这是《疫苗鸿沟》系列报道的第一部分，该系列是一项更新的数据调查，探讨美国可能失去麻疹消除国的地位，因为这种致命病毒卷土重来，儿童疫苗防御体系持续出现裂痕并不断崩溃。1998年，杰弗里·科普兰博士接任美国疾病控制与预防中心主任时，他和同事们承诺在四年内阻止麻疹在美国的传播。他们仅用了两年就做到了。
This is Part 1 of The Vaccine Divide, an updated data investigation into America potentially losing its measles-free status as the deadly virus roars back and childhood vaccine defenses continue to crack and crumble. When Dr. Jeffrey Koplan took over as head of the Centers for Disease Control and Prevention in 1998, he and his colleagues pledged to stop the spread of measles in the United States within four years.
“我们拥有一种优秀的疫苗，”科普兰说，他目前是埃默里大学全球健康副总裁。“所有人都支持。”他将成功归功于全国公共卫生团体的广泛两党支持，包括疾病控制与预防中心和食品药品监督管理局，以及儿科医生和州卫生部门。病毒逐渐退去，当年全国仅有约100例确诊病例。到2000年，这种曾经肆虐童年的病毒在美国被正式宣布消除。
They did it in two. “We had a great vaccine,” said Koplan, now vice president for global health at Emory University. “Everyone was on board.”He attributed the success to widespread, bipartisan support from national public health groups, including the CDC and the Food and Drug Administration, as well as pediatricians and state health departments. The virus receded, with only about 100 confirmed cases in the entire country that year. By 2000, a scourge of childhood was officially eliminated in the U.S. Now, it has roared back.
如今，它卷土重来。根据疾病控制与预防中心的数据，今年已有43起新的疫情暴发，确诊病例超过5000例。八人死亡，其中包括四个尚未达到接种年龄的婴儿。在NBC新闻/斯坦福大学数据调查首次揭示儿童疫苗接种率出现令人担忧的下降一年多后，一项更新的分析发现，这个国家曾经强大的麻疹防御体系中的裂痕已扩大为鸿沟，尤其是在该国最脆弱的地区。
There have been 43 new outbreaks this year, with more than 5,000 confirmed cases, according to the CDC. Eight people, including four babies too young to be vaccinated, have died. More than a year after an NBC News/Stanford University data investigation first revealed an alarming drop in childhood vaccination rates, an updated analysis finds cracks in the nation’s once-robust measles defense have widened into a chasm, particularly in the country’s most vulnerable areas.
在拥有幼儿园免疫率最新数据的美国县中，四分之三的县现在低于社区麻疹防护的推荐阈值，超过一半的县从2024-25学年降至2025-26学年。本周，泛美卫生组织（世界卫生组织的一个成员机构）的一个独立委员会正在华盛顿开会，讨论美国是否已失去其麻疹消除国地位。
Three-quarters of U.S. counties with recent data on kindergarten immunization rates are now below the recommended threshold for community measles protection, with more than half of counties dropping from the 2024-25 to 2025-26 school years. This week, an independent commission of the Pan American Health Organization, a group within the World Health Organization, is meeting in Washington to consider whether the U.S. has lost its measles elimination status.
这个八人小组包括来自美洲各国（包括美国）的流行病学家以及传染病和疫苗专家。在泛美卫生组织官员做出最终决定后，他们将通知美国卫生与公众服务部，可能就在本周。公共卫生专家预计，该小组将撤销美国的麻疹消除国地位。美国是如何放松警惕的 该国的免疫力在数十年来关于儿童疫苗危险性的科学站不住脚的说法中被削弱。
The group of eight includes epidemiologists, infectious disease and vaccine experts from countries in the Americas, including the U.S. After PAHO officials make a final decision, they will inform the U.S. Department of Health and Human Services, possibly this week. Public health experts expect the group to revoke America’s measles-free status. How the U.S. let its guard down The country’s immunity was eroded by decades of scientifically dubious claims about the dangers of childhood vaccines.
随后，在疫情期间，错误信息激增，封锁还导致常规疫苗接种中断。过去一年半以来，数千名美国人——几乎全部未接种疫苗——感染了麻疹。孕妇正在失去胎儿。医生们正在争分夺秒地想办法治疗新生儿的这种疾病。儿童正在经历严重且有时不可逆的神经系统并发症。“如果我们不能控制住这一局面，这些数字只会增加，”纽约大学全球公共卫生学院全球与环境卫生系主任马克·吉特说。
Misinformation then exploded during the pandemic, when shutdowns also led to interruptions in routine shots. Thousands of Americans — nearly all unvaccinated — have been infected with measles in the last year and a half. Pregnant women are losing their babies. Doctors are scrambling to figure out how to treat the disease in newborns. Children are experiencing severe and sometimes irreversible neurologic complications. “If we don’t get this under control, these numbers will only increase,” said Mark Jit, chair of the Department of Global and Environmental Health at the NYU School of Global Public Health.
“每年，情况都只会变得更糟。”“我们已经忘记了麻疹有多可怕，”美国公共卫生协会执行主任乔治斯·本杰明博士说。“在我们的健忘中，我们放松了警惕。”自2025年初以来，公共卫生工作者一直在与麻疹进行一场“打地鼠”式的战斗，西得克萨斯州、犹他州、亚利桑那州、南卡罗来纳州，以及现在的宾夕法尼亚州、印第安纳州、俄亥俄州、明尼苏达州、纽约州和威斯康星州都出现了疫情。
“Every year, the situation is just going to get worse.”“We’ve forgotten how bad measles was,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “In our forgetfulness, we’ve let our guard down.”Since early 2025, public health workers have been in a whack-a-mole battle against measles, with epidemics in West Texas, Utah, Arizona, South Carolina and now Pennsylvania, Indiana, Ohio, Minnesota, New York and Wisconsin.
根据新数据，接种率最低的县的免疫率下降似乎正在加速。在2024-25学年，这些社区的最高疫苗接种率为81.8%。上一个学年，这一比例下降至79.2%。要防止麻疹传播，需要达到95%的免疫率。“这一差距不断扩大的事实确实令人担忧，”博士说。
According to the new data, the fall of immunization rates in the least-vaccinated counties appears to be accelerating. During the 2024-25 school year, the top vaccination rate in those communities was 81.8%. Last school year, it fell to 79.2%. An immunization rate of 95% is needed to prevent the spread of measles. “The fact that this divide is getting greater is really worrisome,” said Dr. Richard Besser, a pediatrician and president of the Robert Wood Johnson Foundation, a nonprofit philanthropic organization focused on health research and programs.
理查德·贝瑟是一名儿科医生，也是罗伯特·伍德·约翰逊基金会的总裁，该基金会是一家专注于健康研究和项目的非营利慈善组织。“它应该做的是推动公共卫生行动，并让易受伤害社区中值得信赖的声音认识到，疫苗与政治无关，而是关于保护健康。”贝瑟曾在贝拉克·奥巴马总统任内担任代理疾病控制与预防中心主任。
“What it should do is lead to public health action and engage trusted voices in vulnerable communities to recognize that vaccines aren’t about politics. They’re about protecting health.”Besser was acting CDC director under President Barack Obama.
疫苗接种率最高的县的报道率也有所下降，但幅度小得多——从2019年的99.3%下降到2025-26学年的97.7%。在一份声明中，美国卫生与公共服务部表示，部长罗伯特·F·肯尼迪 Jr.和疾病控制与预防中心主任埃里卡·施瓦茨“继续推荐MMR疫苗作为预防麻疹最有效的方法。”声明称：“如果泛美卫生组织‘取消美国的消除状态，卫生与公共服务部和疾病控制与预防中心将处理调查结果，并与合作伙伴合作，记录地方性传播中断的情况，并满足重新获得消除状态的要求。’”小幅下降可能带来重大影响。
Coverage in counties with the highest vaccination rates also declined, but much less so — from 99.3% in 2019 to 97.7% during the 2025-26 school year. In a statement, the Department of Health and Human Services said that Secretary Robert F. Kennedy Jr and CDC director Erica Schwartz “continue to recommend MMR vaccination as the most effective way to prevent measles.”If the Pan American Health Organization “removes U.S. elimination status, HHS and CDC will address the findings and work with partners to document interruption of endemic transmission and meet the requirements for re-achieving elimination status,” the statement read.
麻疹是世界上传染性最强的病毒。感染者走过一个房间后，病毒可以在空气中停留数小时。几乎所有未接种疫苗且接触病毒的人都会被感染。这些新数据来自各种州和地方文件，包括一些根据《信息自由法》获得的材料，随后被浓缩成迄今为止最全面的疫苗接种和学校豁免分析。全国范围内，拥有麻疹-腮腺炎-风疹疫苗数据的75%的县和辖区低于麻疹群体免疫所需的阈值，与2024-25年相比有显著增加。
Small declines can have major implications Measles is the most contagious virus in the world. It can linger in the air for hours after an infected person walks through a room. Nearly everyone who’s not vaccinated and is exposed to the virus will become infected. The new data was culled from a wide variety of state and local documents, including some materials obtained under the Freedom of Information Act, and then condensed into the most comprehensive analysis of vaccinations and school exemptions to date. Nationwide, 75% of counties and jurisdictions with measles-mumps-rubella vaccine data fall below the threshold needed for herd immunity for measles, a notable increase compared with 2024-25.
自2019年以来，绝大多数县——86%——的疫苗豁免率有所增加。俄克拉荷马州佩恩县经历了最显著的下降之一，从2019年的95.6%降至仅78.4%。
And since 2019, vaccination exemptions have increased in the vast majority of counties — 86%. Payne County, Oklahoma, experienced one of the most significant declines, from 95.6% in 2019 to just 78.4%.
明尼苏达州斯科特县位于明尼阿波利斯以外，疫苗接种率从2019年的94.6%下降到83%。一些地区提高了疫苗接种率。华盛顿特区的接种率从2019年的78.5%上升到2025年的94.4%。反疫苗态度在宾夕法尼亚州根深蒂固。疫苗接种率的危险下滑正在宾夕法尼亚州实时上演，尤其是在关系紧密的阿米什人社区中。在受灾严重的兰开斯特县，NBC新闻的数据显示，2025-26学年接种麻疹、腮腺炎和风疹疫苗的幼儿园儿童比例为87.6%。
Vaccination rates in Scott County, Minnesota, which is outside Minneapolis, sank to 83% from 94.6% in 2019. Some areas boosted vaccination rates. Washington, D.C., rose to 94.4% in 2025, from 78.5% in 2019. Anti-vaccine attitudes take hold in Pennsylvania The dangerous slide in vaccinations is playing out in real time in Pennsylvania, especially among the close-knit Amish community. In hard-hit Lancaster County, the share of kindergartners who got MMR vaccinations in 2025-26 was 87.6%, NBC News data found.
在2017-18学年疫情之前，该县的免疫率为95.5%。这一下降导致今年发生了一场致命的麻疹疫情，疫情主要在该州的阿米什家庭中传播。住在兰开斯特县的阿米什人本·里尔说，他过去十年目睹了人们对疫苗态度的快速变化。“我们那个年代，你就得接种疫苗。没有疑问，”61岁的里尔说。“这是应该做的事。”他和妻子给他们的六个儿子都接种了疫苗，这些儿子现在都已成年。
Before the pandemic in 2017-18, the county’s immunization rate was 95.5%. That decline precipitated a deadly outbreak of measles this year that has spread mostly among Amish families in the state. Ben Riehl, an Amish man living in Lancaster County, said he has witnessed fast-changing attitudes about vaccines over the past decade. “Back in our day, you got the vaccine. There was no question,” said Riehl, 61. “It was the proper thing to do.”He and his wife vaccinated all six of their sons, who are now grown.
虽然阿米什人倾向于抵制主流医疗干预，但阿米什文化或宗教中并没有任何本质上反疫苗的内容。里尔说，随着时间的推移，阿米什人难免会受到反疫苗言论的影响，尤其是当这些信息被直接带到他的社区时。长期批评疫苗的肯尼迪在成为美国卫生部长之前，是2021年兰开斯特县一场活动的主旨演讲者，他在活动中未引用科学证据，声称疫苗有害。
Though Amish tend to resist mainstream medical interventions, there is nothing in the Amish culture or religion that is inherently anti-vaccine. Riehl said that over time, Amish people couldn’t help but be influenced by anti-vaccine rhetoric, particularly when the message was brought directly to his community. Before Kennedy, a longtime vaccine critic, became the nation’s health secretary, he was a keynote speaker at a 2021 event in Lancaster County, during which he said, without citing scientific evidence, that vaccines are harmful.
该活动吸引了1000多人，大多是阿米什人。“反疫苗人士赢得了阿米什人的信任，”里尔说。“阿米什人不是自己凭空想出了反疫苗的想法。他们受到了外部信息的影响。”宾夕法尼亚州赫希市宾州健康州立大学戈利萨诺儿童医院的儿科传染病医生埃文·夏里说，越来越多的家长带着对疫苗的担忧来到他的诊所。
The event drew more than 1,000 people — mostly Amish. “The anti-vax crowd got the Amish people’s ear,” Riehl said. “The Amish didn’t suck the anti-vax ideas out of their own thumb. They were influenced by outside information.”Dr. Evan Shirey, a pediatric infectious disease physician at Penn State Health Golisano Children’s Hospital in Hershey, said parents increasingly come into his clinic with worries about vaccines.
“我们知道，有些人非常显著地专门来到我们的社区，散布这种病毒不算什么的信息，”正在治疗麻疹患儿的希里说。“当我们看到有人死亡，当我们看到婴儿受苦，当我们看到孩子患上一些在某些情况下会造成永久性损害的疾病时，我们知道那是一个巨大的谎言。这完全是假的。”宾夕法尼亚州病例的激增让一些医生措手不及。
“We know that very prominently, individuals have come to our community specifically to spread the message that this virus isn’t a big deal,” said Shirey, who has been treating children sick with measles. “When we see that people are dying, when we see that babies are suffering, when we see that children are having illnesses that, in some cases, are permanent, we know that that’s a big lie. It’s just false.”The onslaught of cases in Pennsylvania has caught some doctors off guard.
36岁的劳伦·舒普住在匹兹堡郊区因佩里亚尔，她说，她9月初带2个月大的女儿基兰去匹兹堡大学医学中心儿童医院就诊过敏科时，孩子接触了麻疹病毒，之后她反复向医生询问该怎么办。因为第一剂麻疹疫苗要等到1岁才接种，基兰的小身体对病毒毫无抵抗力。舒普说，当她带婴儿去接种富含抗体的免疫球蛋白——这种药物可在接触麻疹病毒后的短时间内注射——时，没有人告诉她家人可以做些什么来降低对社区的风险。
Lauren Shoup, 36, of Imperial, a Pittsburgh suburb, said she repeatedly questioned doctors about what to do after her 2-month-old daughter, Kieran, was exposed to measles during a routine visit with an allergist at the University of Pittsburgh Medical Center Children’s Hospital in early September. Because the first measles shot isn’t given until age 1, Kieran’s tiny body was defenseless against the virus. Shoup said that when she took the baby in for a dose of antibody-rich immunoglobulin, which can be given within a short period of time after a measles exposure, she wasn’t given any directives about what her family could do to minimize risks to the community.
舒普说，婴儿接种抗体注射三天后，阿勒格尼县卫生部门的一名工作人员给她打电话，说婴儿自接触病毒以来就应该被隔离。“我相信科学。我遵循科学，”舒普说。“但因为没有人了解科学，这非常令人沮丧。”匹兹堡大学医学中心的一名发言人在一份声明中说，该医院系统正在“审查所提出的担忧，并始终致力于与公共卫生官员合作，为任何可能接触过病毒的人提供适当指导”。
Three days after the baby received the antibody injection, Shoup said, an Allegheny County health department worker called her and said the infant should have been in quarantine since her exposure. “I believe in science. I follow the science,” Shoup said. “But because no one knows the science, it’s very frustrating.”In a statement, a UPMC spokesperson said the hospital system is “reviewing the concerns that have been raised and remain committed to working with public health officials and providing appropriate guidance to anyone who may have been exposed.”
包括匹兹堡在内的阿勒格尼县，麻疹疫苗接种率从2019年的97.1%下降到上个学年的92.9%。虽然如果母亲接种过疫苗，婴儿出生时会带有一些保护，但这种保护能持续多久尚不清楚。
In Allegheny County, which includes Pittsburgh, the measles vaccination rate dropped from 97.1% in 2019 to 92.9% last school year. While babies are born with some protection if their mothers were vaccinated, it’s unclear how long that lasts.
基兰现在4个月大，还太小，不能接种麻疹、腮腺炎和风疹（MMR）疫苗。“很可怕，因为她还没有接种疫苗，”肖普说。“她仍然容易感染。”美国的麻疹是否已经再次成为地方性疾病？泛美卫生组织官员正在考察，单一麻疹传播链是否已持续超过12个月，以及是否存在相当数量感染源不明的病例。在犹他州，麻疹于2025年6月爆发，卫生官员尚未宣布疫情结束。
Kieran is now 4 months old, still too young for the MMR shots. “It’s scary because she’s still not vaccinated,” Shoup said. “She’s still susceptible.”Is measles already endemic in the U.S. again? PAHO officials are looking at whether a single chain of measles transmission has gone on for more than 12 months, as well as whether there are a significant number of cases for which the source of infection is unknown. In Utah, where measles flared up in June 2025, health officials haven’t yet declared an end to the outbreak.
该州最近诊断出一例病例，病毒仍在废水样本中被检测到。麻疹传播速度极快，即使只有一例病例也被视为疫情。在20世纪90年代，疾病控制与预防中心和食品药品管理局与联邦和州领导人以及儿科医生一道，怀着“共同目标感”鼓励接种MMR疫苗，科普兰说。科普兰由比尔·克林顿总统任命为疾病控制与预防中心主任，并在乔治·W·布什总统就任后继续担任该职务。
One case was diagnosed in the state recently, and the virus is still detected in wastewater samples. Measles can spread so quickly that even one case is considered an outbreak. Through the 1990s, the CDC and the FDA worked together with “a sense of common purpose,” along with federal and state leaders and pediatricians, to encourage MMR vaccinations, said Koplan, who was appointed head of the CDC by President Bill Clinton and continued in the role when President George W. Bush took office.
“科学现在被忽视，人们因忽视科学而丧生，”科普兰说。如果美国失去麻疹消除地位，它将加入加拿大——美洲唯一另一个失去对病毒控制的国家——为更多疾病和死亡铺平道路。“我们必须停止这列失控的火车，然后我们需要让它掉头，开始朝相反的方向行驶，”诺埃尔·布鲁尔说。他是协助疾病控制与预防中心分析美国麻疹情况的独立委员会主席，在泛美卫生组织会议前发表了上述言论。
“Science is now ignored, and people die from ignoring science,” Koplan said. If the U.S. loses its measles elimination status, it will join Canada — the only other country in the Americas that has lost control of the virus — paving the way for more illnesses and deaths. “We’re going to have to stop the runaway train, and then we’ll need to turn it around and start going in the other direction,” Noel Brewer, the chair of an independent committee that assists the CDC in analyzing the country’s measles situation, said ahead of the PAHO meeting.
在MMR疫苗出现之前，每年约有500人死于麻疹并发症，其中大多数是儿童。这一数字几乎相当于美国每年死于癌症的儿童数量的一半。“麻疹并非因为无害而消失，”科普兰说。“它之所以消失，是因为疫苗接种计划有效。”
Before the MMR vaccine, about 500 people died from measles complications every year, most of them children. That’s nearly half the number of kids who die annually in the U.S. from cancer. “Measles has not disappeared because it’s harmless,” Koplan said. “It’s disappeared because vaccination programs have been effective.”