With measles transmission in the United States at levels that haven’t been seen in decades, the principal deputy director of the Centers for Disease Control and Prevention said Tuesday that he would not view the loss of the country’s measles elimination status as a significant event.
“Not really,” said Ralph Abraham, a physician who formerly served as Louisiana’s surgeon general. “You know, it’s just the cost of doing business, with our borders being somewhat porous [and] global and international travel.”
A country does not lose measles elimination status by having imported cases of the disease. With the virus circulating globally, such introductions will occur. Elimination status is lost if, after an introduction, a country is unable to stop ongoing transmission of the virus and circulation continues for a year or longer.
Abraham, who began his tenure at the CDC earlier this month, said that while the agency is helping states quell outbreaks however it can, some transmission is happening within communities where parents have chosen not to vaccinate their children and “that’s their personal freedom.”
“You know, the president, the [health] secretary, we talk all the time about religious freedom, health freedom, personal freedom, and I think we have to respect those communities that choose to go somewhat of a different route,” Abraham said during a press conference called to discuss the ongoing measles outbreaks.
“As CDC, it is also our responsibility and our goal to support these communities in any way that we can to minimize the effects that measles would have, especially on the pediatric population,” he said.
In addition to assisting states, Abraham said he and health secretary Robert F. Kennedy Jr. have been promoting measles vaccination. “We are saying publicly and do believe that the MMR vaccine is a good vaccine to prevent the measles,” he said. (Measles vaccine is administered in a combination vaccine that also protects against mumps and rubella.)
Vaccine advocates say Kennedy has not been publicly forceful about the importance of vaccination and has fanned anxieties about supposed vaccine risks that scientific evidence has shown to be unfounded.
The press conference was held on the one-year anniversary of the first confirmed measles case from the large West Texas outbreak that spread across multiple states and led to three deaths in 2025. As of Jan. 14, a total of 2,242 confirmed measles cases had been reported to the CDC in 2025, the highest single-year total since 1991.
According to Johns Hopkins University’s measles tracker — which posts numbers more quickly than the CDC does — there have already been 336 confirmed cases in 2026. That is more cases in three weeks than the country recorded in most years in the period from 1993 to 2025. The number of measles cases in the U.S. started to decline in the early ’90s, a few years after health officials began recommending two doses of the MMR vaccine instead of one.
It is currently unclear if some of the present transmission traces back to the West Texas outbreak. A CDC scientist who also took part in the press conference said the agency is working to generate and study whole genome sequences of viruses from a variety of locations to try to determine if more recent cases signal ongoing spread or were triggered by new introductions of measles virus from abroad. Reporters were told the CDC scientist could not be identified by name as a condition of participating in the briefing.
The U.S. was said to have eliminated measles in 2000, a status that meant the virus was no longer endemic — not spreading in an ongoing fashion — within the country’s borders.
Canada, which has been in the grips of a large measles outbreak that has spanned most of the country, lost its measles elimination status in November.
On Friday, the Pan American Health Organization announced that its regional verification commission, which is responsible for determining if countries in the region have eliminated measles, will meet on April 13 to study whether the United States and Mexico have lost their elimination status.
The CDC scientist noted that the agency is working to compare whole genome sequences of a variety of viruses from across the country to try to determine if spread is ongoing.
“We need time to be able to do that comprehensive analysis,” the official said, noting that the agency is working with academic and state labs on a new way of analyzing measles genetic data. “We’ve not had to use whole genome sequencing routinely in the past for measles.”
