A 20-year-old Amish woman with leukemia is among the five people in Pennsylvania to suffer a measles-associated death, according to the Philadelphia Inquirer. She had recently married and was the second oldest of nine siblings. She was receiving chemotherapy and steroids when she became the last in her household to fall ill. After more than a week in the hospital with double pneumonia, her family agreed to withdraw the ventilator.
She had wanted the vaccine and could not receive it. Her doctor refused because chemotherapy made the live vaccine unsafe for her, and the same treatment left her unable to fight the virus. Her protection could only ever have come from the vaccination of the people around her, and that wall had been dismantled before she was exposed.
Coverage in Amish communities is low for reasons that include religious conviction and a preference for alternative treatment but also the absence of insurance, of regular contact with the medical system and of any practical way to reach a clinic. The young woman’s grandmother told the Inquirer that the family does not oppose vaccination on religious grounds. Lancaster County has no health department of its own, and no level of government funds the outreach and contact tracing that might have reached a household like hers before the virus did.
The Centers for Disease Control and Prevention (CDC) counts only two measles-associated deaths nationally, marked with an asterisk, while Pennsylvania has documented five.
The Pennsylvania Department of Health recorded 1,136 confirmed cases on October 9, up from 890 on September 27, when the World Socialist Web Site last reported on the outbreak, a rise of 246 in 12 days that includes 157 in the past week alone. Hospitals have admitted 219 patients, a rate of 19.3 percent. Fewer than 1 percent of those infected were fully vaccinated, and two-thirds are adults. Three of the five who died were adults.
The CDC reported 4,080 confirmed cases nationally on October 9, across 47 jurisdictions. Outbreaks account for 95 percent of infections, and 42 new outbreaks have been reported this year.
Pennsylvania’s outbreak, more than a quarter of the national total, is the state’s largest in more than three decades and now the largest in the country. The national epidemic of 1989 to 1991, against which it is measured, ran to about 55,000 cases and 132 suspected deaths, concentrated among unvaccinated preschool children. Paul Offit of Children’s Hospital of Philadelphia warned, “Measles is now endemic in the United States. We’re going to be seeing measles outbreaks for years.”
On September 4, as the WSWS has previously detailed, the CDC abandoned the National Notifiable Diseases Surveillance System as its source for measles deaths and began requiring death certificates processed by the National Center for Health Statistics to list measles as the underlying cause, a designation measles rarely receives because it kills through pneumonia, encephalitis and secondary infection. Pennsylvania instead counts any death within 30 days of symptom onset in a person with a positive test who did not die of an unrelated cause.
The CDC has since dropped the underlying-cause language from its website, leaving only its September 4 statement that it is working with the Council of State and Territorial Epidemiologists (CSTE) on a standardized case definition for deaths due to measles. The agency has set no deadline and has not said whether the definition will restore the long-standing practice of counting deaths among infected patients or make the exclusion permanent.
Oxford Area High School in southern Chester County closed on Friday after officials confirmed a case in the school community, and the county health department ordered the district to verify its employees’ vaccination status. Unvaccinated students and staff must quarantine for 21 days. Chester County had recorded 86 cases by October 7, the third most in the state.
All 303 of last year’s 12th graders at the school were vaccinated, and the district’s middle school reported 96.3 percent among seventh graders. Schools report vaccination data for students but not for staff. The adults who make up most of Pennsylvania’s cases are the population the school data do not measure.
Pennsylvania’s kindergarten coverage for the measles, mumps and rubella (MMR) vaccine fell to 92.7 percent in 2025-26 from 95.5 percent in 2020-21. More than half of the state’s 67 counties fall below the 95 percent threshold for herd immunity. Nationally, kindergarten exemptions reached a record 4.2 percent, rising in 41 states and the District of Columbia.
New York exposes the limits of the published averages. Every New York county reports kindergarten coverage above 95 percent, and the state median stands at 99.7 percent, in a school system that has barred religious exemptions since 2019, yet the state has declared a disaster emergency. The state’s own immunization registry shows that as of January 1 only 80.9 percent of children had received a first MMR dose by age 2 and 52.9 percent in Yates County. Susceptibility clusters in the Amish communities where vaccination rates are especially low, which sit largely outside the school system that produces the data.
New York Governor Kathy Hochul declared the state disaster emergency on Monday. State officials had recorded 108 cases as of October 3, the most since 2019, including 92 since mid-July in under-immunized rural communities across 18 counties. The order suspends ordinary statutory limits so that pharmacists, paramedics and midwives may administer the vaccine and nurses may order tests. Hochul said, “No one should get seriously ill or die from a vaccine-preventable disease.”
A state government has invoked disaster powers to perform the basic work of disease containment, while the federal agency established to lead national disease control runs no campaigns and says nothing in public about childhood vaccination. Andrew Pavia, a pediatric infectious disease specialist at the University of Utah, observed, “In a normal time, CDC and even higher up in HHS, people would be talking about measles … how effective and safe the vaccine is. We’re not seeing that.”
The hollowing out of American public health began long before Robert F. Kennedy Jr. became secretary of Health and Human Services. The Democratic Party declared the COVID-19 emergency over while the virus was still killing en masse, ended free testing and vaccination, and established mass infection as the acceptable price of fully resuming production. Kennedy inherited an apparatus that both parties had already stripped of public confidence, and he has since cut its workforce by more than a quarter.
In January the CDC cut the number of diseases covered by the routine childhood schedule of immunizations from 17 to 11. After a federal judge stayed the change, President Donald Trump reimposed it by executive order on August 10 and demanded that the MMR vaccine be split into three shots, claiming without evidence that “together, there could be a possibility they’re quite lethal.”
By March, 29 states and the District of Columbia had rejected federal childhood vaccine guidance, and New York has since joined 15 other states in suing Kennedy to reverse the changes. The Northeast Public Health Collaborative, which includes both New York and Pennsylvania, follows the American Academy of Pediatrics schedule instead. That has not spared Pennsylvania the largest outbreak in the country, because the state lacks a public health apparatus capable of reaching the communities where the virus spreads.
On October 7 Kennedy announced a federal initiative on vaccine injuries, opening a clinic at the National Institutes of Health (NIH) and paying physicians to report to the Vaccine Adverse Event Reporting System. The announcement video featured NIH Director Jay Bhattacharya, Centers for Medicare & Medicaid Services Administrator Mehmet Oz and CDC Director Erica Schwartz. “We must listen to patients and families who report vaccine injuries—not dismiss or gaslight them,” Kennedy said. “This is how we earn back trust in our public health institutions.” The New York Times reported that the clinic may investigate aluminum-containing vaccines.
Across more than 5.65 billion doses distributed between 2006 and 2024, the federal Vaccine Injury Compensation Program compensated roughly one person per million doses, according to a white paper by the Partnership to Fight Infectious Disease.
The measles vaccine is safe and effective, and mass immunization is an elementary requirement of public health and of the self-defense of the working class. The collapse of confidence in vaccination has been cultivated from the top, by a fascistic right that spread anti-vaccine conspiracy theories and now directs federal health policy. The anti-vaccine movement is a reactionary tendency fostered by sections of the ruling class, and the working class must oppose it.
Kennedy built a career on the claim that vaccines injure children, and the destruction of public health is the conscious aim of the administration he serves. The federal government is building an apparatus to find injuries compensated once in a million doses, in the same months in which it has declined to count at least three of Pennsylvania’s five measles-associated deaths.
The woman who died at Hershey refused nothing. She died because the social defenses that stood between her and a preventable virus had been taken apart over decades, and because the agency charged with rebuilding them is now run by officials who count that destruction as an achievement. Those defenses will not be restored by the state that is dismantling them. Their reconstruction is a political task. The only social force capable of carrying it out is the working class, organized independently of both big business parties and fighting to reorganize healthcare on the basis of social need.