WASHINGTON - U.S. Health Secretary Robert F. Kennedy Jr. requested that a reference to two Pennsylvania deaths be removed from the Centers for Disease Control and Prevention's online measles death table after he questioned whether measles played a role in the fatalities, three people with knowledge of the episode said.
According to the three sources, who spoke on condition of anonymity, the request came even though CDC personnel had accepted the state health department’s own classification that the deaths were linked to measles, a Pennsylvania official close to Governor Josh Shapiro said.
The CDC's recently appointed director, Erica Schwartz, implemented the removal at the direction of the health secretary and did so without objection, the sources said.
A public dispute that preceded the change
The decision to omit the Pennsylvania deaths followed an acrimonious exchange between Health Secretary Kennedy - a long-time anti-vaccine activist who was appointed by President Donald Trump - and Governor Shapiro, a Democrat. The two officials publicly accused one another of politicizing the outbreak in Pennsylvania, the latest state to face a resurgence of measles since the Trump administration took office.
Public health data tracked by the CDC and by individual states indicate declining vaccination rates, and numerous medical organizations have pointed to rising vaccine hesitancy as a major driver of the trend. In Pennsylvania alone, the state health department has reported 540 measles cases this year, according to state reporting.
Public health reaction and official statements
Georges Benjamin, chief executive of the American Public Health Association and a former Maryland secretary of health, said it is "unheard of" for the CDC to publicly cast doubt on the conclusions reached by state and local health departments, even when the agency seeks additional information. "The secretary had no business interfering in the normal process," Benjamin said. "He has an anti-vaccine agenda and he’s using this to play out his anti-vaccine agenda."
Grace Davis Jamison, a spokesperson for the Department of Health and Human Services, which oversees the CDC, said the public health agency "requested details necessary to determine whether measles caused or contributed to the deaths." Jamison said there were conflicting reports between county and state health officials about the circumstances surrounding the fatalities. She declined to comment on the specific roles of the health secretary or the CDC director in the decision to exclude the deaths from the public federal tally.
Schwartz did not respond to a request for comment.
Kennedy's stance, vaccination context
Kennedy has for years argued that vaccines pose greater risks than the illnesses they are intended to prevent, a position at odds with longstanding scientific findings about immunization benefits. The combined measles, mumps and rubella vaccine commonly administered to U.S. children is reported to provide approximately 97% protection against measles infection.
As health secretary, Kennedy has attempted to downplay the implications of rising measles cases in the United States, which have reached their highest levels in more than three decades. He has repeatedly questioned whether the virus was directly responsible for several deaths reported during recent outbreaks.
Timeline and information exchange between state and federal officials
The Pennsylvania health department notified the CDC on the morning of August 25 that two deaths were associated with measles and later posted the information on its website, the Pennsylvania official close to Governor Shapiro said. Pennsylvania’s public report did not provide further details about the circumstances of the fatalities other than noting that both individuals were unvaccinated.
The Pennsylvania official said the CDC did not express concern about the state’s reporting and "signified its ongoing support for the (state health) department’s efforts."
That same day, Kennedy telephoned Governor Shapiro and offered federal assistance to respond to the state’s outbreak, the governor said at a press conference. Shapiro said he thanked the secretary and described the state’s response as aggressive, noting it already included support from CDC and HHS staff. He said he would notify the secretary if additional help was needed.
At the press event, Governor Shapiro also told Kennedy that the health secretary’s prior public statements had encouraged conspiracy theories and misinformation about vaccine safety, saying those statements were "having a negative impact on communities across America."
Escalation on social media and data access issues
The following day, August 26, Kennedy posted on X that Governor Shapiro had refused to share information with the CDC and suggested the deaths might have been "altogether fabricated by one of the Governor’s hopeful staffers."
That same day, the Pennsylvania health department discussed some case details with the CDC, the official close to Shapiro said. The federal agency requested health records that contained personally identifiable information about the deceased, which state law prevents Pennsylvania from sharing, the official said. The state offered to supply de-identified records, but the federal agency had not endorsed the necessary paperwork to accept them, the official added.
A spokesperson for the Pennsylvania health department said the state has "provided all required epidemiological data to the CDC."
CDC reporting change and outstanding questions
The CDC postponed its routine weekly update to its measles data webpage on the Friday following those exchanges. When the online page was updated on Sunday, it omitted the Pennsylvania fatalities and included an asterisk beside the deaths table with a note reading: "At this time, available information does not establish whether measles caused or contributed to the (Pennsylvania) deaths or whether the individuals died from other causes while infected with measles."
The CDC has not set out what specific evidence it will require to determine whether the Pennsylvania deaths were caused or contributed to by measles, and agency officials are not conducting the investigation in tandem with the state health department, according to the accounts provided to Reuters.
Implications and next steps
The federal-state exchange highlights tensions over data sharing, patient privacy protections, and differing interpretations of causation in outbreak-related deaths. Officials on both sides have described ongoing contact and data exchanges in varying terms, while public messaging from the health secretary and the Pennsylvania governor has become a focal point of the dispute.
At present, the public record consists of the state’s notification that two unvaccinated individuals died and the CDC’s updated web note that available information does not establish that measles caused or contributed to those deaths. Further determinations will depend on additional data and whether state and federal agencies resolve the outstanding information and legal issues regarding identifiable health records.