Tracking Measles

How has the Tracking Report evolved, particularly in light of recent measles outbreaks?

A major inflection point for the Tracking Report came at the start of the Trump administration when efforts were made to scale back or alter existing federal data streams. That raised real concerns about the reliability of publicly available data. People started worrying they wouldn’t have access to trustworthy, independent interpretation of health trends.

So we expanded our efforts. We didn’t just rely on federal data; we dug into state and local sources that feed into those federal numbers. We preserved and aggregated that information ourselves. Most importantly, we interpreted it. That’s our biggest value-add. We don’t just report the numbers—we explain what they mean, what they don’t mean and what gaps might exist in the data.

When the federal response to the measles outbreak downplayed the severity, saying it had peaked or wasn’t that bad, we didn’t see that reflected in the data. Our role became even more critical: offering independent, unbiased interpretations based on the actual numbers, and flagging where limited testing or reporting might obscure the full picture.

What are the biggest gaps you see in the federal response to measles?

The biggest gaps we’re hearing directly about come from the states. They asked for help early—technical assistance, access to vaccines, guidance—and the federal government was slow to respond. Communication was a major concern.

Even worse, some messaging from top federal officials has contradicted established public health evidence, suggesting there were alternatives to vaccines for measles prevention. That’s just false. There are no proven alternatives. These mixed messages made states’ jobs harder at a time when they were already overstretched due to budget cuts and staff shortages. So the most damaging gaps have been in the spread of misleading or factually incorrect information from federal sources.

How do you ensure that the data the Pandemic Center shares is timely and accurate, especially when federal sources lag or conflict?

We go straight to the original sources: state and local health departments in the U.S. and Ministries of Health or the WHO globally. We report what they report. Sometimes we catch things earlier than dashboards do—say, a press release announcing new cases before it’s reflected online.

But we don’t verify raw data ourselves. We’re not pulling from medical records. We rely on public health infrastructure. Our job is to get to those primary sources quickly and then offer expert interpretation. Our team includes trained scientists who are deeply familiar with how to read and contextualize this kind of data.

We’ve learned that people don’t just need numbers—they need help making sense of them. It’s not enough to say cases are up 50%. People need to know: What does that mean for me, for my family, for my community? 

Why do you think there’s been such reluctance to declare a public health emergency over measles? Would it make a difference if one were declared?

Public health emergencies are administrative tools. They allow for changes in how resources are deployed, but they don’t necessarily mean you can’t respond without one.

So I’m not saying we need an emergency declaration for measles, but I am concerned that the Secretary of Health and Human Services has repeatedly downplayed the seriousness of the outbreak. This is the largest and deadliest measles outbreak in decades, and we’re on the verge of losing our measles elimination status. That absolutely sounds like an emergency to many people.

The worry is that if we did need new procedures or more resources, that declaration might not happen because the situation is being publicly minimized.

Many of these cases are in unvaccinated communities. What works when it comes to addressing vaccine hesitancy and misinformation?

First, we need misinformation to stop spreading from federal channels. The measles vaccine is one of the safest and most effective tools we have. There is no credible alternative to it.

Beyond that, it’s a longer-term challenge. We need to build trust within communities. That means partnering with local leaders, listening to people’s concerns and not dismissing them. People need to feel heard.

You can’t parachute in during a crisis and expect immediate compliance. Trust takes time. In the 2017–2019 measles outbreak, communities that already had trusted relationships—like local health workers working with religious groups—were more successful in responding.

But building that trust takes resources. And unfortunately, since COVID, we’ve seen public health budgets shrink. Still, this kind of work is essential infrastructure for future preparedness.

What lessons should public health officials take from the measles outbreak?

The biggest lesson is that most Americans still support vaccines and expect strong public health responses. The problem isn’t widespread opposition; it’s the erosion of trust in specific communities.

In places where public health agencies haven't maintained relationships, the vacuum gets filled with misinformation. We need to rebuild those relationships from the ground up.

We can’t afford top-down, one-size-fits-all approaches. We need bottom-up partnerships that reflect the lived experiences of the people we’re trying to protect.

The latest tracking report provides updates on nine different diseases, from vector borne viruses to bird flu. Are we seeing an unusual amount of infectious threats?

Yes, while measles has rightly gotten attention, it’s not the only concern. There are many outbreaks occurring at once, and the list is growing. One challenge we face now is how to keep the tracking report concise, yet comprehensive enough to reflect this surge.

We’re in an era of increased outbreak activity. And clear, timely and reliable communication is one of our most effective public health tools.

What worries you most today?

I’m worried on a number of fronts, because I think what we saw with measles is a kind of the canary in the coal mine. We shouldn’t be having these outbreaks in the U.S. It signals deeper problems: inadequate protection, strained public health infrastructure and weakened trust.

Even small outbreaks can extract enormous tolls on health, resources and security. It costs tens of thousands of dollars per measles case to contain an outbreak. That’s not just a health concern. It’s an economic one, too. If we spend all our resources reacting to preventable diseases like measles, we’ll be less prepared for the next big threat—whether it’s another pandemic or even a biological attack.