A surge in measles infections across the United States is forcing families of immunocompromised children to make difficult decisions about school and daily life. In 2026 so far, nearly 3,000 confirmed cases have been reported, marking a 35-year high for the highly contagious disease. Pennsylvania recorded the first two measles-related deaths of the year just as the new school year began.
The rise coincides with declining vaccination coverage nationwide. Community protection against measles requires roughly 95 percent of a population to be vaccinated, and outbreaks are emerging in areas where rates have fallen below that mark. In Lancaster County, Pennsylvania, only 87.6 percent of kindergartners and 83.3 percent of seventh graders are fully vaccinated against the virus.
The Risk for Children Who Cannot Be Vaccinated
The exact number of American children with weakened immune systems is unknown, but a Centers for Disease Control and Prevention study estimated that 2.6 percent of children are immunocompromised. Immune deficiencies can stem from genetic causes or from secondary factors such as chemotherapy during cancer treatment. These children either cannot receive vaccines or may fail to build a strong enough immune response.
Measles poses a serious threat to anyone, but the danger is far greater for this group. The virus can trigger life-threatening complications including pneumonia and brain swelling. It can also erase the body’s memory of past infections, a phenomenon known as immune amnesia, leaving patients vulnerable to other diseases.
Victoria Schiano, national community engagement coordinator for Little Lobbyists, a nonprofit advocating for children with complex medical needs and disabilities, described the return of measles as “absolutely terrifying.” Her 10-year-old son has mitochondrial disease and lives in Chester County, Pennsylvania, which currently has the state’s second-highest number of cases. He cannot be vaccinated and receives weekly infusions of immunoglobulin, concentrated antibodies from donated blood plasma, to help fight infections. “Measles is dangerous for anyone, but for him, this absolutely could be life or death,” she said.
Families Weigh School, Safety, and Isolation
Schiano’s son already wears a mask, uses a plexiglass screen at school, and the family practices careful handwashing. Even so, they have limited his time with friends and activities such as karate. She said the family is prepared to remove him from school if even a single confirmed measles case appears in the district.
That option carries its own consequences. During the Covid-19 pandemic, remote learning was linked to increased social isolation as well as behavioral and mental health problems among students. Schiano noted the strain of balancing her son’s safety with his quality of life, adding that he “just wants to play and to do all the things that he sees other kids doing.”
Some parents have already committed to keeping their children home. Amalia, a South Carolina parent using a pseudonym for privacy, has chosen online schooling this year for her 16-year-old son, who has immunoglobulin A deficiency, a condition in which the body does not produce enough of an antibody found in mucous membranes and body fluids.
