Measles Is Back: A Warning We Should Not Ignore
Amar Duggirala, D.O., MPH, FAAFP
MCMS Board Member
This year has provided a stark warning of what can happen when misinformation about vaccines and vaccine-preventable diseases spreads unchecked. Declining vaccination rates, increasing global measles activity, and confusion surrounding changing vaccine guidance have created an environment in which diseases we once brought under control are again gaining a foothold.
As of September 10, 2026, the CDC had reported 3,294 confirmed measles cases in the United States this year. National MMR vaccination coverage among kindergarteners has fallen from 95.2% in the 2019–2020 school year to 92.4% in 2025–2026—below the 95% target generally associated with community protection against measles. For perspective, measles was declared eliminated in the United States in 2000.
Maryland is not immune to this resurgence. As of September 10, Maryland had reported 40 confirmed measles cases in 2026, compared with 0 cases from 2020 through 2022 and only five cases combined from 2023 through 2025. The Maryland Department of Health is currently responding to an outbreak among unvaccinated individuals in Carroll, Cecil, and St. Mary’s counties, although there is currently no evidence of widespread community transmission.
Fortunately, Maryland continues to maintain relatively high childhood vaccination rates, with more than 96% of kindergarten students consistently reported as vaccinated. But statewide averages can provide false reassurance. Pockets of under-vaccination can exist even in states with high overall coverage, and Maryland is closely connected to neighboring jurisdictions and the rest of the country through daily commuting and domestic and international travel.
The resurgence of measles is particularly frustrating because we have an extraordinarily effective preventive tool. Two doses of the MMR vaccine are approximately 97% effective at preventing measles, and people appropriately vaccinated according to the U.S. schedule are generally considered protected for life against measles.
Many of our patients, and parents of our pediatric patients, have never seen measles and may understandably view it as a non-concerning disease.
Measles is one of the most contagious infectious diseases. Among susceptible people exposed to someone with measles, as many as 90% may become infected. The virus can remain infectious in an airspace for up to two hours after an infected person leaves, and patients can transmit measles beginning four days before the characteristic rash appears. By the time the diagnosis becomes obvious, others may already have been exposed.
Nor is measles simply an inconvenient childhood rash. It can cause pneumonia, encephalitis, hospitalization, and death. Serious complications can occur even in previously healthy individuals, while infants, pregnant women, adults over age 20, and immunocompromised patients face particularly high risks.
Maryland took an important step this year with passage of the Vax Act, which was supported by medical organizations including MedChi, the Montgomery County Medical Society, and the Maryland Academy of Family Physicians. Effective July 1, the law gives the Maryland Secretary of Health authority to issue state recommendations for immunizations, screenings, and preventive services based on evidence-based scientific and clinical guidance. The Secretary may draw on recommendations from organizations including the American Academy of Pediatrics, American Academy of Family Physicians, and American College of Obstetricians and Gynecologists, as well as federal and state guidance.
Importantly, the law helps preserve access to vaccines by requiring certain state-regulated health plans to cover Maryland-recommended vaccines without out-of-pocket costs and by expanding pharmacists’ ability to administer recommended vaccines. Maryland is therefore no longer dependent solely on federal recommendations when establishing its own vaccine guidance.
At a time when federal vaccine messaging, recommendations and policies have been confusing or even contradictory, I believe this independent, evidence-based authority is particularly important. Physicians need clear guidance grounded in the best available scientific evidence, and our patients deserve confidence that the recommendations we make are based on that evidence.
Measles is not only an issue for pediatricians and family physicians. It is an issue for every physician. An unrecognized case entering a medical office, urgent care center, emergency department, hospital or operating room can expose other patients, including those who are immunocompromised or too young to be vaccinated, as well as our staff and their families.
As physicians, we remain among our patients’ most trusted sources of health information. We should use that trust. Ask about vaccination status. Correct misinformation when we encounter it. Encourage vaccination not only to protect the individual patient sitting in front of us, but also the vulnerable patients who share our waiting rooms, schools, workplaces, and communities.
We eliminated sustained measles transmission in this country once. We should not accept its return as inevitable.
For information about free vaccines for eligible adult patients in Maryland, visit the Maryland Vaccine Program through the Maryland Department of Health.
Amar Duggirala, DO, MPH, FAAFP
Family Physician and Medical Director, Poolesville Family Practice
MCMS Board Member
Board Chair and Immediate Past President, Maryland Academy of Family Physicians
Sources for data in this article from:
Johns Hopkins - Tracking Measles Cases in the U.S.
Maryland Department of Health - Measles
MDH - 2026-2027 vaccine guidelines for children and adults
Kaiser Family Faoundation - MMR Vaccination Coverage Among Children
KFF - Kindergarten Routine Vaccination Rates Continue to Decline
