Canada and the Region of the Americas Lose Measles Elimination Status: Is the United States Next?

By: Jacqueline Powers

Image: Illustrator: Alissa Eckert

On November 10, 2025, the Pan American Health Organization (PAHO) announced that Canada has lost its measles elimination status following a commission’s determination that endemic transmission is occurring in the country.^1,2 As a result, the Region of the Americas has also lost its measles-free designation. Endemic spread is defined as a continuous chain of transmission for at least twelve months.³ PAHO reviewed recent epidemiological and laboratory data to confirm that there has been sustained transmission of the same measles strain for over a year.²

Measles is a highly contagious disease that can cause serious health complications, especially in children under the age of five.⁴ The current outbreak in Canada began in New Brunswick in October 2024, quickly escalating into a multijurisdictional outbreak of over 5,000 cases in 2025.⁵ As of November 10, 2025, nearly 90% of cases have occurred in unvaccinated individuals, and the virus has primarily impacted children.⁵ Seven percent of cases have been hospitalized, and two deaths have been reported from congenital measles.⁴  

Vaccination offers the best protection against measles; however, vaccine coverage has declined in recent years. To prevent measles outbreaks through herd immunity, 95% of the population needs to be vaccinated. However, data from four Canadian provinces and one territory reveal that only 82.5% of two-year-old children had received the measles, mumps, and rubella (MMR) vaccine in 2023.⁶ This decline in vaccination rates may be attributed to the spread of misinformation, challenges in accessing vaccines and healthcare, the lack of a national vaccination registry, decreased public health funding, and limited outreach to certain communities including religious and rural areas.^7,8 

Canada is not the only country in the Region of the Americas battling measles. In 2025, the United States has seen 1,723 confirmed measles cases in 43 states as of November 12.⁹ The outbreak began in West Texas in January 2025, and, as the one-year mark approaches, there is concern that the U.S. will also lose its measles elimination status.¹⁰ Although the outbreak in West Texas was declared over in August, measles outbreaks are ongoing across the country with recent cases being reported in South Carolina and Utah.¹⁰ To evaluate potential endemic spread, PAHO will need to connect recent outbreaks to the original cases in Texas.¹⁰ If they can do so and measles continues to spread into early 2026, then it is likely that the U.S. will no longer be considered measles-free for the first time since eliminating the disease in 2000.^{10, 11} 

To re-establish its measles elimination status, Canada will need to interrupt the spread of the current measles strain for at least twelve months.² PAHO and the Public Health Agency of Canada are working with partners at all levels to increase vaccination coverage, strengthen data sharing, improve surveillance, and provide evidence-based guidance.² Similar action should be taken in the U.S. to stop the spread of measles and to maintain its measles-free status. Though challenging, the path towards eliminating measles is achievable and will require a commitment to public health action.

1. https://www.paho.org/en/news/10-11-2025-paho-calls-regional-action-americas-lose-measles-elimination-status
2. https://www.canada.ca/en/public-health/news/2025/11/statement-from-the-public-health-agency-of-canada-on-canadas-measles-elimination-status.html 
3. https://www.cdc.gov/surv-manual/php/table-of-contents/chapter-7-measles.html#:~:text=An%20endemic%20genotype%20is%20the,to%20be%20import%2Dassociated%20cases 
4. https://www.cdc.gov/measles/about/index.html 
5. https://health-infobase.canada.ca/measles-rubella/#a21 
6. https://www.canada.ca/en/public-health/services/immunization-vaccines/vaccination-coverage.html 
7. https://www.cidrap.umn.edu/measles/canada-loses-measles-elimination-status-after-record-year-outbreaks
8. https://www.bbc.com/news/articles/cy7e2lv4r8xo 
9. https://www.cdc.gov/measles/data-research/index.html 
10. https://www.scientificamerican.com/article/measles-elimination-status-threatened-in-u-s-and-canada/ 
11. https://www.ap.org/news-highlights/spotlights/2025/canada-loses-measles-elimination-status-after-ongoing-outbreaks/