The CDC Tracker Still Omits Pennsylvania’s Two Measles Deaths

The CDC’s national measles tracker still lists no deaths for 2026, after Pennsylvania confirmed two measles-associated deaths in Lancaster County. A footnote on the federal page says available information does not establish whether measles caused or contributed to the deaths.

The fight between Gov. Josh Shapiro and Health Secretary Robert F. Kennedy Jr. is the noise. The quieter split sits with the people who actually classify the dead: a county coroner, the state health department, and a CDC director barely a month into the job.

Three Official Counts for the Same Two Deaths

The Centers for Disease Control and Prevention’s measles page, updated August 30, reports 2,903 confirmed measles cases in the United States as of August 27 and prints an asterisk in the 2026 deaths cell. Last year the same page counted 3 measles deaths. Pennsylvania’s health department still counts two. Lancaster County Coroner Stephen Diamantoni, a Republican family doctor first elected in 2007, has said his office has not certified a death caused by measles.

Those are not rounding errors. They are three offices answering three different questions about the same two people, both unvaccinated Lancaster County residents.

WHO IS COUNTING WHAT

On the federal map, Pennsylvania still shows 443 cases as of August 27, a lag behind the state’s later tally. HHS press secretary Grace Davis Jamison said the two deaths “have not been confirmed based on the information currently available to CDC.” The agency’s press office sent questions to Kennedy’s office at HHS.

The Coroner Found a Ruptured Spleen

One of the two people is no longer a blank. A newborn boy died on August 14 at a birthing center in Strasburg Township, hours after a midwife delivery. Diamantoni has said measles virus showed up in the infant’s lung tissue. The forensic pathologist who did the autopsy, Dr. Wayne Ross, called the cause a traumatic laceration of the spleen and subsequent bleeding, and did not treat measles as a driver of the rupture.

Diamantoni later said measles was still listed under Part II of the death certificate, the line for other conditions that contributed but did not produce the underlying cause. He has said he does not believe measles contributed and that the listing was meant to give a broader view of the child’s health. He also said the spleen showed no swelling or enlargement, and that the baby lost a massive amount of blood.

Paul Offit, a pediatrician at Children’s Hospital of Philadelphia who treated measles during the 1989-1991 epidemic, has argued the other way: congenital measles can enlarge the spleen and thin its capsule, which can tear during birth. That is a medical disagreement about one organ in one infant, not a dispute about whether the child existed.

The parents, an Amish couple, did not know their son’s death had become national news. They do not watch television, use the internet, or take a newspaper. The mother had measles after other children in the house fell ill, became severely sick, and went into labor about a month early. The baby was not breathing. Paramedics gave oxygen and chest compressions. The midwife told the parents measles had a role. They believed that. They had not been told about a ruptured spleen. The father had been vaccinated. The mother and the other children had not.

A newborn is not eligible for the routine measles shot, which starts at 12 months. If the baby was infected in the womb, the mother’s lack of vaccine is the exposure that matters. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and an infectious-disease physician in Pittsburgh, said maternal measles is tied to preterm birth, which raises the risk of an infant dying.

The coroner’s account and the state’s account are not necessarily in conflict. They are two offices answering two different questions, but nobody in Harrisburg explained that, so the public was left to choose between fraud and incompetence.

Amesh Adalja, senior scholar, Johns Hopkins Center for Health Security

Lancaster County has no local health department of its own. The coroner gets information from the state. Diamantoni has said he still does not know who the state’s second person is supposed to be.

What Pennsylvania Means by Measles-Associated

Shapiro and Health Secretary Dr. Debra Bogen announced the first measles-associated deaths in 35 years on August 25 in Lancaster, the state’s first such deaths since 1991. The department would not give ages or other identifying facts, citing privacy. The phrasing in the release also called them deaths “related” to measles, which is how most of the country heard it.

After Diamantoni and Lancaster County Commissioner Josh Parsons said the coroner’s office had no measles-caused deaths on its books, the department posted a narrower definition.

HOW THE STATE IS USING THE TERM

• The trigger: Laboratory or epidemiologic evidence of measles is present.
• The gap: A medical certifier or coroner may not list measles as the immediate cause of death.
• The legal point: Not every death in Pennsylvania has to go to a coroner, so a state epi file can exist without a coroner’s measles ruling.
• The infant file: The department said one of the two deaths is the baby the coroner is already reviewing.

Bogen, a pediatrician, said she had “thoroughly reviewed the case investigation information and sadly can confirm that there were two recent measles-associated deaths in Lancaster County.” Press secretary Neil Ruhland said every reported measles case is reviewed against the CDC case definition and that the department “has provided all required epidemiological data to the CDC” on both deaths. The state reported the deaths to the CDC measles response team on the morning of August 25 and met with federal officials the next day.

Measles deaths are not usually coded with measles as the immediate cause anyway. Pneumonia, brain swelling, and bleeding are the events on the last line. The associated label is built for outbreak work, a faster flag than a finished certificate. That speed is useful in a county with hundreds of cases. It is also the opening Kennedy walked through.

Last Year the Deaths Went on the Board Anyway

Federal measles counting has, for years, started with the states. Health departments investigate, apply the measles case definition for national notification set with the Council of State and Territorial Epidemiologists, and send CDC the national picture. Dr. Debra Houry, who was the agency’s chief medical officer until she resigned last year, said CDC has historically relied on that state and local expertise. Dr. Nirav Shah, a former CDC principal deputy director, called the idea of second-guessing a state epidemiologist “pretty remarkable.”

The 2025 deaths show how that used to work. Two unvaccinated school-age children died in Texas and one unvaccinated adult died in New Mexico. Houry noted that the New Mexico death was added to the national total even while it was still under investigation, including a person who tested positive after death. After a Texas child died, Children’s Health Defense, the group Kennedy helped build, argued the child had died of bacterial pneumonia that doctors could have managed differently. Pneumonia is a common measles complication. CDC counted that death.

Shah has described infection-related death tallies as an umbrella that includes people who tested positive and then died close to that test, often within 10 days. That is the rule Pennsylvania says it is using. It is also the rule Kennedy has spent years attacking as a COVID-era trick. The Lancaster files handed him a coroner who would not say “from measles,” and a state that would.

Officials familiar with the decision said new CDC Director Erica Schwartz, confirmed this month, ordered the unusual footnote onto the surveillance page. The page listed 0 deaths on August 29, showed 2 on August 30 with a note that health departments make measles-associated death determinations, then replaced the 2 with the asterisk later that afternoon. States have been the arbiter of these counts. This week they are not.

Lancaster County’s Outbreak Did Not Wait

While the death cell is frozen, the outbreak is not. Pennsylvania’s public measles dashboard, updated Mondays, Wednesdays, and Fridays, had 497 confirmed cases across 34 counties by this week, with 87 people hospitalized. 227 of those cases are in Lancaster County, 45.7 percent of the state total. On August 25, when the deaths were announced, the count was 393 cases across 28 counties.

THE LANCASTER FILE

• County share: 227 of Pennsylvania’s 497 confirmed measles cases this year are in Lancaster County.
• Hospital care: 87 people have been hospitalized statewide.
• Kindergarten shots: 87.6 percent of Lancaster kindergartners had two MMR doses in the last school year, under the 95 percent mark used for community protection.
• Statewide shots: 93.2 percent of Pennsylvania kindergartners, 94.6 percent of seventh graders, and 96.9 percent of twelfth graders had both required MMR doses in 2025-26.
• Amish estimate: The health department estimated last year that about 25 percent of Lancaster’s Amish community had received MMR.

Two doses of MMR are described by the state as giving 97 percent lifetime protection. Among Pennsylvania’s counted cases, officials have said none were fully vaccinated. The Shapiro administration says it has given more than 4,100 MMR doses at 91 pop-up clinics since the outbreak began in April, with 40 more clinics planned, and that 35,000 Pennsylvanians received an MMR dose in July, 10,000 more than a typical month. The department also told clinicians they may vaccinate infants as young as 6 months in this outbreak.

Nationally, 94 percent of the 2,903 confirmed 2026 cases are in people who are unvaccinated or whose status is unknown, and 223 of those patients (8 percent) have been hospitalized. South Carolina (670) and Utah (526) still sit above Pennsylvania on the federal case table. Measles has also been turning up away from home, including an Asheville hotel measles exposure notice that reached guests after they had already left.

Bogen said people in Pennsylvania are not familiar with measles after more than three decades without it, and do not fully understand how severe it can be. Shapiro, speaking as a father of four, said the illness and death from measles is “completely preventable.” Death from measles is uncommon, the department says, on the order of one to three patients per 1,000 cases. Rare is not the same as zero, which is the number the federal tracker is still publishing.

The Charge That the Deaths Were Invented

Parsons, the county commissioner, spent August 26 asking Harrisburg for facts the press conference had not given. He wrote that he had spoken with Diamantoni and senior coroner staff, that the office then had “zero measles deaths in Lancaster County,” and that it had “one death of a person who died WITH measles, but not from measles.” He said he did not know whether the state was counting that infant, and knew nothing about the second death. He said he had gotten no answers from the governor’s office or from Penn Medicine Lancaster General Health.

Kennedy quoted that post and went further. He called Shapiro’s trip to Lancaster an “unseemly rush” and a replay of “the Democrats’ COVID playbook.” Then he wrote that the announcement appeared premature, “and the deaths may even have been altogether fabricated by one of the Governor’s hopeful staffers.”

Governor Shapiro's unseemly rush to Lancaster County to convene a national press conference and his giddy delight in announcing two measles deaths was a morose commentary on the contemporary political dialogue. The performance was a replay of the Democrats' COVID playbook:… https://t.co/LvZf3br1dB

— Secretary Kennedy (@SecKennedy) August 26, 2026

Fabricated is a word for invented corpses. The infant on the autopsy table is not invented, and neither is a positive measles test in lung tissue. The live argument is whether measles tore the spleen, listed on Part II, or sat in the background of a traumatic bleed. Parsons asked for ages and locations the law allows a department to release without naming a family. The state chose privacy. That silence did not invent the deaths. It did hand Kennedy a hole to fill, and he filled it with fraud.

The same pattern showed up around the Texas children last year, when pneumonia on a chart was treated as proof measles had been framed. CDC still counted those deaths. This time the agency Kennedy oversees is the one holding the national number at zero. Schwartz has publicly supported childhood vaccines. The footnote on her watch still does Kennedy’s favorite piece of work: it keeps measles mortality off the board while an outbreak is running.

A Second Child Is Now Under Review

On August 31, Diamantoni said his office had just received a report of another child who died with measles and had opened an investigation. He said a cause could take weeks. He would not assume it is the same person the state counted. If it is not, Pennsylvania’s two files and the coroner’s two files may not even describe the same pair of people. If it is, the second national argument is still waiting on a pathologist.

WHAT WE KNOW

• The infant: A newborn died August 14 at a Strasburg Township birthing center, tested positive for measles, and was certified as a spleen laceration, with measles listed as a contributing condition.
• The state total: Pennsylvania still counts two measles-associated deaths in unvaccinated Lancaster County residents, the first since 1991.
• The federal page: CDC is publishing 2,903 confirmed U.S. cases and an asterisk instead of a 2026 death total.

WHAT IS UNCONFIRMED

• The second person: The department has not released age or clinical detail on the other death, and the coroner has not matched it to a finished certificate.
• The spleen: Offit and the autopsy are still at odds on whether congenital measles made the rupture possible.
• The national count: CDC says it will update the death total as more information arrives. It has not said what evidence would move the asterisk.

The family that lost the newborn already buried a son they were told died of measles. The coroner’s office is still working a second child’s file. Until those two records close, the country’s official measles deaths for the year remain a blank, and Pennsylvania’s remain two.

Disclaimer: This article is news reporting and analysis of public-health data, official statements, and death-classification disputes. It is informational only and is not medical advice, a diagnosis, or a recommendation about vaccination, pregnancy, or the care of anyone who has been exposed to measles. Readers who need personal guidance should speak with a licensed physician, pediatrician, or local health department before making health decisions. Case counts, death classifications, and outbreak figures reflect the CDC page, Pennsylvania Department of Health releases, and coroner statements available as of September 2, 2026, and those figures can change as investigations finish.