CDC removes measles deaths from official count under new director

On August 25, Pennsylvania's Department of Health announced two deaths from measles in Lancaster County—the first measles fatalities in the state in 35 years. Both victims were unvaccinated. Within days, the Centers for Disease Control and Prevention placed an asterisk in its national death tally where those two names should have appeared. The agency said it could not yet determine whether measles had caused the deaths or whether the two had simply died of other conditions while infected with the virus. The distinction—dying "with" measles versus dying "of" it—would keep them out of the official count.

Three current and former CDC officials told the Washington Post that the decision came from Erica Schwartz, the agency's new director. Deb Houry, who served as the CDC's chief medical officer until resigning a year earlier in protest over the firing of Schwartz's predecessor, called the move "a big deviation in protocol." The timing was striking: as of August 27, the CDC had already recorded 2,903 confirmed measles cases nationally—surpassing the entire total from the previous year.

The medical logic behind the distinction collapses under scrutiny. Measles almost never appears as the immediate cause of death on a death certificate. What appears instead is pneumonia, or encephalitis, or hemorrhage—the direct mechanism of dying. Measles is the underlying condition that triggered it. Nirav Shah, who served as the CDC's principal deputy director until February 2025, explained that the agency's infection-associated death counts have always included anyone who tested positive and died within roughly ten days, without parsing whether the infection was the primary or secondary cause. For a director to override a state epidemiologist on that basis, Shah said, amounts to the politicization of public health.

The "with or of" formulation did not originate with Schwartz. In March 2025, after the first child died of measles in Texas, Robert F. Kennedy Jr. published an op-ed in Fox News arguing that tens of thousands died with or of measles annually in nineteenth-century America, and that the collapse in measles mortality came from sanitation and nutrition rather than vaccination. The distinction itself was not new either. During the COVID-19 pandemic, the CDC had deployed the same language for six years as a propaganda tool, most aggressively when counting child deaths. In March 2022, the agency recoded its data and cut its count of pediatric COVID-19 deaths by nearly a quarter overnight. Greg Travis, who built the only independent excess-death tracker operating in the country, told the World Socialist Web Site he had never seen a death toll in an age group spike upward and then crash downward as it did then. The purpose was transparent: to remove dead children from arguments for school closures.

One of the two measles deaths was a newborn. The Atlantic located the family—an Amish household on 45 acres with 13 children. They had no internet or television. They learned their son's death had become a national controversy only when a reporter appeared at their farm. In early August, measles moved through the house. The mother, pregnant at the time, developed a fever of 102 degrees and went to a clinic on August 13. She went into labor the next day, still acutely infected. The boy died roughly half an hour after birth. The coroner's pathologist attributed the death to a ruptured spleen and found the organ neither enlarged nor inflamed. Coroner Stephen Diamantoni initially told reporters measles had played no role, then later called it a contributing factor, and it was entered on the death certificate as such. Paul Offit of the Children's Hospital of Philadelphia has since noted that congenital measles can enlarge the spleen and thin its capsule, that a burst spleen is difficult to assess in a newborn, and that splenic rupture in a newborn is otherwise extraordinarily rare.

The mother could not have protected herself. The MMR vaccine is contraindicated in pregnancy, and she had never received it. Only the immunity of people around her could have shielded them both, and that immunity has been eroding for years. Unvaccinated children from past decades grew up unvaccinated, and for 40 years nothing happened to them because everyone surrounding them was vaccinated. On the day the deaths were announced, Lancaster County Commissioner Josh Parsons declared on social media that the coroner's office knew of no measles deaths. Kennedy amplified the claim within 24 hours, writing on X that the deaths "may even have been altogether fabricated by one of the Governor's hopeful staffers." Governor Josh Shapiro held a news conference to announce the deaths and attack Kennedy, then withheld the epidemiological evidence that would have settled the matter. Having made the deaths a political event, Democrats declined to investigate them.

The outbreak has spread far beyond Lancaster County. As of Wednesday, Pennsylvania had confirmed 530 cases across 36 counties, up from 393 nine days earlier, with 242 in Lancaster County and the remainder scattered through half the state. Offit estimates the true figure is closer to 2,000, reasoning that two deaths among roughly 400 reported infections implies a fatality rate of one in 200—five times the rate measles ordinarily produces. Measles has also been spreading through immigration detention since January, with 14 confirmed cases and 112 quarantined detainees at Camp East Montana on Fort Bliss as of March, and two cases among more than 400 children held at Dilley. Over the past 50 years, immunization has averted 154 million deaths worldwide, with the measles vaccine alone accounting for 93.7 million of them—more than every other vaccine combined. What the CDC has done—removing two confirmed deaths from the national record—is only the beginning.