Pennsylvania Seeks CDC Aid for Measles Outbreak, Ties Request to Death Recognition

Pennsylvania's health department has initiated a request for emergency federal assistance to combat one of the nation's largest and deadliest measles outbreaks, but attached a condition that has intensified a dispute with the Trump administration.

In a letter to CDC Director Erica Schwartz on Wednesday evening, state Health Secretary Debra Bogen said the state had begun the process to request Epi-Aid, a form of short-term CDC support during public health emergencies. Bogen wrote that the CDC's decision not to publicly acknowledge four measles-associated deaths reported by the state undermines its response, and that the department would withdraw the request if the agency cannot transparently and accurately communicate information about those deaths.

The request marks a shift for Pennsylvania, which had previously resisted CDC help while arguing it had the outbreak under control. The state's outbreak has since expanded to more than 700 confirmed cases across 37 counties, with four deaths linked to measles. It is the latest state to confront the worst U.S. measles resurgence in over three decades, driven by rising vaccine hesitancy.

The situation has become a focal point of tension between Health Secretary Robert F. Kennedy Jr. and Governor Josh Shapiro, a Democrat. Kennedy has questioned whether deaths reported in U.S. measles outbreaks since he took office were caused by the virus or another factor, and instructed the CDC not to include the Pennsylvania fatalities in a national tally. Disease experts describe such intervention by a health secretary in state health determinations as highly unusual and warn it could downplay the risks of measles to the public.

Kennedy has accused Shapiro of politicizing the outbreak and failing to request federal help. Shapiro has criticized Kennedy, a long-time anti-vaccine activist who has promoted policies to reduce childhood immunization, for amplifying public fears about vaccines without scientific evidence. Kennedy and Schwartz have blamed Shapiro for not accepting earlier offers of Epi-Aid.

When Pennsylvania announced its first two measles-associated fatalities on August 25, the disease had sickened 393 people across 28 counties. Shapiro praised his health department's vaccination efforts, and the state declined to ask the CDC to send personnel. The state health department, like others, already has CDC career staff permanently assigned to assist and they have helped with the outbreak; an Epi-Aid would represent an additional form of federal assistance.

Since then, the disease has spread and new infections have accelerated. One of the fatalities announced this week occurred in Mifflin County, now the state's second-highest case count and located over 100 miles from the outbreak's initial epicenter in Lancaster County. Meanwhile, the pace of state-provided measles vaccinations appears to be slowing: in August, the health department administered over 3,500 doses of the MMR vaccine, which offers 97% protection after two doses, but that number fell to around 1,100 doses in the first half of September.

The CDC did not immediately respond to a request for comment.