The Trump administration has changed the way it counts measles deaths amid an outbreak in Pennsylvania, which on Sunday saw the third apparent measles-related death in the state reported by a local coroner.
The US Centers for Disease Control and Prevention (CDC) is now using data from the National Center for Health Statistics (NCHS), which is a way to track mortality trends over time, according to a note published to the agency’s website on 4 September.
It’s a “puzzling” move, said Debra Houry, a former CDC chief medical officer. “The change doesn’t make any sense,” she added. This system is “not meant to confirm an individual case”; instead, it’s “usually focused on high-quality, long-term mortality trend analysis”, she said.
Previously, the CDC used a system called the National Notifiable Diseases Surveillance System (NNDSS), which the agency has described as the supply chain for data from local jurisdictions and states to the federal government.
“CDC will report measles deaths if and when the National Center for Health Statistics reports measles as the underlying cause of death,” said Emily Hilliard, a US Department of Health and Human Services (HHS) spokesperson.
The CDC put an asterisk under its tally of deaths that leads to a note saying the NCHS “does not currently have any death records from 2026 that indicate measles is the underlying cause”.
Officials in Pennsylvania have confirmed two deaths this year, a newborn and a six-week-old infant, associated with measles. And a 40-year-old woman in Jefferson county, Pennsylvania, died on Saturday from probable measles, said Greg Furlong, the county’s coroner.
The woman was unvaccinated and she had chronic obstructive pulmonary disease (COPD) with 24/7 oxygen support, both of which made her vulnerable to complications. The woman had not sought medical care for her apparent infection. “They were going to, but obviously got to the point where it turned to the worst and ultimately led to her death,” Furlong said.
She had the classic measles rash and other symptoms, and a close contact had recently tested positive for measles.
A nasal swab is undergoing testing for measles and results are expected within days. But the death will be classified as probable measles-related because of the epidemiological connection to a confirmed case, Furlong said.
The woman would not have died without the measles case, despite her conditions, the coroner said.
“None of us know when our last day is here on this Earth,” he said. “But I strongly 100% believe if this wouldn’t have come into her life that she would be alive today,” he said, adding: “Even with her underlying conditions, I believe she’d be alive today.”
Maintaining a measles immunization rate of at least 95% is “absolutely” important for protecting people who are vulnerable to infection, Furlong said. That’s especially true for those who can’t be vaccinated, like infants under the age of six months and pregnant people.
“We can all learn from this, and hopefully we can encourage more people who aren’t immunized to get immunized,” Furlong said, adding: “People do not want to be a statistic.
“Hopefully this is something that more people get tested, more people get immunized. It’s something we thought we had eradicated, and here we are,” he said. “But it’s a shame that had to lead to somebody’s death.”
Pennsylvania had 676 confirmed measles cases as of Friday, but Furlong said he believed the official case numbers are an undercount and there are more infections that are not being reported. “I 100% guarantee it,” he said.
Furlong made the announcement on Sunday because “it’s informing people of something that we should all be aware of”, he said. Once the Pennsylvania department of health completes its investigation of the death, including the results from the nasal swab, it will notify the CDC of the case.
Robert F Kennedy Jr, the HHS secretary, has not commented on the death, posting on X about fitness, Medicaid and Medicare fraud, and screen time.
Kennedy previously argued without evidence that the two earlier deaths may not be from measles, and he asked Erica Schwartz, the CDC’s director, not to count the deaths in the official CDC tally, according to reporting by Reuters. The day after the Reuters report was published, the CDC changed its data source on measles deaths.
Kennedy also spent nearly two decades at the helm of the Children’s Health Defense, an anti-vaccine organization, and he has repeatedly spread misinformation about vaccines.
“CDC’s recommendation for the MMR vaccine has remained unchanged, and the Secretary has repeatedly said that the MMR vaccination remains the most effective way to prevent measles infection,” Hilliard, the HHS spokesperson, said.
