Measles Elimination

With the end of the NY state measles outbreakexternal icon, the United States has maintained our measles elimination status of nearly 20 years.

While we expect importations of measles cases into the United States to continue, the risk for measles for the majority of the population would still remain low. That is because most people in the United States are vaccinated against measles.

The World Health Organization (WHO) definespdf iconexternal icon measles elimination as “the absence of endemic measles virus transmission in a defined geographical area (e.g. region or country) for at least 12 months in the presence of a surveillance system that has been verified to be performing well.” In 2000, measles was declared eliminated from the United States.  That means the disease is no longer constantly present in this country. However, travelers continue to bring measlesexternal icon into the United States, and it can sometimes spread and cause outbreaks among people who are not vaccinated. If a measles outbreak continues for a year or more, the United States could lose its measles elimination statusexternal icon.

The U.S. will continue to detect and respond to measles cases

Measles outbreaks continue to occur in countries around the world so there is always a risk of measles importations into the U.S.

  • When measles is imported into a community with a highly vaccinated population, outbreaks either don’t happen or are usually small.

The outbreaks in New York State (“Rockland County”) and New York City have ended.

  • The outbreaks in New York City and New York State started on September 30 and October 1, 2018, respectively. These outbreaks were associated with importations from Israel and had ongoing transmissions for almost one year in large, close-knit, and under-vaccinated Orthodox Jewish communities. They accounted for 75% of measles cases in the U.S. during 2019. These outbreaks threatened the measles elimination status of the United States.
  • On September 3, 2019, New York Cityexternal icon declared the end of their measles outbreak, followed by the New York State Department of Healthexternal icon declaring the end of their outbreak on October 3, 2019.
  • CDC has been working with the Pan American Health Organization (PAHO) throughout the year to keep stakeholders updated on measles surveillance. CDC will meet with PAHO’s Regional Verification Commission in the coming months to review the U.S. data and verify measles elimination status.
  • CDC will continue to work with state and local partners to try to identify every case of measles and prevent measles transmission within this community and beyond. CDC will also continue to work with local partners to strengthen vaccine confidence in these communities to prevent a future recurrence of this situation.
Eliminating measles in the U.S. was a historic achievement

Achieving measles elimination status and maintaining it for 19 years was a historic public health achievement.

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  • Even if we lose our measles elimination status, vaccine coverage in the U.S. remains high. Therefore, the majority of the U.S. population remains at low risk for getting the disease.
  • The best thing you can do to protect yourself and your community is to make sure you and all of your loved ones get vaccinated on time according to CDC’s routine immunization schedule.
  • Achieving and maintaining elimination status has been a major undertaking. It has required a significant investment of people, time, and resources. (See Measles Epidemiology in the United Statesexternal icon. J Infect Dis 2004; 189(Suppl 1) May 2004: S1–90 and Elimination of Endemic Measles, Rubella, and Congenital Rubella Syndrome From the Western Hemisphereexternal iconJAMA Pediatr. 2014;168(2):148-155). Reestablishing elimination status would take time and resources.
  • However, there won’t be any economic, political, or practical penalties for losing elimination. Losing measles elimination would have no adverse implications for the immunization program, its funding, or access of America’s children to vaccination either in the private sector or through the federally funded Vaccines for Children Program. 
The measles vaccine protects you and your community

Children should be vaccinated on schedule with MMR vaccine.

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  • Recommendations for infants traveling internationally have not changed. Infants (6 through 11 months old) should receive 1 dose of measles-mumps-rubella (MMR) vaccine before travel. This dose does not count as the first dose in the routine childhood vaccination series.

During an outbreak of measles, public health authorities might recommend an early dose of MMR for infants 6—11 months old who live in, or are traveling to, communities in the U.S. where there is ongoing, community-wide transmission of measles. They may also recommend a second dose of MMR for children 1—4 years of age, and/or adults who previously only received one dose, depending on the age of the affected population. Check the local health department’s website for specific recommendations.

Page last reviewed: October 4, 2019