JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – October 1, 2026– MEASLES
“Researchers at the University of Maryland used a mathematical model to determine the impact of Florida dropping the measles, mumps and rubella (MMR) vaccine from child immunization mandates.
The results indicated that the move could trigger the largest measles epidemic in the U.S. in nearly half a century, with projected pediatric deaths numbering in the hundreds within five years.
The study was published in the journal Proceedings of the National Academy of Sciences on September 28.
Last year, Florida Governor Ron DeSantis vowed to end all vaccine mandates in the state—which would make it the first state to do so—and last month, a proposal, signed by Florida Surgeon General Joseph Ladapo, suggested that students entering pre K-12 classes would no longer have to be vaccinated against Hepatitis B, varicella (chicken pox), Haemophilus influenzae type b (Hib), and pneumococcal conjugate. The MMR vaccine was not included, and is still currently required by state law.” (1)
“The Florida Department of Health has proposed dropping immunization requirements for four diseases for students entering school.
The proposal would remove mandates for Hepatitis B, chicken pox, Haemophilus influenza type b, and pneumococcal conjugate vaccines.
This change would also broaden vaccine exemptions to include “moral and ethical beliefs” for parents opting out.
The Florida Department of Health wants to drop immunizations for four diseases from public and private school entry requirements. Last year, Florida Surgeon General Joseph Ladapo and Gov. Ron DeSantis vowed to end all vaccine mandates in the state.
Under a proposal signed by Ladapo and filed Aug. 24, students entering PreK-12 classes would no longer have to be vaccinated against Hepatitis B, varicella (chicken pox), Haemophilus influenza type b (Hib), and pneumococcal conjugate.
The new rule would also make it easier for parents and guardians to opt their children out by expanding the current religious exemptions to include “moral and ethical beliefs,” and allow parents and college students to keep their records out of the state’s vaccine database.”
Florida’s rate of vaccine exemptions for kindergartners is already higher than the national average, according to the Centers for Disease Control and Prevention (CDC).
The public has 21 days, or until Sept. 14, to submit comments on the rule before its final approval.” (2)
Pennsylvania reports 5th measles-related death in the state, https://www.nbcnews.com/health/health-news/pennsylvania-measles-death-5th-outbreak-state-cdc-2026-rcna600766
CDC reports second measles death in US while excluding Pennsylvania deaths, https://www.theguardian.com/us-news/2026/sep/29/cdc-reports-second-measles-death
“CDC’s reticence extends beyond social media. Four measles-associated deaths reported by Pennsylvania were initially absent from the agency’s national dashboard. In late August, CDC posted two of the Pennsylvania deaths, then added an asterisk and language that it was reviewing additional information. The deaths were later removed without a clear explanation. Now two deaths are reported on CDC’s dashboard as of September 28 without identifying the states. This is not transparency; it is silence at a moment when families need clear, accurate information to protect their children.
Why are these deaths being left off the official tally? There’s a disagreement between federal and state officials over how to count measles deaths—even though Pennsylvania investigated each death and reported them to CDC through the established nationally notifiable disease surveillance system that has been used by state and local health departments across the country for years. In late August, when officials from Pennsylvania announced the first two deaths there, Robert F. Kennedy Jr., Secretary of Health and Human Services (HHS), even questioned if the deaths were fabricated. But Pennsylvania’s definition of a measles-associated death ensures that deaths unrelated to underlying measles infection are not counted.
Leaders at HHS and CDC have said they are working to clearly define measles deaths and that it will update its counts as reviews are complete. But the agency has not explained which deaths they are currently counting, how these decisions are being made, why the data reporting system used by states was changed, and how they will account for the secondary infections and other complications caused by measles. Two former leaders of the National Center for Health Statistics have called this out publicly, writing in STAT that these changes will delay reporting and add to public confusion about the severity of measles.”
1.Scientists Warn Florida Could Face Its Biggest Measles Outbreak in Decades, by Jasmine Laws, https://www.(3)newsweek.com/florida-could-see-its-biggest-measles-outbreak-in-50-years-study-12499552
2.Florida to end school vaccine requirements for chicken pox, Hep B, by C. A. Bridges, https://www.usatoday.com/story/news/state/2026/08/25/florida-proposes-ending-school-vaccine-requirements/91447190007/
3.Children Are Back in School. Measles Is, Too, by Deb Houry, https://time.com/article/2026/09/30/children-are-back-in-school-measles-is-too-debra-houry-essay/
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai