New York Declares Measles Emergency as U.S. Cases Hit Highest Level in Decades

Originally published August 16, 2026. Updated October 6, 2026, with new reporting following New York’s measles disaster emergency declaration, and additional commentary from Brian Labus, Ph.D., M.P.H., REHS, associate professor of epidemiology and biostatistics at the University of Nevada, Las Vegas.

Measles is having a resurgence in the United States, and 2026 is shaping up to be the worst year for the disease in decades. As of October 1, more than 3,800 confirmed cases had been reported nationwide, already surpassing the full-year 2025 total of 2,289 cases, itself the highest annual count in more than three decades. Cases have now been reported across 47 jurisdictions, with active outbreaks including Pennsylvania, Wisconsin and Ohio.

The surge escalated further this week when New York Governor Kathy Hochul declared a State Disaster Emergency on October 5, the first such declaration by a U.S. state since the current surge began. New York has recorded 108 cases this year, up from 48 in all of 2025, with 92 of them concentrated since July 15 in underimmunized rural communities across 18 counties. The order expands who can administer the measles, mumps and rubella (MMR) vaccine, including paramedics, EMS providers, midwives and pharmacists, and allows nurses to order measles testing.

The main driver: Declining vaccination rates

Public health experts point to one factor above all others behind the current surge: a gradual, multiyear decline in childhood MMR vaccination rates. Measles is considered the most contagious vaccine-preventable disease, meaning it’s typically the first to resurface when community immunity drops, even slightly.

“The current nationwide surge in cases is being driven by a decline in immunization throughout the population,” said Brian Labus, Ph.D., M.P.H., REHS, associate professor of epidemiology and biostatistics at the University of Nevada, Las Vegas. “Nearly 95% of the people infected since cases first surged in early 2025 have been completely unvaccinated.”

That sensitivity is why small dips in vaccination coverage can have an outsized impact. According to public health estimates, just a 1% decrease in childhood MMR vaccination rates could lead to roughly 17,000 additional measles cases, 4,000 hospitalizations and dozens of preventable deaths nationwide each year. As pediatric infectious disease expert Richard Besser, M.D., put it, measles functions as “the canary in the coal mine” for broader gaps in vaccination coverage.

Achieving herd immunity against measles requires a vaccination rate above 95% in a community, Labus said. “There is a misconception that herd immunity means that no one will be infected with measles,” he said. “What herd immunity actually means is that if measles is introduced into the population, there will not be enough people to maintain a sustained transmission in the population. Once we drop below that level, there are enough susceptible people in the population that measles can gain a foothold and continue to spread through the community once it is introduced.”

Why outbreaks spread so quickly once they start

Measles doesn’t need many opportunities to spread. The virus is airborne and can linger in a space for up to two hours after an infected person leaves the room. In an unvaccinated population, a single case can lead to as many as nine out of 10 close contacts becoming infected. That’s why outbreaks tend to take hold quickly in communities where vaccination coverage has fallen below the threshold needed for herd immunity, even if national vaccination rates overall remain relatively high.

Early symptoms, Labus said, include “a high fever, cough, a runny nose and red, watery eyes. A few days later, the characteristic rash erupts on the face at the hairline and works its way down the body.”

What “elimination status” means, and why it’s at risk

The United States officially eliminated measles in 2000, meaning the disease was no longer continuously spreading within the country, though cases could still arrive from travelers. Maintaining that status requires stopping any chain of transmission within 12 months of it starting. With U.S. outbreaks now stretching across multiple states and years, including a Pennsylvania outbreak that has surpassed 1,000 cases and five deaths, international health experts are expected to review later this year whether the U.S. should retain its elimination status, a designation the country has held for a quarter century.

What this means for individuals

For most people, the practical takeaway is straightforward: The MMR vaccine remains highly effective, and staying current on it is the most reliable way to reduce personal and community risk. Asked what he’d want a hesitant parent to understand before deciding on the vaccine, Labus pointed to how well it has worked historically.

“The measles vaccine works so well that we eliminated the disease in the United States,” he said. “But because people stopped seeing how serious the disease is, they have become more afraid of the vaccine than the disease. People have also forgotten how serious measles can be. Just because every kid used to get it doesn’t mean that there is anything mild about it. Around 10% of people infected this year have been hospitalized, and around one in 1,000 have died. There is also a perception that the vaccine is somehow dangerous, but severe side effects are actually quite rare, especially in comparison to the risk of serious health problems caused by the disease itself.”

Public health officials recommend that anyone unsure of their own or their child’s vaccination status check with a health care provider, particularly as outbreaks continue in Pennsylvania, Wisconsin and Ohio. “Unvaccinated people are at much greater risk of developing the disease anywhere measles is spreading,” Labus said.

This measles trend serves as a reminder that vaccination isn’t just a personal decision. It’s also what keeps community-level protection strong enough to prevent outbreaks, and emergencies, like the one now underway in New York.