Measles reaches highest number since elimination. Start of a Covid wave? Incoming Medicaid cuts, GAVI, and some good news
The Dose (July 7)
YLE is back from a much-needed break. Happy (belated) 4th of July to this beautiful and complicated country. It’s messy, but it’s ours. And I look forward to continuing the fight for the health of everyone who lives here because, after all, true freedom depends on good health.
As a mom to two little Texan girls who visit the flooded area every year, I’m absolutely heartbroken and sickened by what happened to the Bubble Inn cabin and the surrounding area. An area that is usually filled with deer, lush green grass, and the laughter of children tubing down the water, is now marked by unimaginable loss of life, signs of innocence lost, such as pink-draped bunk beds, and the heartache of families. There are no words. I hope you’ll join me in donating to the Red Cross or local organizations. I’m hugging my girls extra tight, while wishing and hoping the missing come home soon.
Now, here’s the latest in public health, and what it means for you.
Disease “weather” report
Measles cases have reached an all-time high since elimination
Well, it finally happened. Over the weekend, the U.S. reached 1,281 measles cases in 2025—the highest number since the disease was declared eliminated in 2000, and the most we’ve seen since 1992 (when there were 2,126 cases).
We’ve managed to keep measles at bay for decades thanks to high vaccination rates. But those rates are slipping, and since measles is the most contagious virus on Earth, it’s often the first to resurge when vaccination coverage declines. Interestingly, measles also flares up every four to five years for decades (even before vaccinations) for reasons we epidemiologists don’t know.
A high case count doesn’t automatically mean the U.S. loses its measles elimination status. That status—defined by the WHO—means measles is not endemic in the U.S. (i.e., it doesn’t spread continuously without being sparked by international travel).
Note: Contrary to rumors blaming measles on illegal immigration, historical data shows that measles is usually caught abroad by U.S. residents, who then bring it back home. Here’s the data.
We would only lose that designation if an outbreak lasts more than 12 months. Currently, we’re about halfway to losing elimination status, thanks to a large West Texas outbreak that began in January and is still simmering. Although it has slowed, transmission continues across multiple counties in several states, making it a key driver of the national surge.
CDC updates the measles count every Wednesday, so I expect headlines when the count is “official” (my referenced number is in big thanks to the Yale School of Public Health, which keeps a more up-to-date tally). If you’re up to date on your vaccines, your risk of measles remains very low. Here are your top 10 FAQ on MMR and measles protection.
Covid-19: Summer wave brewing?
Covid-19 levels remain low overall, but we may be seeing early signs of a summer wave. Wastewater data—an early and reliable indicator of community spread—is sending mixed signals. CDC’s wastewater data hasn’t shifted much, but another source, WastewaterSCAN, is showing a rise across all U.S. regions (see below). In some states, such as Nevada and Texas, levels are increasing in both datasets. Another early indicator—the number of positive tests—has also begun increasing.
Will we see a national summer wave? I’d be surprised if we didn’t. Three forces usually drive a surge:
Weather/humidity and human behavior (more indoor time during summer heat)
Waning immunity (it’s the highest it’s ever been following a mild winter wave and minimal vaccination rates)
Variants (Covid-19 keeps mutating. The latest Omicron descendant [NB.1.8.1] is circulating but not spreading as quickly as it did in other countries)
Typically, the U.S. follows Europe’s lead, and in the U.K., Covid-19 cases were increasing slightly, but they have now started to decrease, resulting in a wimpy summer wave thus far. This may suggest that the U.S. will not experience a significant summer wave either. However, these days it’s so hard to compare across countries given different landscapes. (For example, in the U.K. more than 60% get vaccinated for Covid compared to US’s 25%.)
Covid-19 is still a relatively young virus. We don’t fully understand its seasonal rhythm. For now, we wait. If you’re over 65 or severely immunocompromised, make sure you’re up to date on your Covid-19 vaccines (that means two doses a year.)
Buckle up for Medicaid cuts.
Last week, Congress passed the largest health care cuts in U.S. history. Nearly $1 trillion will be cut over the next ten years. Instead of building a future where we prevent disease, feed children, reduce medical debt, and help people live longer, this bill takes us in the opposite direction.
Millions will lose coverage. Hundreds of hospitals may shut down, particularly in rural areas, with up to 400 at risk. (Hover over the map below to see the number in your state.) One in four nursing homes could also close. Together, this will result in an expected 50,000 people dying each year from preventable causes.
There’s been a striking lack of clear, plain-language explanations about what’s actually in the bill. Even headlines like “11 million may lose health insurance” don’t explain how or why. I’ll be back Wednesday with a “translation.”
What can we do? These changes rely on administrative burden to quietly trim coverage. The confusion alone will result in people losing access to care, saving the federal government money. That means we’re not powerless:
Help neighbors: Many will face new forms, deadlines, and confusing rules.
Inform families: Kids aren’t auto-enrolled in free school lunch anymore.
Check CHIP: Children may still qualify for Medicaid even if their parents lose coverage.
Support: Donate to rural hospitals, food pantries, and care networks.
Vote: This is a policy choice. Make your voice heard.
Spread the word: Only 8% of Americans are even aware that Medicaid cuts were included in this bill.
These cuts will take years to unfold and are usually implemented quietly, bureaucratically, and devastatingly. Let’s not let that happen.
RFK Jr.’s latest anti-vaccine crusade goes global
RFK Jr. announced that the U.S. will no longer financially support GAVI, the global vaccine alliance. This is a direct hit to one of the most effective public health partnerships in modern history.
What is GAVI?
GAVI—the Global Alliance for Vaccines and Immunization—was created in 2000 to solve a very specific problem: vaccines were being developed, but the poorest countries couldn’t afford them, and manufacturers had no financial incentive to serve those markets. GAVI stepped in to bridge this gap. By pooling donor funding and purchasing vaccines in bulk, GAVI makes them affordable and accessible in countries where disease outbreaks are most deadly and health systems are weakest.
Thanks to GAVI, more than 1 billion children in low- and middle-income countries have been vaccinated, and more than 17 million lives have been saved. Today, GAVI helps vaccinate nearly half the world’s children. It is one of the clearest examples of what successful, coordinated global health action looks like.
Yet in his justification, RFK Jr. barely mentions any of this. Instead, he used the announcement to cast doubt on vaccines. He cited a flawed 2017 observational study to claim that DPT (Diphtheria, Pertussis, and Tetanus) vaccines increase mortality in girls, ignoring confounding, biases, and the fact that more rigorous follow-up studies—including studies by the same researchers—found no such effect. Their 2022 conclusion: “We did not find that DTP was associated with increased female mortality.”
The U.S. provided about 13% of GAVI’s budget (second highest contributor behind the U.K.). The funding was already appropriated through 2030, and it doesn’t even flow through HHS—it’s part of the State Department’s foreign aid. But apparently, process and procedure no longer matter. The Gates Foundation has since pledged $1.6 billion to help fill the gap, but it is likely not enough.
Why does this matter to you? Pulling support from GAVI isn’t just bad in humanitarian and global leadership terms; it could also be dangerous—undermining global disease prevention, weakening pandemic preparedness, and threatening the health of children everywhere, including here in the U.S.
Good news: Payers speaking up, preventive care, HHS restructuring, and NIH grants
We’ll take all the wins we can get:
Payers start to speak up. AHIP (national health insurance association) and the Alliance of Community Health Plans affirmed their commitment to covering fall vaccines, ensuring patients aren’t left with unexpected costs, regardless of what RFK Jr. recommends. Of course, it could vary by payer. The first payer, Blue Shield of California, said that it will cover all routine vaccinations. I expect more to come out soon.
Preventive care is protected. The Supreme Court ruled that insurers must continue to cover preventive services at no cost, including cancer screenings and PrEP.
Caveat: RFK Jr. will have oversight over the U.S. Preventive Services Task Force, which determines whether a preventive intervention helps patients. He could gut and replace that whole committee, like he did with vaccines. Time will tell.
HHS mass firings and reorganization blocked by a federal judge that deemed it “probably unlawful” and issued a temporary block to the reorg’s next steps.
NIH grants partially reinstated. Another judge reinstated $1.1 billion in NIH research grants, but only in states whose attorneys general joined the lawsuit. These are overwhelmingly blue states. Universities are still awaiting the arrival of the funds.
In case you missed it
Katelyn joined Pod Save America to discuss the future of vaccines in the U.S., her ongoing meetings with MAHA grassroots, and the parallels between public health mistakes and challenges and those facing the Democratic Party.
Last week’s America Dissected podcast on ACIP and more.
PopHive launch—a new way to access and visualize siloed public health data.
Bottom line
You’re all caught up for the week in public health. Enjoy the viral lull, and I hope you can unplug and recharge, given *waves hands in the air* everything going on.
Love, YLE
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE is a public health newsletter that reaches over 380,000 people in more than 132 countries, with one goal: to translate the ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below
RFK the Lesser and the Trump administration are the worst things to happen to public health in the history of public health. They are all sociopaths in my book, and they are actively harming people -- especially, as usual, the poorest and least powerful among us.
But that's also what many of those people voted for.
Eventus stultorum magister est. Fools must be taught by experience.
Nothing to shout "Hooray" about here, but I again appreciate your information and your good sense. We are continuing to see the expected consequences of our national ignorance, arrogance, and cruelty. We also see the efforts of those striving for health and science. Keep it coming, and thank you!