CDC, Pennsylvania clash over measles deaths

The Centers for Disease Control and Prevention (CDC) is disputing two measles deaths reported by Pennsylvania and excluding them from its official weekly tally of deaths, a radical departure from the agency’s normal practice of accepting and including a state’s data.

The decision to question Pennsylvania’s classification of measles deaths represents a key test for new CDC Director Erica Schwartz, who took charge of the agency last month amid a pledge to operate independently from Health and Human Services Secretary Robert F. Kennedy Jr.

It also inserts the nation’s public health agency into the middle of a political feud between Gov. Josh Shapiro (D) and Kennedy about whether the deaths were a result of measles, or whether measles was present but unrelated.

The deaths were not included on the CDC’s website, which is typically updated on Fridays. The update was delayed until Sunday, when the agency’s website was edited multiple times.

“This week’s measles outbreaks update will not include the two measles-associated deaths reported by the Pennsylvania Department of Health on August 25 while CDC reviews additional information regarding the circumstances and causes of death,” an asterisk on the agency website states . “At this time, available information does not establish whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles. CDC will update the national count as additional information becomes available.”

Details on the two deaths released by the Pennsylvania Department of Health (DOH) were vague, leaving a void of information. The state first disclosed the deaths last Tuesday, and Shapiro held a press conference to discuss them shortly afterwards.

One of the two deaths involved a newborn with a ruptured spleen. Details of the second case have not been disclosed. The only other details shared were that the patients were unvaccinated and from Lancaster County, and both tested positive for the measles virus.

Neil Ruhland, a spokesman for the Pennsylvania DOH, said every reported measles case is “thoroughly reviewed to confirm it meets the Centers for Disease Control and Prevention’s (CDC) case definition for a measles case.”

Ruhland said the agency has “provided all required epidemiological data to the CDC regarding the two measles-associated deaths in Pennsylvania. DOH values its long-standing collaborative relationship with professional staff at the CDC and will continue to work with federal partners moving forward to address the ongoing measles outbreak.”

Shapiro and state health officials said the deaths were “measles-associated,” a term the state uses when measles is present, but the disease may not be identified the immediate cause of death.

“CDC is committed to providing the public with accurate information. The two measles-associated deaths announced by Pennsylvania have not been confirmed based on the information currently available to CDC,” Grace Davis Jamison, a spokeswoman for the federal Department of Health and Human Services (HHS), told The Hill in a statement. “CDC therefore delayed its weekly update while seeking additional information to ensure its national reporting is accurate.”

Jamison did not say which CDC officials made the decision to question Pennsylvania’s reporting and delay updating the data.

Pennsylvania is in the midst of a growing measles outbreak that has sickened 497 people and hospitalized 87 as of Monday. During his press conference last week, Shapiro put the blame on Kennedy and the Trump administration for sowing doubt about vaccines.

“When the information we see coming from the federal government, in some cases, isn’t driven by facts and by science, it makes it even more confusing for parents, and that has a serious impact,” Shapiro said .

Kennedy denied any responsibility for the drop in vaccination rates. In a social media post, he suggested the deaths might have been “fabricated by one of the Governor’s hopeful staffers” to score political points.

“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,” Kennedy wrote on the social platform X.

The CDC’s official X account then doubled down on Kennedy’s skepticism.

“We appreciate Secretary Kennedy’s efforts to clarify conflicting information from Pennsylvania officials about whether the two reported deaths were caused by measles. CDC is working to determine what actually occurred,” the agency said Thursday. “Under President Trump’s and Secretary Kennedy’s leadership, CDC will follow the facts and tell the American people the truth.”

The CDC’s delay and refusal to accept Pennsylvania’s data is not typically how the agency operates regarding measles. CDC relies on state health officials to investigate and report measles cases to the federal government.

Measles is considered an urgent “notifiable condition,” and standard protocol is to notify the CDC by phone within 24 hours of a confirmed case.

“CDC doesn’t adjudicate those cases or deaths,” said Deb Houry, the former chief medical officer at the CDC during last year’s West Texas measles outbreak that resulted in the deaths of two unvaccinated school-aged children.

In Texas, Houry said the CDC was notified of the deaths by the state health department and then they were included in the agency’s measles dashboard.

When New Mexico reported an unvaccinated adult died and measles was found in his system, Houry said CDC recorded that death as well, even though it was under investigation.

If the CDC starts to question what states report, it could undermine the trust and needed collaboration between the federal government and states, experts said.

Houry said she was disappointed by the political tone of CDC’s messaging.

“When there’s a time of 400 plus measles cases and growing in the community, the focus should be on what can be done in the community versus this back and forth. So it’s very disappointing that this is what we’re seeing,” Houry said. “I had high hopes for Dr. Schwartz, but the fact that she is not working collaboratively with the state on this is not a good sign, and the focus really needs to be on what is being done in these communities.”