Minutes before a news conference announcing two measles-related deaths in Pennsylvania, Gov. Josh Shapiro (D) had a heated call with the Trump administration’s top health official.
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Before television cameras on Tuesday, the governor accused Health Secretary Robert F. Kennedy Jr. of sowing confusion about vaccines and contributing to the return of a disease the United States eliminated more than a quarter-century ago. Shapiro said he told Kennedy that the state did not want additional help from the federal government.
The exchange has erupted into an extraordinary public feud and set off a partisan flurry of accusations over outbreaks of the highly contagious disease, which is easily prevented by a vaccine. Shapiro and Kennedy have traded lengthy barbs on social media, accusing each other of fearmongering.
Scrutiny of Shapiro’s announcement deepened Thursday, after a county coroner said that the pathologist who examined a newborn who tested positive for measles did not believe the virus played a role in the baby’s death. Kennedy and his allies have accused Shapiro’s administration of prematurely declaring that the outbreak had turned deadly. Some infectious-disease experts normally critical of Kennedy said Shapiro and his team should have offered more information from the start.
Democrats and public health experts contend that Kennedy — the founder of a prominent anti-vaccine group — has downplayed outbreaks of measles, and that his rhetoric over the years has undermined vaccination that could prevent or control the outbreaks. Some have gone so far as to blame Kennedy for several measles-associated deaths during President Donald Trump’s second term.
“Americans are DYING from measles — a preventable disease — because Trump and RFK Jr. have decimated trust in vaccines,” Sen. Patty Murray (D-Washington) posted on X.
Kennedy has a lengthy history of disparaging vaccines, including at a 2021 appearance in undervaccinated Lancaster County, Pennsylvania, where state health officials reported the two deaths. In response to criticism about Kennedy’s history of anti-vaccine activism, the White House often notes that Kennedy, as health secretary, has said that vaccination is “the most effective way to prevent the spread of measles” and that parents should get their children vaccinated for measles. Some public health experts have said Kennedy has muddled that message by falsely claiming that the vaccines are not safety tested.
The back-and-forth over Pennsylvania’s measles outbreak offers an early glimpse of how vaccines, infectious diseases and trust in government could become defining issues in the next presidential campaign. Democrats positioning themselves for 2028 have been eager to show they are taking on the Trump administration, and many embrace vaccines as a bipartisan general-election issue and an opportunity to depict Republicans as out of touch with science.
Shapiro, a governor in a presidential swing state who is cruising to reelection in November, is widely expected to run for president. Kennedy, who ran for president as an independent in 2024, has batted down speculation he would launch another campaign.
“Secretary Kennedy has stoked confusion amongst parents and others — and the result has been less protection from measles and more cases,” Shapiro posted Wednesday on X.
Kennedy has used his personal and official government social media accounts to contend that Shapiro is using the moment for political gain. He suggested that the deaths “may even have been altogether fabricated by one of the Governor’s hopeful staffers.”
“Governor Shapiro’s unseemly rush to Lancaster County to convene a national press conference and his giddy delight in announcing two measles deaths was a morose commentary on the contemporary political dialogue,” Kennedy wrote on social media Wednesday.
As of Thursday, left-wing political influencers were talking about measles about five times more often than right-wing figures, according to a Washington Post analysis of their social media posts, podcasts and newsletters. The frequency of the mentions this week by the left is the highest since early 2025 during the West Texas measles outbreak, which infected more than 700 people and contributed to the deaths of two unvaccinated children.
In response to questions from The Post, Democratic House candidates in competitive Pennsylvania districts rallied behind Shapiro in his feud with Kennedy. Shapiro has focused his midterm strategy on boosting their campaigns, and victories would shore up his political brand ahead of a White House run.
“Public health is going to be very important in the debate for who becomes the next president,” said Hawaii Gov. Josh Green (D), a family physician and fierce critic of Kennedy. He said he and Shapiro have discussed launching a national vaccination campaign.
Pennsylvania political strategists and other state Democrats cautioned against interpreting Shapiro’s comments about Kennedy as presidential positioning, arguing that any governor confronting a ballooning outbreak with hundreds of infections would be obligated to challenge federal messaging he or she believed was harming residents.
“He’s absolutely doing the responsible thing and calling it out, and not just letting RFK say what he wants to say,” said Susan Wild, a former Democratic congresswoman from Pennsylvania.
The Pennsylvania measles outbreak also shows the tricky politics of public health, which has become increasingly polarized since the coronavirus pandemic and the rise of anti-vaccine misinformation. Shapiro has come under fire for how his administration has communicated about the deaths with unusually sparse detail that was contradicted by some local officials.
Lancaster County Coroner Stephen Diamantoni said in an interview that officials discovered signs of a measles infection in a newborn who died of a spleen laceration hours after birth on Aug. 14.
But Diamantoni said the forensic pathologist who conducted the autopsy did not believe measles played a role in the death. The coroner said his office shared this information with the state health department hours before Shapiro’s announcement.
A spokesman for Shapiro did not return a request for comment late Thursday night on the coroner’s account. State health officials have said they classify deaths as “measles-associated” when the virus is present, even if the disease is not identified as the immediate cause of death.
Several infectious-disease experts said the governor, along with his health department, should have initially released more information about the deaths, such as the age of those infected. Instead, others including anti-vaccine activists have filled the void.
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“A vacuum in public health information never stays empty — it gets filled by whoever moves fastest and cares least about accuracy,” Amesh Adalja, an infectious-disease physician in the Pittsburgh area, said in a text message. “The state and Gov. Shapiro’s communication failures and opacity invited RFK Jr and his allies in by engraved invitation and they now control the narrative while an unchecked measles outbreak spreads throughout the state.”
Measles cases in Pennsylvania, which reached 424 cases as of Wednesday, began climbing during the summer, prompting state officials to warn of potential exposures at local stores and to host pop-up vaccination clinics. The U.S. would soon report the most measles cases in any year since 1991, outpacing last year’s total with months of 2026 left to go.
Most children recover after several days of fever, cough and an itchy rash, but the disease can also cause pneumonia, brain swelling, deafness and intellectual disability. Fatalities have become extraordinarily rare, with nearly 1 to 3 of every 1,000 children infected dying of respiratory and neurologic complications, according to the Centers for Disease Control and Prevention.
On Tuesday, state health department officials said they had confirmed two measles-associated deaths of individuals who were not vaccinated. The deaths in Lancaster County were the first related to measles in Pennsylvania in 35 years, they said, and the first deaths reported this year in the U.S.
At the press conference, Shapiro and health officials repeatedly said they would not be providing additional information to protect patient privacy.
Diamantoni, a Republican family doctor first elected coroner in 2007, said one of those cases was a newborn who died in a birthing center after a delivery with a midwife. The case, which state officials later confirmed was one of the two they announced, is still under investigation and does not bear the hallmarks of a measles death, he said.
Measles can cause significant inflammation to the spleen, making it more fragile and susceptible to life-threatening rupture, the state health department said Thursday. Diamantoni, who was not at the autopsy, said the pathologist told him the spleen was not enlarged and not inflamed.
The differing accounts prompted a Republican Lancaster County commissioner to lambaste the state’s handling of the death announcement.
“You cannot drop a bombshell like this and then essentially say all the information around it is top secret,” Josh Parsons, the commissioner, said in a lengthy X post on Thursday. Parsons did not respond to requests for comment.
Public health agencies generally provide basic information about the victims of disease outbreaks, such as age, gender and whether they had underlying health conditions, but with varying degrees of detail.
“The only way to remedy the confusing communication about these tragic deaths is to provide adequate information that clarifies the medical circumstances of those individuals while respecting the families at this difficult time,” said Demetre Daskalakis, the former director of the CDC center that oversees immunization and respiratory viruses, including measles, who resigned a year ago to protest what he called Kennedy’s politicization of science.
Will Simons, a spokesman for Shapiro, defended the limited disclosures as protecting patient confidentiality while promoting public health through quick disclosure of deaths. He said safeguarding patients’ information helps public health officials maintain the trust of their communities.
A spokeswoman for Kennedy responded to questions by pointing to a CDC post on social media that said the agency was ready to help Pennsylvania respond to the outbreak. The CDC said Kennedy was trying to “clarify conflicting information” about the reported deaths and faulted the governor’s office for not providing information and declining offers of assistance. Pennsylvania officials disputed this account.
“Accuracy is critical to reliable national data, transparency, and public trust,” the CDC said on X.
Pennsylvania’s outbreak has unfolded as childhood measles vaccination rates have fallen statewide.
The share of kindergartners vaccinated against measles in Pennsylvania fell from 96.4 percent in 2019 to 93.2 percent in 2025, and vaccination rates have plummeted across much of the country since before the pandemic.
In Lancaster County, that drop was much steeper, with the rate falling from nearly 95 percent — the level experts consider necessary to prevent an infection from triggering an outbreak — to about 87 percent in the 2025-2026 school year. Over this same period, families seeking philosophical and religious exemptions from vaccine requirements doubled to 4.7 percent and 5.9 percent, respectively.
Major Democratic rapid-response accounts like FactPost and Headquarters, as well as Democratic politicians, circulated a video clip of Kennedy downplaying measles during an appearance in Lancaster County in 2021.
“I am a measles survivor,” Kennedy, then the head of an anti-vaccine group, said to laughs from the crowd. “We had to stay home and watch TV the whole week with all of my brothers and sisters.”
He claimed, as he often had, that the cure for measles was chicken soup and vitamin A. And he warned some in the audience that government officials would do everything in their power to make them vaccinated.
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Laura Beveridge contributed to this report.
