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Pennsylvania has reported more than 1,350 measles cases in 2026, with over a third in Lancaster County, the center of the U.S. outbreak. Health workers and community members say some Amish and Mennonite residents are becoming more open to vaccination, though views remain mixed and the reported total may undercount infections.
Some Amish and Mennonite residents in Pennsylvania’s Lancaster County are showing greater openness to measles vaccination as an outbreak that has made the state the country’s hardest-hit continues to affect Plain communities and their neighbors. Pennsylvania has recorded more than 1,350 cases this year, including over a third in Lancaster County, according to state figures cited by MedPage Today; local leaders say the official count may be low because many people do not seek medical care.
The outbreak has especially affected Amish and conservative Mennonite communities, where vaccination rates are generally lower than among the wider population, although practices and views vary. Community leaders and researchers told MedPage Today that low vaccination has often reflected custom and habit rather than religious opposition. Some residents are now pursuing shots after seeing infections among relatives or weighing the risk of missing work during illness.
Union Community Care, a nonprofit with clinics in Lancaster and surrounding towns, has held small vaccination clinics serving Plain communities. The organization said those efforts have resulted in about 450 measles vaccinations. It is also offering some infants an earlier measles, mumps and rubella (MMR) dose than the usual schedule, following health experts’ advice for areas experiencing outbreaks. The report described one family bringing its 10-month-old son for his first MMR dose.
Vaccination views remain divided. One Amish farmer interviewed by the outlet said he opposed vaccines even after he and his wife cared for their young twins during measles. Other residents said they chose vaccination after infections began affecting family members or because of concerns about the consequences of getting sick. The report said many interviewees declined to be named, in keeping with Plain-community customs.
Outbreak Crosses Community Lines
The spread matters beyond Lancaster County’s Amish and Mennonite communities. Residents of Plain communities and the wider public share markets, schools, health services and other public spaces, making it difficult to treat the outbreak as confined to one population. Clinicians told MedPage Today that people from different communities encounter one another in everyday settings, while vaccination gaps exist among both Plain residents and members of the general public.
Measles is highly contagious, and although many cases are mild, it can cause serious complications, including pneumonia and encephalitis, and can be fatal. The outbreak also illustrates how falling vaccination rates in the wider public, combined with historically lower rates in some communities, can allow a disease long considered eliminated from routine U.S. transmission to spread again. Pennsylvania has recorded three measles-associated deaths in Lancaster County and two in other counties, according to the report.
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Lancaster County’s Measles Surge
The report, published October 31, describes Lancaster County as the center of the nation’s worst measles outbreak in 35 years. Pennsylvania had the highest case total in the United States, with more than 1,350 reported cases in 2026 at the time of publication. State figures showed that totals had fallen from a September peak, but some doctors expected cases could rise again during winter, when people spend more time gathered indoors.
Measles was declared eliminated from the United States in 2000, meaning sustained domestic transmission had been stopped; cases can still be brought in and spread when they reach under-vaccinated groups. The report said attitudes toward vaccination in Plain communities have shifted over time, with trust cooling after strict COVID-19 measures. Experts and community leaders described a gradual approach to outreach, emphasizing relationships and encouragement rather than pressure.
“We are all interconnected.”
— Diego Hijano, a physician at St. Jude Children’s Research Hospital
Case Counts and Views Still Vary
The true number of infections is unclear. Pennsylvania’s reported total may be an undercount, according to community leaders cited by MedPage Today, because many people with measles do not visit a doctor. The report did not provide an alternative estimate. It also did not give a current breakdown of cases by community, vaccination status or age, so the scale of transmission within individual groups cannot be established from the available figures.
It is also unclear whether the recent increase in vaccine acceptance will persist or how much the clinics’ roughly 450 doses will affect transmission. Attitudes remain mixed, and the report offers accounts from individuals rather than a survey measuring changes across Amish and Mennonite populations. The reasons and degree of vaccine acceptance differ between communities and households.
Winter Conditions and Outreach Ahead
Health workers will continue outreach and vaccination efforts as Pennsylvania monitors the outbreak. Doctors cited in the report are watching for a possible increase in cases during winter, when indoor gatherings become more common, despite the decline from the September peak. The timing and size of any further rise are not known.
The immediate focus is on reaching residents who may be at risk and providing vaccination options, including earlier infant doses in outbreak areas when advised by health experts. Further state case updates should clarify whether the decline continues and how many infections are being identified. The report did not specify a timetable for new totals or a statewide end date for the outbreak.
Key Questions
How many measles cases has Pennsylvania reported?
State figures cited in the October 31 report showed more than 1,350 cases in 2026, with over a third in Lancaster County. Community leaders said the official total may be an undercount, but no alternative figure was provided.
Are Amish and Mennonite residents becoming more open to vaccination?
Some are, according to health workers and community members interviewed by MedPage Today. The report describes people seeking vaccination after infections affected relatives or raised concerns about being unable to work. Views vary, and it does not provide a population-wide survey.
Why are Plain communities affected by the outbreak?
The report says vaccination rates have generally been lower in Plain communities, often because vaccination was not customary rather than because of religious doctrine. The communities also interact regularly with the wider public through markets, schools, clinics and business.
Could measles cases rise again in Pennsylvania?
Some doctors expect cases could increase during winter, when people gather indoors more often. Pennsylvania’s reported rates had declined from a September peak, but the report said the future course of the outbreak was uncertain.
Source: medpagetoday.com
