2026 Measles Projection and What to Do About It Part II
By Cory Franklin
April 15th, 2026
In my ongoing review of America’s measles outbreaks, which I discussed here last month, I thought I might look ahead on what might happen in the country for the rest of 2026.
How serious is the 2025-2026 measles outbreak that has gripped the US and what can be done to quash it? The dramatic rise in measles cases in the last 15 months requires action. But is this the calamitous public health emergency that some public health officials and media have proclaimed? Not when you put the numbers in context.
With the first quarter of 2026 over, it is possible to extrapolate the likely US figures for measles cases, hospitalizations and deaths for the year. The extrapolation is a rough estimate and measles cases will fluctuate depending on several factors including seasonal factors and whether school is in session. The numbers could change. But here are the projected estimates for 2026 based on current figures from the U.S. Centers for Disease Control and Prevention:
Expected total 2026 measles cases nationwide: Between 5,000 and 7,000. Adjusted for the current American population, this means 12-20 measles cases/million population.
In 2025 there were 2,300 cases for the entire year, or 6 cases/million, so there is an undeniable upward trend.
This is notable because there was less than 1 case/million annually in the first decade of the 21st century. Vaccination rates fell concurrently during this interval.
But some perspective is necessary: While measles vaccination rates in the US are below the desirable 95% herd immunity threshold, the current relatively high vaccination rate of 91% means the US caseloads shouldn’t begin to approach the immediate post-World War II period, before the introduction of the measles vaccine, when cases were 200 times higher per capita than they are today.
Contrast this also with the present high rate of measles cases in Canada. In 2025, there were 160 cases/million people in the country – 25 times as many cases per capita as the US experienced. This year Canada is again on pace to exceed the US with three to four times as many cases per capita.
Expected total 2026 US hospitalizations for measles: Between 300 and 500 patients, that is, 1 hospitalization/million population. This would mean in 2026 on average each day only one person will enter the hospital to be treated for measles in the US, posing no strain on hospitals.
The figure is based on the current hospitalization rate of 5% of all measles cases – substantially below the often cited 20% hospitalization rate the CDC currently quotes on its website. Why so? Because the agency’s calculation has overstated current real-world numbers.
The “new normal” of most measles cases, being treated with outpatient care, seems stable – hospitalizations were only 6% of cases in 2025 and in the first quarter of 2026, there was essentially one hospitalization/day nationally: 91 in 92 days. The reason for the declining hospitalization rate is unknown; one theory is the older cohort infected with measles today handles infection better than infants and young children do.
Expected total 2026 deaths from measles: 3 to 6, with a potential range of about 0-10. Put another way: at least a possibility we will see no deaths from measles this year and it is unlikely we will see more than 10, barring unforeseen circumstances.
The current mortality rate of measles is slightly under .1%, so based on the number of expected cases, the number of deaths will be 1-2/100 million of the country’s population.
Measles has become a far less life-threatening condition, with mortality falling off drastically in the first half of the 20th century, even before the introduction of measles vaccine (which subsequently reduced the mortality further to its current fractional level). Again, the reasons are uncertain – possibly a combination of better nutrition and population immunity or a less lethal iteration of the virus.
Measles can still be a serious life-threatening condition – the rare neurologic complication and late-life complications including loss of immunity still occur. But even in the current outbreak, deaths from measles this year are likely to be on the same order as fatal snake bites, and fewer than deaths from lightning strikes or insect stings.
While not a dire emergency, measles remains a problem that requires better management to avoid the morbidity, mortality, economic and human costs of infection. Because the vast majority of cases occur in the unvaccinated, increasing vaccination rates with the goal of at least 95% of the population is obviously the key. This involves four approaches:
First, better public messaging. In any risk-benefit equation, measles vaccine makes sense. Decades of experience clearly indicate the risks of the vaccine are virtually negligible and far less likely to occur than the benefit conferred by preventing infection. U.S. Department of Health and Human Services director Robert F. Kennedy Jr. and Surgeon General nominee Casey Means deserve reproach for not advocating for measles vaccine more vigorously.
Contrary to many opinions, RFK Jr. is not to blame for the epidemic – the majority of cases are in patients older than age 5, so their lack of early-childhood vaccination occurred well before Kennedy’s tenure. But his rhetoric has been contributory and should stop.
Second, consider tightening school requirements mandating vaccination before attendance. The trend has been the other way -increasing medical and religious exemptions and the result has been a suboptimal vaccine rate for kindergartners in many states. This demands a reexamination of immunization exemptions at all levels, from preschool to university.
When California abolished personal-belief exemptions, measles coverage in incoming kindergartners increased in two years from 92.8% to 95.1%. When to allow vaccine exemptions – religious, medical or personal – is a difficult question but one that deserves greater public attention.
Third, a rapid response team should be in place when a local outbreak occurs. This is better coordinated at the state rather than the federal level and should include prompt reporting, immediate isolation of cases, contact tracing and targeted vaccination in vulnerable communities, including holding emergency immunization clinics. Fortunately, this is occurring in most outbreaks today and is probably the best aspect of our measles response.
Fourth, better screening of new residents from other countries where there are suboptimal vaccination rates. The 2024 measles outbreak in Chicago, and the West Texas federal detention and Spartanburg, S.C. outbreaks earlier this year all involved travelers or immigrants from other countries. (Spartanburg has the highest percentage of Ukrainian immigrants of any metropolitan area in the US and Ukraine has one of the lowest vaccination rates in Europe.)
Because vaccination standards vary wildly around the globe, new arrivals to this nation are a high-risk group by definition. Screening for measles vaccination should be mandatory for those from other countries seeking to live in the US. Many have not been vaccinated.
Measles 2026 in the US is not COVID 2020 or influenza 1919. It is far less of a problem, but we have the resources to stop the spread of the disease. This will require less hyperbole and more resolve.
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Dr. Cory Franklin
Cory Franklin, physician and writer, is a frequent contributor to johnkassnews.com. Director of Medical Intensive Care at Cook County (Illinois) Hospital for 25 years, before retiring he wrote over 80 medical articles, chapters, abstracts, and correspondences in books and professional journals, including the New England Journal of Medicine and JAMA. In 1999, he was awarded the Shubin-Weil Award, one of only fifty people ever honored as a national role model for the practice and teaching of intensive care medicine.
Since retirement, Dr. Franklin has been a contributor to the Chicago Tribune op-ed page. His work has been published in the New York Times, New York Post, Washington Post, Chicago Sun-Times and excerpted in the New York Review of Books. Internationally, his work has appeared internationally in Spiked, The Guardian and The Jerusalem Post. For nine years he hosted a weekly audio podcast, Rememberingthepassed, which discusses the obituaries of notable people who have died recently. His 2015 book “Cook County ICU: 30 Years Of Unforgettable Patients and Odd Cases” was a medical history best-seller. In 2024, he co-authored The COVID Diaries: Anatomy of a Contagion As it Happened.
In 1993, he worked as a technical advisor to Harrison Ford and was a role model for the physician character Ford played in the film, The Fugitive.
Comments 20
Very rational, reasonable and decidedly nonpartisan. Thank you. I was particularly drawn to number 3 and 4. A rapid response team. This should be the case for natural emergencies as well as health. Our response to natural disasters is also lacking and it doesn’t seem to matter if the red or blue team is in charge.
As for number 4. Covid was raging. There were lots of sick people. It’s obvious our health care system was stretched to the limits. Yet, people were allowed to enter the nation illegally, and sent at our expense, all over the nation. They were not tested for Covid, nor were the offered, or required to take the experimental mRNA injection.
We’ve memory holed this entire debacle because our 401k’s have zoomed. Now, I saw in the WAPO where there are shortages of workers in various industries. No one is telling the truth here.
Government conduct during Covid and their incessant lies and misrepresentations have cast doubt on our health care system, people lost their jobs, children were harmed, suicided spiked, all for profit.
The Great Barrington Declaration was correct, and all three of the main authors were besmirched and vilified. Sanjay Gupta is still on TV, and Fauci has a pardon.
Trump approved operation warp speed, he shut the country down, then when the data proved inconvenient, instead of coming clean, he allowed the con to go on, while dismissing Covid as a flu.
Trump is not the only culpable party here, obviously. Our own government seems to be at war against us, especially the poor and working class.
Well as someone who was on the front lines (so to speak) during the initial onset of Covid, let me set the record straight and correct some of your misconceptions. First, the pandemic hit at the end of the Trump presidency. As such much about the virus was unknown and even misunderstood. Second, Mr. Trump’s role in Warp Speed was critical, foundational and instrumental. Warp Speed itself, was one of the greatest national accomplishments in my lifetime. It was right up there with Apollo, Manhattan, and D-Day. In my view the US rescued the world: from bench to jab. This has never ever been done before in such a short time span. And none of it would have happened with out Mr. Trump. No prior President in my opinion would have had the guts or the balls to cut through the incredible governmental red tape and overrule the ginormous static federal bureaucracy. The irony is that Mr. Trump could not bask in well-deserved glory over this monumental singular accomplishment because much of his base is “vaccine skeptical.” To belittle Donald Trump’s crucial role in Warp Speed is just pure ignorance on your part.
And of course there was the Great Barrington Declaration which you rightly praise. Well guess what? One of its authors, Dr. Jay Bhattacharya is presently head of the NIH and Acting Head of CDC. Oh, and guess who initially appointed Dr. Bhattacharya? That would be none other than Donald Trump. So here’s a suggestion Robert. Quit your sanctimonious gasbagging and actually become acquainted with the facts … even if inconvenient.
As usual great stuff Cory. But I do think you are letting Mr Kennedy off the hook too easily. Sure as you point out much of these events were set in motion well before his appointment as Head of HHS. But as a vaccine skeptic (and well published PI attorney) and a scion of arguably the most iconic and storied political family in American history – certainly in my lifetime – he had great influence well before his appointment.
Bruce:
You may well be right.He is definitely not helping.
But the bigger story evolving is that this might not be an RFK thing.
Unvaccinated people are the reason for these outbreaks here and in Canada.
But what is the reason behind the high number of unvaccinated?
In Canada, where I don’t know how much people listen to RFK, 40% of the patients are over 18, about 30% here.
If we assume that virtually everyone vaccinated for measles was vaccinated as a young child, then these people went unvaccinated more than 10 years ago, some 20 or 30 years or more ago for whatever reason. It has nothing to do with the diminishing rate of kindergarten vaccination today, which is always mentioned.
The elephant in the room, which is never mentioned, is that many if not most of these people may not originally be from the US or Canada.
In other words the high unvaxxed rate and the measles outbreaks may be people from other countries who came here. But amazingly enough, that is not being recorded by health officials or covered by the media – who could confirm or disprove it.
RFK may have only a minor peripheral role.
The elephants in the room whether it be measles or a host of other infectious diseases we thought had been eradicated are the result of unvetted immigrants whether illegal or legal that have poured into our western hemisphere from every sh..hole in the world, it is no mystery.
I concur 100% 👍
That’s exactly what I said to my friend back in 2022 when millions of illegal
Immigrants flooded across the border. Regardless of whether or not they had valid reasons for coming here NO ONE was talking about the infectious diseases they may be carrying! And now we blame people who question the number of vaccinations a baby receives early in life (older vaccines polio, dtap, MMR, tetanus all proven safe are not the issue) instead of correctly checking the vaccination and immigration status of the people where the outbreaks occur.
Thank you, Cory. As always, excellent statistical analysis of a disease that sould be under greater control except for the events of the last few years.
Of additional concern to me is the re-emeergence of bacterial meningitis in children, which we have not seen in decades since the vaccine became available in 1987. Most practicing pediatricians have never seen a case in their career.
Prior to the vaccine there were 20,000 cases with 1000 deaths per year. After the introduction of the vaccine, cases fell to fewer than 50 per year.
Compared to the complications of measles, meningitis has a greater likelihood of devastating consequences such as death, brain damage, deafness, inability to walk and talk.
Vaccine rates fell to 77.6% in 2021! How do we sound the alarm on the re-emergence of this scourge?
Francine Palma Long, MD
Another elephant in the room.
Thank you for a well researched and written article. I know I’m better educated after reading it. It made me feel that I time-warped back a few decades to when journalism was responsible and had trust in news media.
Very strange that diseases that had pretty much eradicated in this country suddenly made strong comebacks with the admittance of MILLIONS of third world illegales into our country. Whose fault is it? Joe Biden? Our fine Democrat politicians? The CDC for not issuing a public safety warning to the public about allowing the entry of these millions of unvetted illegals? Whose fault is it? Trump is obviously to blame. RFKennedy is obviously to blame. Racism is to blame. Global warming , yes, to blame. The suppression of LBGDEFG rights has a massive part in these diseases spread. The elimination of DEI policies is also culpable. Voter ID laws have resulted in people being fearful of vaccinating adding to these diseases spreading. The fear of ICE enforcement in schools has led children to cower in closer proximity to each other, forcing pathogens upon one another. There are many obvious contributions to the spread of measles and other diseases but let’s cut to the core cause: ITS TRUMPS FAULT, ALWAYS TRUMPS FAULT. NO MATTER WHAT HAPPENS, IT WILL ALWAYS BE TRUMPS FAULT. How do I know this? THE MEDIA TOLD ME SO. THE TELEVISION NEWS. THE NEWSPAPER. SOCIAL MEDIA. THEY WOULDN’T LIE WOULD THEY?
There’s a clip on YouTube with comedians David Spade and Dana Carvey talking about how they figured out the Covid scare was bullshit. When Bidens government began to let in illegals by the millions WITHOUT vaccinating a single one. All while threatening Americans with the loss of their jobs, travel restrictions and imprisonment for not taking the shot. Neither of these guys could be referred to as a “conservative” yet they both called bullshit on what happened back then. Both were right.
I can assure you the initial Covid wave was not bullshit. All you had to do was check the ICUs at my hospital (VA Hines) and my affiliate (Loyola University) to see in real time people dying horrible respiratory deaths; let alone the pile of dead bodies outside many NYC hospitals. Elderly folks like me were clearly at risk (one of my close colleagues in Endocrinology died in respiratory failure from Covid). The vaccines broke the back of the pandemic. It was lifesaving for those in my cohort and likely those with concomitant co-morbidities. The bullshit was that Biden and company told us we were all at the same risk or treated everyone as if they were the same risk. The fact was – unlike the 1918 flu pandemic W shaped mortality curve – that was not so. Old folks like me and maybe those a little younger were undoubtedly at risk. Otherwise healthy children were not. And the benefit to otherwise healthy adolescents of the vaccine was clearly very much in doubt. The BS was Biden and company never acknowledged these truths even when they became obvious. Biden and his factotums in the CDC denied the efficacy of natural immunity. And perhaps their greatest denial of reality was maintaining the myth that the vaccines would totally prevent infection and transmission when in fact the original clinical trials were not powered to answer those questions in the first place But let me assure you that in the cohort clearly at risk – those 60 and above – the initial Covid vaccines were lifesaving. The data from our nation’s ICUs from virtually every state in the union clearly confirmed what my lyin’ eyes told me. I am personally thankful and forever grateful to Donald Trump for forcing the massive and ginormous ship of state to develop in record time these lifesaving vaccines. I guess you had to be there to witness first-hand – up close and personal – the initial havoc of Covid to realize the enormous contribution these vaccines made. As far as Biden not requiring “immigrants” to be vaccinated, well this is not any different than a variation of the elephant in the room that Dr Franklin describes regarding the recent measles outbreak. Both situations prove that political dogma rule when the truth proves inconvenient. In both cases inconvenient to the Democratic Party liturgy.
I read what Mr. Diaz was saying was not that Covid itself was a scam, bur rather that EVERYONE was at equal risk was a scam.
I know that after reading, and speaking with both physicians and virologists, I came, independently, to the conclusion that closing schools was more about preserving the teacher and substitute teacher cadre, many of whom were in the high risk age group themselves as well as caring for more aged parents than it was about children’s health. YES keeping children safe and well is crucial, and YES, children could and did become infected with Covid. But telling the world that we’re going virtual school so the teachers survive isn’t going to play as well as telling the world we’re doing it to protect children.
I am sure that you, Dr. Franklin are fully aware that measles were the most dangerpous in the 1950’s until the vaccine was introduced in 1963. Today all the anti vaxxers expresing their rights to not be vaccinated have endangered the population. Being retired Chicago Police I’m all for peoples rights. Right until they endanger someone else. If someone feels the need, no matter how ignorant that need may be for immunization exemptions, so be it. These same people neeed to be isolated from the rest of society. Something akin to the scarlet letter. They should all be forced to wear a large red letter V around their necks so everyone knows they refuse to be vaccinated and are a danger to society. If you want that right to not be vacinnated, wear your right proudly. Tell everyone. Don’t be afraid or ashamed, just don’t be around anyone else that you can infect and then be the cause for the start of an epidemic. Ignorance is rampant. These people are correct, they have rights. We as a society also have a right to not be sick. Perhaps the insurance companies should weigh in and start refusing to provide coverage to people that refuse to utilize common and customary healthcare. Then when they get sick they can also heal thyself.
I agree. I should be able to lead the life I choose unless it interferes with with you doing the same. Then we have a problem. Can’t speak for Dr Franklin. But my view is next to clean water and sanitation vaccines are the greatest public health advance in human history. I guess I am biased somewhat since I was once an original “Polio Pioneer.”
Um…if you are willfully vaccinated, you are (I guess) immune to the disease that you fear the unvaccinated might give you. Therefore why would it matter to you if I don’t have the shot? Why should I have to wear a badge identifying myself as
“unvaccinated”? How about I wear an armband? Much more stylish. Dr. Kleinman has made a point about the initial first wave of Covid. As the virus spread and more data was studied it was accepted that it was most hazardous to the elderly, people with respiratory conditions or people with other health issues. Was it really necessary to shut down the country? The state of Illinois for a year? Debatable. As the great Chicago Mayor Rahm Emmanuel once stated, ” never let a good crises go to waste”. This outbreak gave our government a great opportunity to conduct a social experiment on a massive scale. Not only on how to mind control millions of people but on how to commit fraud on a MASSIVE scale. The small fry PPP loan fraudsters are getting local headlines but maybe Dr. Kleinman can tell us WHERE DID THE BILLIONS OF DOLLARS IN MEDICAL EQUIPMENT GO? Is it being warehoused? Donated to local hospitals? Ukraine? Sold on the black market? WHERE IS ALL OF THIS EXPENSIVE EQUIPMENT? Just like our tax dollars that were used to buy this stuff. DISAPPEARED.
I think I was very clear regarding the cohort for which the vaccines were by far most effective. And if it was not clear to you then let me be clear: the elderly and the sick benefited. The otherwise healthy young did not. And it was NOT necessary to shut down the country – particularly when the epidemiology of the virus was clarified early on. In fact the as judging by excess mortality data (using Sweden as a “gold standard”) the “shut down” of our country likely caused more harm overall than the virus itself. And yes, the Covid era, was marked by enormous fraud. None of that discounts my initial argument as to what I personally witnessed: absolute havoc in my hospital pre vaccine and reasonable “control” post vaccine. I do not think my positions are contradictory.
Enrique you ask great questions. As far as why would one be concerned about an unvaccinated person if one is vaccinated? I think this raises the larger societal issue of “herd” immunity. Not everyone can safely be vaccinated for various reasons. So depending upon the disease in question (its R value) and the efficacy of the vaccine, in question it is possible for an unvaccinated person to be “protected” in the absence of self vaccination via “herd” immunity. If a lot of folks choose not to be vaccinated then the threshold for “herd immunity will never be reached. There might be other reasons to your question, but that is the main one I can think of. Thank you.
Very informative and good piece. I’m glad he addressed immigration. When 15 million or so people entered our nation illegally, with no checking, is it possible the sudden outbreak is less about vaccinations going down and more about people coming from countries where such vaccinations are not required or enforced?