AI-written summary synthesised from 3 independent reports, listed below. No human editor reviewed this. AI can misread or omit facts — read the originals.
ABSTRACT

Pennsylvania's health department has begun the process of requesting emergency assistance from the Centers for Disease Control and Prevention to contain a measles outbreak, on the condition that the CDC publicly recognize four people in the state who died from measles-related complications, according to a letter from state Health Secretary Debra Bogen. The Hill and Al Jazeera reported that Bogen said the department would rescind its request for a CDC Epi-Aid if the agency could not transparently communicate information about those deaths. HHS said the CDC has not received the formal request through its normal channels and would not accept conditions on public health assistance. The state reports 731 confirmed measles cases across 38 counties this year, with four deaths attributed to measles-related illness, and Al Jazeera reported 141 hospitalizations.

Al Jazeera English

Pennsylvania ties CDC measles aid request to recognition of four deaths

Sep 17, 2026, 5:08 PM

Pennsylvania's health department has begun the process of requesting emergency assistance from the Centers for Disease Control and Prevention to contain a measles outbreak, on the condition that the CDC publicly recognize four people in the state who died from measles-related complications, according to a letter from state Health Secretary Debra Bogen. The Hill and Al Jazeera reported that Bogen said the department would rescind its request for a CDC Epi-Aid if the agency could not transparently communicate information about those deaths. HHS said the CDC has not received the formal request through its normal channels and would not accept conditions on public health assistance. The state reports 731 confirmed measles cases across 38 counties this year, with four deaths attributed to measles-related illness, and Al Jazeera reported 141 hospitalizations.

Context

Pennsylvania's health department announced that 731 measles cases have been confirmed in 38 counties so far this year, with four deaths from measles-related illness as of Tuesday, according to The Hill. Al Jazeera reported the state also lists 141 hospitalizations and that only four confirmed cases, fewer than one percent, involved vaccinated people. When the first two deaths were announced on Aug. 25, Al Jazeera reported, the state had 393 cases across 28 counties.

Al Jazeera reported the dispute began in August, when Pennsylvania reported that two unvaccinated people died of measles in Lancaster County, home to Amish and Mennonite communities with under-vaccinated populations. The CDC initially included those deaths in its national tally, then removed them after HHS Secretary Robert F. Kennedy Jr. questioned whether measles had caused or contributed to the fatalities, with the agency saying available information did not establish whether measles caused or contributed. Al Jazeera reported a county coroner reported on Sept. 13 that a 40-year-old woman died from complications associated with measles, and that the state confirmed that death and announced two additional deaths on Sept. 15. CT Public reported the deaths included a 40-year-old woman with an active infection and an 18-year-old with a rare neurological complication, and that Shapiro said two were infants in Lancaster County. Both Al Jazeera and CT Public reported all four were unvaccinated.

According to Al Jazeera, an Epi-Aid is a CDC mechanism for rapid, short-term assistance during an urgent public health problem; such deployments generally last one to three weeks and involve Epidemic Intelligence Service officers analyzing epidemiological data, evaluating surveillance systems and recommending measures to control disease, with the requesting health authority retaining overall leadership of the investigation. The Hill reported Pennsylvania had previously declined offers of federal assistance while handling the outbreak internally, though Bogen noted the department meets regularly with CDC staff and recently made two requests for technical assistance.

Matthew Ferrari, director of Pennsylvania State University's Center for Infectious Disease Dynamics, told Al Jazeera that 'measles-associated' death has long been a standard used by the World Health Organization and CDC, that it is the most useful distinction because such a case could have been prevented by measles vaccination or by early detection and isolation, and that measles is severely immunocompromising so a secondary infection is often the ultimate cause of death. Dr. Andrew Pavia, a spokesperson for the Infectious Diseases Society of America, told Al Jazeera the distinction should not be controversial and that the impact is public confusion and erosion of trust in CDC staff communicating without political interference. The Hill reported public health experts and former agency officials have said it is highly unusual for the CDC to dispute how a state classifies and reports measles cases and deaths, and that the situation could affect how states interact with the federal government. The CDC said it is working with the Council of State and Territorial Epidemiologists to develop a standardized definition for a measles death to ensure consistent reporting, and that deaths will be counted only if its National Center for Health Statistics identifies measles as the underlying cause based on death records submitted by the states.

CT Public reported Dr. Stanley Martin, director of infectious diseases at the health system Geisinger, said many vulnerable people previously were protected by herd immunity, and that with vaccination rates dropping 'chinks in the armor are occurring' and susceptible people are suffering the consequences. He said Geisinger is working with the state Health Department to provide vaccine clinics, and that vaccine misinformation is a major hurdle. Bogen, speaking at a news conference, said the Department of Health and its partners are 'acting with urgency, and we are acting with care.' The Hill reported the outbreak has been the focal point of a political dispute between Gov. Josh Shapiro, a potential 2028 presidential candidate, and Kennedy, and that the CDC has been excluding the deaths from its weekly national measles death tally.

All Perspectives
Pennsylvania Department of Health (Debra Bogen): Health Secretary Debra Bogen wrote that the CDC's choice not to publicly recognize the deaths undermines the state's response, and that state and federal officials need a trusting relationship based on 'respectful, transparent, and factual communication.' She wrote that if the CDC is unable to transparently and accurately communicate information about the measles-associated deaths, the department 'will respectfully rescind our request for a CDC Epi-Aid.' At a news conference she said the Department of Health and its many partners are 'acting with urgency, and we are acting with care.'
HHS / CDC: An HHS spokesperson said the CDC has not received the formal Epi-Aid request through its normal channels. The spokesperson said the CDC 'will not submit to political blackmail that conditions critical public health assistance,' that 'the people of Pennsylvania should never be used as leverage in a political dispute over how deaths are classified,' and that 'CDC will not allow Governor Shapiro to politicize this process. We owe the American people accurate, consistent, and transparent public health information.' HHS said federal outbreak assistance and national mortality reporting are separate processes and rejected the idea that the two should be linked. The CDC said it is working with the Council of State and Territorial Epidemiologists on a standardized measles death definition, and that deaths will be counted only if its National Center for Health Statistics identifies measles as the underlying cause.
Gov. Josh Shapiro: Shapiro said county coroners independently confirmed each of the four measles-associated deaths, and that vaccine skepticism and misinformation from the Trump administration is making the situation worse. Speaking on CNN's 'The Source,' he said: 'I'm not going to accept that until RFK does what is right and stops reaching down into his administration and directing the CDC staff not to acknowledge the pain and suffering of these four families in Pennsylvania.'
Robert F. Kennedy Jr.: The Hill and Al Jazeera reported that Kennedy openly questioned whether the deaths in Pennsylvania were directly caused by measles and accused Shapiro of politicizing the outbreak. CT Public reported that in late August, after the state announced its first two measles-associated deaths, he questioned whether the deaths actually happened.
Matthew Ferrari, Pennsylvania State University: Ferrari told Al Jazeera that 'measles-associated' death has long been a standard used by the World Health Organization and CDC. 'It's the most useful distinction because it is a case that could have been prevented by a measles vaccination, or by early detection and isolation,' he said. 'Measles is severely immunocompromising, so it is very often a secondary infection that is the ultimate cause of death.'
Dr. Andrew Pavia, Infectious Diseases Society of America: Pavia told Al Jazeera the distinction should not be controversial. 'The impact, though, is confusion for the public and erosion of trust in the ability of CDC staff to communicate to the public without political interference,' he said.
Dr. Stanley Martin, Geisinger: Martin said many vulnerable people used to be protected by herd immunity. 'And now we see, with the vaccination rates dropping, chinks in the armor are occurring. And people who are susceptible are, of course, suffering the consequences,' he said. He said Geisinger is working with the state Health Department to provide vaccine clinics, and that vaccine misinformation is a major hurdle.
Position not represented in the source reporting: Robert F. Kennedy Jr.; CDC Director Erica Schwartz.

Where sources differ

  • HHS spokespeople are identified differently by outlet: The Hill names Emily Hilliard as an HHS spokesperson, while Al Jazeera names Grace Davis Jamison as HHS press secretary. Both outlets attribute the same statement to an HHS spokesperson.
  • The Hill and Al Jazeera report that Robert F. Kennedy Jr. questioned whether measles caused or contributed to the deaths, while CT Public reports he questioned whether the deaths actually happened.
  • CT Public refers to Robert F. Kennedy Jr. as 'Health Secretary,' while The Hill and Al Jazeera identify him as Health and Human Services Secretary.
  • The Hill reports the Epi-Aid request was made without naming a recipient, while Al Jazeera reports the letter was sent to CDC Director Erica Schwartz on Wednesday.
Gaps & Unknowns
  • Whether Pennsylvania formally submitted the Epi-Aid request and whether the CDC received it remains disputed; no source establishes receipt or the current status of the request.
  • No direct statement from Robert F. Kennedy Jr. appears in the supplied sources; his position is reported only through other outlets' descriptions.
  • No comment from CDC Director Erica Schwartz, named by Al Jazeera as the letter's recipient, appears in any source.
  • The standardized definition for a measles death being developed with the Council of State and Territorial Epidemiologists has no stated criteria, timeline or effective date in the sources.
  • No source provides independent verification of the medical cause of each of the four deaths beyond state determinations and county coroners cited by Shapiro.
  • The full county-by-county breakdown of cases and hospitalizations is not given; Al Jazeera alone reports 141 hospitalizations.
  • It is not established whether the deaths listed by Pennsylvania would be reclassified under the CDC's prospective standardized definition.
  • The cost, scope or expected duration of any federal assistance is not established beyond the general description of Epi-Aid procedures.
Sources & Further Reading
  1. The Hill — original — by Nathaniel Weixel
  2. Al Jazeera English — by Catherine Nouhan
  3. CT Public — by Sydney Roach

Read the original at The Hill

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