By Cory Franklin

March 15^th, 2026

Most news reports about the current status of measles in the United States are formulaic and predictable. They will tell you that to date in 2026, measles cases have passed 1,000 and are on pace to exceed last year’s total of nearly 2,300. You will be informed that 97% of the cases are in either the unvaccinated or under-vaccinated, with a current South Carolina outbreak accounting for a large percentage of the cases. Many articles warn that the country may lose the measles elimination status it has had since 2000.

All true, and the blame for the deterioration of the public health system is frequently placed on DHHS Secretary Robert F. Kennedy Jr. and his daft statements on vaccination. A trenchant quote is usually included from an infectious disease expert along the lines of “the damn house is on fire.”

The facile narrative is that the measles outbreak of 2025-26 is merely the result of vaccination rates falling below a threshold value of 95%. That is accurate as far as it goes. But the 2026 measles story is complicated and many questions remain unaddressed by the boilerplate story.

Some questions journalists and public health experts should be asking:

Measles is generally considered a disease of young children.

Why are a majority of the patients with measles older than expected? 

75% of patients are over 5 years old, and in 2025, more patients were over 20 than were under 5. The peak demographic age is between 5 and 19.

If vaccine skepticism was simply the result of RFK Jr.’s blather (and the COVID pandemic), why is the average age of cases around 9? RFK Jr.’s rhetoric and policies may be contributory but they were not causative for an older demographic that was not vaccinated years before RFK took office.

Why now, in the past two years, and why so many countries?

Measles cases in Canada surged in 2025, 25 times higher per capita than in the United States, the highest rate in North America. In 2025, Mexico had six times as many cases per capita as the United States. Cases in the UK and Western Europe dropped in 2025, but in 2024 they were the highest in a generation. The suboptimal international vaccination rates were present before 2024. Why did the explosion in measles cases occur so recently and so abruptly?

That suddenness raises another question:

What role do new arrivals from under-vaccinated countries play in the measles outbreaks hitting developed countries?       

The current outbreak in South Carolina, by far the largest in the country, is centered in upstate Spartanburg County.  Generally unreported is that many cases in this region can be traced in part to the Ukrainian and Slavic immigrant community there.

The overall vaccination rate in this community is low, which is reflected in the community’s schools and churches – in one charter school the vaccination rate is 20%. The press and to a certain extent the public health system have not devoted sufficient attention to the interplay of the measles outbreak and newer arrivals in America.

Yet another question of near-instant origin:

 Why are measles hospitalizations so low?                                                                          

The 2026 rate of hospitalization for measles in the US is 4%; in 2025 it was 11%.  A 2025 CDC estimate was that 20% of all measles cases required hospitalization, so clearly the current figures are much lower than expected.

Some infectious disease experts, including one of the country’s leading vaccine specialists, Dr. Paul Offit, believe this is due to underreporting of hospitalizations. Offit said, “It’s vast underreporting …measles makes you sick.”

Perhaps, but it is unlikely there is enough hospital underreporting to reach the 20% figure and it is just as likely there are disproportionately more unreported measles cases that did not require hospitalization. The low hospitalization figures do not necessarily mean measles is less severe than in the past – it can still be dangerous – but this question, like the others raised here, requires urgent investigation.

The healthcare press and experts hardly distinguished themselves during the COVID pandemic. In the fall of 2020, a reporter for The Atlantic wrote that Iowa could expect to see “nothing less than a tsunami” over the coming holiday season because the state failed to take the precautions the author believed necessary.

There was no tsunami; cases and hospitalizations dropped by 75% between Thanksgiving and New Year’s. Rather than concede that the spread of COVID is not well understood, the reporter attributed the drop to emergency measures the state took after her article came out, an assertion without much evidence.

Along those lines, in late 2020 Dr. Atul Gawande, the respected doctor-author, explained the relatively low COVID-19 rates in India when compared with those in the U.S.: “Indians have embraced masks thanks to a combination of factors, including a healthy fear of the virus among the public, a unified voice from authorities, billions of automated phone messages.” By that spring, India was averaging of 400,000 cases a day, one of the highest totals of the pandemic. No explanation by Dr. Gawande.

The simple narrative of measles outbreaks as a result of under-vaccination is true but almost certainly incomplete. Suggesting otherwise is lazy journalism and lazy public health leadership.    There is more to the story, much of it unknown, and the public is ill-served when those responsible for asking questions fail to do so.

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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.