro “the least transparent governor in America” who “got caught trying to sneak a 502 page invasion of privacy and parental rights through.”

A spokesperson for Shapiro declined to comment Friday, deferring to the state health department.

September 25, 2026
New poll shows RFK Jr. is unpopular among Pa. voters amid feud with Shapiro over measles

A large majority of likely Pennsylvania voters dislike Health and Human Services Secretary Robert F. Kennedy Jr., according to a poll conducted in the wake of his clash with Gov. Josh Shapiro over the state’s measles outbreak.

The poll, released Thursday, found that 61% of respondents have an unfavorable view of Kennedy, while only 33% said they hold a favorable one of him.

“He’s the one person in the poll that does worse than President [Donald] Trump,” said Don Levy, the director of the Siena Research Institute, which conducted the poll on behalf of The Inquirer and New York Times.

Kennedy, who has a history of anti-vaccine activism, has been embroiled in a heated debate with Shapiro, the state’s popular governor, over measles-associated deaths in Pennsylvania.

“The poll shows that people see RFK Jr. for what he is: the single worst person to be HHS secretary during a massive measles epidemic,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and a longtime critic of Kennedy.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

State health officials have been responding to a measles outbreak of more than 800 cases, as of Wednesday, that included four deaths, two of them infants.

Kennedy accused Shapiro of fabricating two of the deaths, although he later acknowledged one was caused by measles.

The survey of likely voters was conducted between Sept. 15 and 21, a period that overlaps the war of words between the Democratic governor and Trump’s health secretary.

“This serious situation continues to be made worse by RFK Jr. playing games with public health and safety,” Shapiro said on X last week. “It’s long past time for [Kennedy] to stop stoking vaccine skepticism and misinformation and compromising the serious mission of the nation’s public health agencies.”

For his part, Kennedy, in a post on X last month, accused Shapiro of choosing “to politicize this outbreak instead of implementing a unified public health response.” He also contended in that post that he has promoted vaccination as the “most effective way to prevent measles infection.”

But Kennedy has explicitly stated that vaccines cause autism, Offit noted, and late last year, Kennedy ordered the CDC to change its website to say its long established position that vaccines don’t cause autism is not an evidence-based claim.

Kennedy has also said that the measles vaccine was never fully tested and that it wanes over time, both of which have been disputed by medical authorities with decades of evidence backing its safety and efficacy.

Lesa Yeager, a 63-year-old independent voter from State College who participated in the survey, said she was concerned about the spread of measles in Central Pennsylvania, and she wished Kennedy would “encourage people to the get the vaccines.”

She wasn’t familiar with his back-and-forth with the governor, but said her frustration with Kennedy is longstanding.

“I have a kid with special needs, and [Kennedy] is going on about how the vaccines cause autism, and everybody knows that’s not true,” she said. “He has spread such misinformation, and he’s wackadoodle.”

For weeks, the CDC did not publicly list Pennsylvania’s measles-associated deaths, reportedly at Kennedy’s order, a charge his agency denied. “It looks as though RFK is ignoring measles deaths here,” Offit said.

On Wednesday, the CDC acknowledged that a measles-associated death had occurred in 2026, without saying where it happened. The CDC said the number is “subject to change.” Pennsylvania is the only state where a measles death has been widely reported.

In a statement, Emily Hilliard, HHS press secretary, declined to address the poll, but said that the public’s trust in vaccines was eroded significantly during the pandemic, caused by “mismanagement, overreach, misinformation, and mandates.”

“Attributing the measles resurgence to the Trump administration fundamentally misrepresents when and why the resurgence began,” Hilliard said, adding that Kennedy has “been clear that vaccination remains the most effective way to prevent measles.”

Kennedy and Shapiro have repeatedly battled over vaccine policy during the Trump administration. Shapiro joined a lawsuit earlier this year over federal changes to the childhood vaccine schedule.

Trump last month signed an executive order that said the MMR vaccine — a combination vaccine that protects against measles, mumps and rubella — “should be administered in three separate single-disease shots” during three separate doctor’s visits. Immunologists have disparaged the idea, saying there’s no medical reason to do so.

Shapiro has said Pennsylvania won’t alter immunization guidelines in response to Trump’s order.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

The poll found that 53% of likely voters trust Shapiro to do a better job on vaccine policy than his Republican opponent Stacy Garrity, a Trump-backed candidate who participated in Kennedy’s “Make American Healthy Again” event in Harrisburg earlier this year.

Staff writers Michelle Baruchman and Gillian McGoldrick contributed to this article.

September 25, 2026
Pa. measles outbreak grows past 800 cases; House Democrats press CDC on omitted deaths

Pennsylvania’s largest measles outbreak in three decades, currently the largest in the country, passed another sobering milestone on Wednesday: State health officials reported that more than 800 people have contracted the highly contagious disease so far this year.

The latest case counts show an increase of 111 measles cases in the last week, bringing the total to 835 people with known infections. Physicians and local health officials say this is likely an undercount, with many cases going unreported.

Chester County logged 12 new cases in the last week, bringing its total cases to 78. The outbreak in the suburban Philadelphia county is now the state’s third largest, having more than tripled in size since early August.

Chester is the only county in the Philadelphia region with cases in the current outbreak, which began in April. Montgomery County reported three cases in a separate outbreak earlier this winter.

All but a few have been in unvaccinated people.

Statewide, children under 18 make up nearly a third of the confirmed cases, and about one in five reported cases have required hospitalization.

The state reported four rare “breakthrough” cases of measles in vaccinated people earlier this month.

More than half of Pennsylvania’s 67 counties have now reported at least one measles case.

Lancaster County, with 342 cases, has the highest case counts in the state, followed by Mifflin County, which has reported 94 cases.

State officials have reported four measles-associated deaths, all affecting people who were unvaccinated and confirmed to have measles infections.

The deceased include two infants from Amish families in Lancaster County, an 18-year-old in Mifflin County who died from a serious neurological complication of measles, and a 40-year-old woman in Jefferson County with severe respiratory conditions.

But state and federal officials have clashed over how to characterize the deaths, with the Lancaster County coroner saying he did not believe measles caused one of the deaths.

The state considers all four “measles-associated deaths,” meaning deaths that occur within 30 days of symptom onset in a person with clinical evidence of infection and a positive laboratory test for measles, and who did not die of another unrelated cause, like a car crash.

The Centers for Disease Control and Prevention for weeks omitted these deaths from its public tracking of the toll of measles outbreaks nationally, under the leadership of President Donald Trump’s Health and Human Services secretary, Robert F. Kennedy Jr., a longtime anti-vaccine activist. Kennedy at one point suggested that Shapiro’s administration had “fabricated” the deaths in Lancaster County.

The CDC updated its dashboard on Wednesday to note one measles-related death in the country, without further explanation.

In a statement, an HHS spokesperson said that the National Center for Health Statistics received a report of a measles-related death from “a state.” The center verified that the death occurred and that measles was the underlying cause of death, and the CDC website was subsequently updated, the department said without specifying which state the death occurred in.

On its website, the agency says it is still reviewing death data and developing a new standard definition of a measles-associated death.

The state has maintained all four deaths fit its definition for a measles-associated death.

House Democrats ask for a briefing

New Jersey Rep. Frank Pallone said Wednesday he is still waiting for a response to a letter he sent last week as the top Democrat on the U.S. House committee that oversees healthcare, looking for answers about the CDC’s characterization of the death.

In the letter, Pallone asked for CDC director Erica Schwartz to brief committee Democrats on her “extraordinary decision” to omit the measles-associated deaths from the agency’s measles data dashboard.

The letter noted news reports that showed the dashboard had briefly included two measles-associated deaths in Pennsylvania before they were removed from the website.

Health and Human Services representatives did not immediately return a request for comment on the letter.

“I think this is the ultimate hypocrisy on the part of the secretary,” Pallone said. “He promised radical transparency, every day during his confirmation hearings. I think now what we’re getting is the opposite, which is a cover-up.”

Pallone said he was concerned that Kennedy’s anti-vaccine rhetoric has contributed to rising measles cases across the country, and worried that the agency, at Kennedy’s behest, is trying to redefine measles deaths to dodge blame for the rise in cases.

“What Pennsylvania did was the traditional scientific criteria for deaths from measles,” Pallone said. “What [is the CDC] trying to do? Change that? Based on what?”

September 23, 2026
Pennsylvania measles cases near 800 in ongoing outbreak

Pennsylvania recorded nearly 100 new cases of measles in the last week, bringing the total case count for this year to 792, state officials said Monday.

The state’s measles outbreak is the largest in the country in 2026 and is centered in Lancaster County, which has reported more than 300 cases this year.

Chester County has confirmed 76 measles cases so far this year, the third-highest total in the state behind Mifflin County in Central Pennsylvania, which has reported 93 cases.

State officials have reported four deaths associated with the outbreak: two infants in Lancaster County, a 40-year-old woman in Jefferson County, and an 18-year-old in Mifflin County.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

The state defines a “measles-associated” death as one that occurs within 30 days of symptom onset in a person with clinical evidence of infection and a positive laboratory test for measles, and who did not die of another unrelated cause, like a car crash.

Lancaster County’s coroner said one of the infants died from a lacerated spleen, not measles, though the baby tested positive for the disease. Physicians have noted that measles can weaken a spleen and make it more vulnerable to rupture.

Federal officials have clashed with the state over its characterizations of the deaths.

Democratic Gov. Josh Shapiro has faulted President Donald Trump’s Health and Human Services secretary, Robert F. Kennedy, Jr., a longtime anti-vaccine activist, for spreading misinformation about the safety of the measles vaccine and contributing to declining vaccination rates.

Kennedy, in turn, suggested Shapiro’s administration “fabricated” two of the deaths, though he later acknowledged one death was caused by measles.

The Centers for Disease Control and Prevention still has not listed the deaths on its data dashboard for measles outbreaks.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

Officials there have suggested the state is not cooperating with the agency and said officials had not requested emergency help from its Epi-Aid program, which provides short-term technical assistance and subject matter expertise during health crises, as other states with outbreaks have. Trump, in a White House appearance with Kennedy on Friday, called Shapiro “close to incompetent.”

“Incompetence is denying the tragedy of four measles-associated deaths in Pennsylvania,” Shapiro wrote on X in response.

Pennsylvania health secretary Debra Bogen said last week the state was already working with CDC staff, and had begun the process of requesting an Epi-Aid team — on the condition that the agency acknowledges the deaths in Pennsylvania.

Measles exposures in Philadelphia

Chester County is the only county in the Philadelphia area that has reported measles cases in the current outbreak, which began in April. (Montgomery County confirmed three cases in a separate outbreak in the winter.)

But Philadelphia health officials have reported two potential measles exposures, at the Children’s Hospital of Philadelphia and the Philadelphia International Airport.

On Sept. 11, city health officials said, a person with measles visited a neonatal intensive care unit and several other areas at the hospital at 3401 Civic Center Blvd. in University City. Infants exposed in the NICU were isolated and treated with antibodies to help decrease their chances of acquiring or becoming seriously ill from the highly contagious disease, CHOP officials said.

Two days later, on Sept. 13, a person with measles traveled through Terminals B and F at the airport, as well as areas connecting to Terminals C, D, and E, health officials said. The potential exposure was unconnected to the CHOP incident.

Measles infects up to nine in 10 unvaccinated people exposed to it, and young children are at particular risk for complications from the virus, which can include pneumonia and brain swelling.

State efforts to vaccinate

About 95% of a community must be vaccinated against the virus to prevent its spread, but vaccination rates across Pennsylvania have been dropping for years. Hundreds of kindergartens in the Philadelphia region report vaccination rates well below this “herd immunity” rate.

State officials said in a statement Monday that more Pennsylvanians have expressed interest in getting vaccinated as the outbreak spreads.

The health department will offer free measles, mumps, and rubella vaccinations from Sept. 26 through Oct. 3 at the Bloomsburg Fair in Columbia County, which has reported two measles cases.

The clinic is “just the latest way the department is meeting Pennsylvanians where they are, to ensure they have the facts and evidence to make decisions about vaccination for themselves and their family,” officials said.

State workers have hosted 148 pop-up vaccination clinics and given out more than 4,800 MMR vaccinations in affected areas since April, with “dozens” more scheduled in the weeks and months ahead, officials said, “based on community interest and need.”

Other healthcare providers have also seen renewed interest in vaccination this year, state officials said. Typically, providers give out about 25,000 MMR doses a month, but in August, more than 46,000 doses were administered, and more than 25,000 doses were given out in the first two weeks of September.

September 21, 2026
Why haven’t state officials revealed more about Pennsylvania’s measles deaths?

In the last month, Pennsylvania health officials have announced four measles-associated deaths but have been tight-lipped about almost every detail, beyond sharing their county of residence and that all were unvaccinated.

Most of what the public knows about the four deaths linked to the outbreak — ranging in age from a newborn to a 40-year-old — has come from local coroners in Jefferson, Mifflin, and Lancaster Counties. In one case, a family also spoke to the media.

Pennsylvania’s health department has cited state privacy laws that they say prohibit them from releasing more information. Legal and public health experts acknowledge the state faces legal restrictions, but some argue that the state should do whatever it can to ensure more information about the deaths is made public.

More details about a death, they say, help the public to understand the risks of measles and the benefits of vaccination to prevent the spread of the highly contagious disease.

Transparency around how the state defines measles-associated deaths and unvaccinated people can also head off misinformation, they said, in a highly politically charged environment.

The spreading outbreak has sickened 767 people — now the largest outbreak in the United States — and hospitalized 150 people as of Friday. The deaths reported by the state mark Pennsylvania’s first in 35 years, and the most seen nationally from measles in three decades.

Here’s what to know about Pennsylvania’s privacy laws and how officials communicate in infectious disease outbreaks.

What is known about the measles-associated deaths in Pennsylvania?

State officials announced two “measles-associated” deaths in Lancaster County late last month, though they did not define the term in an initial news release on the cases. They did not provide any additional information, beyond saying both victims were unvaccinated and residents of Lancaster County.

Lancaster County’s coroner subsequently shared that he had investigated one of the deaths, involving an infant who contracted measles in utero and died shortly after birth. The baby tested positive for measles, but, the coroner said, died from a ruptured spleen. Physicians have pointed out that measles can damage a person’s spleen, putting it at higher risk for rupture.

The state has continued to characterize the Lancaster County infant’s death as “measles-associated,” meaning it occurred within 30 days of symptom onset in a person with clinical evidence of infection and a positive laboratory test for measles, and who did not die of another unrelated cause, like a car crash.

Lancaster’s coroner said a second death, in a 6-week-old Lancaster County baby, was caused by measles. The child also had Amish lethal microcephaly, a fatal genetic disorder that makes it especially risky to contract a respiratory illness like measles.

State officials confirmed two more measles-associated deaths last week.

Jefferson County’s coroner said measles led to the death of a 40-year-old unvaccinated woman with severe respiratory conditions. A postmortem test showed the woman had an active measles infection, and she had also been exposed to a person with a lab-confirmed measles case.

Mifflin County’s coroner also confirmed that an unvaccinated 18-year-old died of a rare neurological complication of measles.

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

Why are state and federal officials clashing over the deaths?

Starting with the initial news conference to announce the first two deaths, Democratic Gov. Josh Shapiro has traded barbs with President Donald Trump’s Health and Human Services secretary, Robert F. Kennedy, Jr., over the outbreak.

Shapiro has accused Kennedy, a longtime anti-vaccine activist, of spreading misinformation contributing to a decline in vaccination rates. Kennedy said in a social media post that Shapiro’s staff may have “fabricated” the deaths, after the Lancaster County coroner’s comments, though Kennedy later acknowledged one infant’s death was caused by measles.

Federal officials said Tuesday they were aware of the third and fourth deaths reported in Pennsylvania but have not updated the federal website tracking measles cases to reflect any of the deaths reported by Pennsylvania. They have said they will record measles-related deaths when the National Center for Health Statistics “identifies measles as the underlying cause based on death record information submitted by the states.”

Democrats and public health experts have harshly criticized the decision, saying it’s a departure from established procedures for recording infectious disease deaths.

State health officials said they have discussed the details of each case with CDC professional staff, “at length.”

“At no point did CDC staff express any concern or issue with the data we provided,” they wrote in a statement.

Why is the health department not releasing more information on measles-associated deaths? Why can coroners give out more information?

Pennsylvania health officials have cited two state laws: one prohibiting public access to death records and another that requires the state to keep records of diseases confidential, except when it’s necessary to inform the public of the risk of communicable disease.

But coroners and medical examiners are county officials who operate by different rules, the state said in a frequently-asked-questions document posted online last week. Laws governing coroners’ duties and the state’s right-to-know statute allow them to provide the public with identifying details like a person’s cause and manner of death, the state says.

“Releasing additional details beyond what we did could have led to the unnecessary identification of individuals and their families. Further, the specific details of a single case do not change the important message that measles is a highly contagious virus that can cause severe illness and complications, and the MMR vaccine is the best protection against it,” state health officials said in a statement.

Legal experts say decision-making around what to reveal about a death during a measles outbreak is difficult, and privacy laws do apply to health departments.

Robert Field, a professor emeritus at Drexel University’s Thomas R. Kline School of Law, said health departments typically release aggregate data about disease outbreaks, not individual deaths.

“Confidentiality and privacy are major issues for any health department, which is why the regulations are stricter,” he said. With just a few measles-associated deaths reported, he said, releasing further details about the deaths could risk identifying families.

“A newborn dying with a ruptured spleen — there aren’t a lot of those,” he said, referencing one case in Lancaster County. “In terms of additional information, further details that would ID the patients — that would be off-limits.”

Why are some experts criticizing state officials over their communications strategy?

Releasing less information about a death risks creating an “information vacuum,” especially in a highly politically charged environment, said Amesh Adalja, an infectious disease physician at the University of Pittsburgh Medical Center.

Unlike the first two deaths, announced by the state last month without further detail, the public immediately knew more about the two disclosed last week, he noted, crediting coroners in Jefferson and Mifflin Counties who have been forthcoming with information about the deaths.

“Coroners talking in detail about cases they’ve been handling, as well as the parents of the neonate that died” provided “really important information that helped bring a lot of clarity to an information vacuum,” said Adalja, who is also a senior scholar at the Johns Hopkins Center for Health Security.

Adalja has said the state should have been clearer from the onset about how it defines measles-associated deaths, and could have provided information about the victims’ general age ranges — for example, whether they were adults or children. And the state could involve other officials who are not restricted by the same privacy laws, he said.

“If they assess they are bound by Pennsylvania state law in a way that county coroners are not, include coroners in the press conferences,” Adalja said.

He added that Shapiro and Kennedy’s political fight over the nature of the deaths risks overshadowing a serious measles outbreak that has sickened hundreds.

“The anti-vaccine movement has really made inroads here — people are calling this a hoax,” he said. “It’s obviously not a hoax. And there are real actions that need to be taken. It’s much harder to do that work when you [are] engulfed in some political problem.”

(function(){function e(){window.addEventListener(`message`,function(e){if(e.data[`datawrapper-height`]!==void 0){var t=document.querySelectorAll(`iframe`);for(var n in e.data[`datawrapper-height`])for(var r=0,i;i=t[r];r++)if(i.contentWindow===e.source){var a=e.data[`datawrapper-height`][n]+`px`;i.style.height=a}}})}e()})();

Arthur Caplan, a New York University professor emeritus, wrote in an Inquirer op-ed Thursday that the state should provide “maximum information” about the deaths “in order to prevent further harm.”

He sharply criticized Kennedy, accusing the nation’s top health official of spreading misinformation about vaccine safety and the threat of measles: “[Nothing] the federal government has to say about measles is trustworthy,” he wrote.

In an interview, he said state should weigh privacy obligations with the need to inform the public about whether victims had exposed others to measles.

“In the middle of an epidemic, those laws need to be pushed as far as you can,” he said.

Drexel’s Field said the state could also have emphasized that “unvaccinated” does not necessarily mean that a person chose not to take a measles, mumps, and rubella vaccine. Some people, like newborns, pregnant women, and people with weakened immune systems, are unable to be vaccinated.

“People should know that if they choose not to be vaccinated and contribute to the spread, it could affect people who did not decline vaccination by choice but are in such fragile health that there is no choice,” he said.

State officials have said that even revealing that someone was too young to be vaccinated would be enough to identify the deceased in small communities.

It’s imperative that health officials balance the need to inform the public and maintain trust amid the growing outbreak, Field said, especially as vaccination rates drop.

“If the credibility of the state health department is questioned by the public, then I think we’re in big trouble. And that would be a very unfortunate outcome of this,” he said.

September 21, 2026