Over the past year, Utah has faced significant challenges in managing measles outbreaks, raising concerns about the United States maintaining its measles-free status. More than 680 individuals became ill since the initial outbreak began on June 20, 2025. Unlike outbreaks in Texas, South Carolina, and Arizona, containing the spread in Utah proved difficult, impacting undervaccinated communities across nearly every county. Cases emerged in healthcare facilities, large retail stores, restaurants, and youth sporting events. In February, an outbreak during a state high school wrestling championship resulted in at least 46 cases among attendees.

The Nature of Measles

Measles is highly contagious, leading to symptoms such as a distinctive rash, high fever, severe cough, ear infections, and diarrhea. Although most individuals recover, some, including young infants, pregnant individuals, and those with weakened immune systems, face risks of severe complications like pneumonia, encephalitis, blindness, or even death. Even healthy individuals may encounter issues years later, such as a rare but fatal degenerative brain disease manifesting a decade after infection. The measles vaccine, safe and providing 97% protection after two doses, plays a crucial role in prevention.

Sustained Spread and Response

Despite a recent slowdown, state epidemiologist Leisha Nolen remains concerned that the start of school and colder fall weather might trigger a resurgence. “It’s still here, it’s still transmitting,” Nolen stated. “A few cases in the wrong community could lead to a major flare-up.” The southwestern part of Utah experienced the worst spread, with 265 cases reported since last summer. The virus impacted 22 of Utah’s 29 counties.

In the rural northeast, conditions favored further spread. The TriCounty health region, consisting of Daggett, Duchesne, and Uintah counties, experienced the second-largest decline in childhood vaccination rates statewide. Over 16% of kindergarteners lacked measles vaccines last year. Statewide, 12.8% missed their vaccines, falling short of the 95% vaccination rate required to prevent outbreaks. This spring, 74 measles cases were recorded in the tri-county region following the youth wrestling event, with the virus spreading through schools and households.

Sydnee Lyons, TriCounty Health Department’s public information officer, noted a rise in vaccine hesitancy. Nonetheless, local and state officials view TriCounty’s response as successful. They focused on mitigating the inevitable spread by excluding unvaccinated students from in-class schooling and advising infected individuals to isolate. Public appeals encouraged more vaccinations.

Community Efforts and Challenges

TriCounty’s infectious disease specialist, Cyndie Mattinson, recounted a positive experience with a concerned parent, alleviating worries about judgment from health professionals. “Perceptions changed. We weren’t there to police. We aimed to help and support the community,” Mattinson said.

National and International Implications

Utah’s year-long battle with measles could influence the United States’ meales-free status. A country achieves this status by preventing sustained local spread for at least a year. As of June 18, the U.S. recorded 2,104 cases, nearing last year’s total. Whether Utah’s initial clusters connect with a major outbreak along the Utah-Arizona border remains unclear.

In November, global health experts will assess if the United States and Mexico have maintained their measles elimination status. Canada lost its status last year due to persistent outbreaks. In Utah, physicians such as Dr. Ellie Brownstein continue advocating for improved public health policies. During the outbreak’s peak, Dr. Brownstein opposed legislative efforts to ease vaccine waiver accessibility.

“I don’t know that we get it to end,” Dr. Brownstein said. “It’s challenging getting this genie back in the box due to enough potential spreaders,” she acknowledged.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The Associated Press retains sole responsibility for all content.