2026年1月21日 / 美国东部时间晚上9:07 / KFF健康新闻
经过一年持续不断的麻疹疫情爆发，已导致超过2400人患病，美国即将失去其无麻疹国家的地位。然而，新任命的美国疾病控制与预防中心（CDC）副主任拉尔夫·亚伯拉罕（Ralph Abraham）在本周的记者吹风会上表示，他对此前景并不在意。
“这只是我们边境对全球和国际旅行存在一定开放性所带来的‘做生意的成本’，”亚伯拉罕说道，“我们有一些社区选择不接种疫苗，这是他们的个人自由。”
然而，自2025年1月20日得克萨斯州西部致命麻疹疫情正式爆发并蔓延至其他州和墨西哥以来，检测到的麻疹病例中，仅有约10%来自其他国家的感染。其余病例均为本土感染。这标志着自2000年美国消灭麻疹以来的一个转变。过去，美国偶尔会出现因境外感染传入的麻疹病例，但由于极高的疫苗接种率，这些病例很少引发大规模疫情。两剂麻疹-腮腺炎-风疹（MMR）疫苗能有效预防感染并阻止病毒传播。
为维持无麻疹状态，美国必须证明麻疹病毒在2025年1月20日至2026年1月20日期间未在国内持续传播一年。为回答这一问题，科学家正在调查南卡罗来纳州、犹他州、亚利桑那州和得克萨斯州的主要疫情是否存在关联。
卫生官员证实，这些疫情中主要的麻疹病毒株均为D8-9171型。但由于这种病毒株也存在于加拿大和墨西哥，CDC科学家目前正在分析麻疹病毒的完整基因组（约16,000个基因字母长度），以确定美国境内的病毒株彼此之间是否比与其他国家的病毒株更为密切相关。
CDC预计将在几个月内完成研究并公开数据。随后，与世界卫生组织（WHO）合作监督美洲地区的泛美卫生组织（PAHO）将决定美国是否会失去无麻疹状态。而这意味着，代价高昂、可能致命且可预防的麻疹疫情可能会再次频繁发生。
拉尔夫·亚伯拉罕2019年照片。Michael Democker / 美联社
“当你听到亚伯拉罕这样的人说‘这是做生意的成本’时，你怎么能更冷漠呢？”儿科医生兼疫苗专家保罗·奥菲特（Paul Offit）在1月20日由健康博客Inside Medicine主办的在线讨论中表示。“去年美国有三人死于麻疹，”奥菲特补充道，“我们在2000年消灭了这种病毒——彻底消灭了它，消除了这种最具传染性的人类感染的传播。这是一件值得自豪的事情。”
亚伯拉罕表示，接种疫苗仍然是预防麻疹最有效的方法，但父母必须有决定是否为子女接种疫苗的自由。自2020年以来，多个州放宽了学校疫苗接种要求，导致疫苗接种率下降。2024-25学年，创纪录的约13.8万名幼儿园儿童获得了疫苗豁免，占当年入学儿童总数的比例创下新高。
美国卫生与公众服务部部长小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）曾成立反疫苗组织，其对疫苗的不实信息传播使得疫苗相关信息变得混乱。在其任职期间，他一直削弱疫苗的有效性。他在全国性电视节目中反复传播经科学驳斥的谣言，称疫苗可能导致自闭症、脑部肿胀和死亡。
布朗大学大流行中心主任詹妮弗·努佐（Jennifer Nuzzo）批评特朗普政府专注于寻找可能保住美国无麻疹状态的基因技术细节。“这是错误的关注点。我们的注意力必须放在阻止疫情爆发上，”她说。
“如果我们保住无麻疹状态，那应该是因为我们已经阻止了麻疹的传播，”她表示，“这就像他们试图在曲线评分上及格一样。”
根据KFF健康新闻的调查，在西得克萨斯州疫情爆发的前几周关键期，特朗普政府阻碍了CDC协助该地区的能力，并减缓了联邦紧急资金的发放。然而，该机构去年加强了行动，为地方卫生部门提供麻疹疫苗、宣传材料和检测支持。亚伯拉罕表示，卫生与公众服务部将向爆发疫情的南卡罗来纳州提供150万美元，以应对自近四个月前开始的疫情，截至1月20日，该州病例已达646例。
前CDC国家免疫中心主任德梅特里·达斯卡拉基斯（Demetre Daskalakis）于去年8月因抗议肯尼迪的行为而辞职。他表示，如果CDC的基因组分析显示去年的疫情源于国外的独立输入，政治任命者可能会将保住无麻疹状态的功劳归于肯尼迪。
而如果研究表明疫情存在关联，达斯卡拉基斯预测，政府将质疑研究结果并淡化国家无麻疹状态的丧失：“他们会说，谁在乎呢。”
事实上，在吹风会上，亚伯拉罕告诉《Stat》记者，国家无麻疹状态的丧失并不意味着麻疹会大规模流行：“失去无麻疹状态并不意味着麻疹会广泛传播。”
但数据显示情况相反。去年的病例数是1991年以来最高的，而1991年之前，政府尚未制定疫苗政策以确保所有儿童都能通过麻疹免疫获得保护。
劳伦·索瑟（Lauren Sausser）报道。
KFF健康新闻是一个全国性新闻编辑室，致力于深入报道健康问题，是KFF（一个独立的健康政策研究、民意调查和新闻机构）的核心运营项目之一。了解更多关于KFF的信息，请访问其官方网站。
As U.S. is poised to lose measles-free status, RFK Jr.’s new CDC deputy downplays its significance
January 21, 2026 / 9:07 PM EST / KFF Health News
After a year of ongoing measles outbreaks that have sickened more than 2,400 people, the United States is poised to lose its status as a measles-free country. However, the newly appointed principal deputy director at the Centers for Disease Control and Prevention, Ralph Abraham, said he was unbothered by the prospect at a briefing for journalists this week.
“It’s just the cost of doing business with our borders being somewhat porous for global and international travel,” Abraham said. “We have these communities that choose to be unvaccinated. That’s their personal freedom.”
Infections from other countries, however, accounted for only about 10% of measles cases detected since Jan. 20, 2025, the official start of the deadly measles outbreak in West Texas, which spread to other states and Mexico. The rest were acquired domestically. This marks a change since the U.S. eliminated measles in 2000. Measles occasionally popped up in the U.S. from people infected abroad, but the cases rarely sparked outbreaks, because of extremely high rates of vaccination. Two doses of the measles, mumps, and rubella vaccine strongly prevent infection and halt the virus’s spread.
To maintain its measles elimination status, the U.S. must prove that the virus has not circulated continuously in the nation for a year, between Jan. 20, 2025, and Jan. 20, 2026. To answer the question, scientists are examining whether the major outbreaks in South Carolina, Utah, Arizona, and Texas were linked.
Health officials confirmed that the main measles virus strain in each of these outbreaks is D8-9171. But because this strain also occurs in Canada and Mexico, CDC scientists are now analyzing the entire genomes of measles viruses — about 16,000 genetic letters long — to see whether those in the United States are more closely related to one another than to those in different countries.
The CDC expects to complete its studies within a couple of months and make the data public. Then the Pan American Health Organization, which oversees the Americas in partnership with the World Health Organization, will decide whether the U.S. will lose its measles elimination status. And that would mean that costly, potentially deadly, and preventable measles outbreaks could become common again.
https://news-multimedia-1393112320.cos.ap-guangzhou.myqcloud.com/ap19218565695725.jpg
Ralph Abraham in 2019. Michael Democker / AP
“When you hear somebody like Abraham say ‘the cost of doing business,’ how can you be more callous,” said pediatrician and vaccine specialist Paul Offit, in an online discussion hosted by the health blog Inside Medicine on Jan. 20. “Three people died of measles last year in this country,” Offit added. “We eliminated this virus in the year 2000 — eliminated it. Eliminated circulation of the most contagious human infection. That was something to be proud of.”
Abraham said vaccination remains the most effective way to prevent measles but that parents must have the freedom to decide whether to vaccinate their children. Several states have loosened school vaccine requirements since 2020, and vaccine rates have dropped. A record rate of kindergartners, representing about 138,000 children, obtained vaccine exemptions for the 2024-25 school year.
Information on vaccines has been muddied by Health and Human Services Secretary Robert F. Kennedy Jr., who previously founded an anti-vaccine organization. He has undermined vaccines throughout his tenure. On national television, he has repeated scientifically debunked rumors that vaccines may cause autism, brain swelling, and death.
Jennifer Nuzzo, director of the Pandemic Center at Brown University, disparaged the Trump administration’s focus on finding genetic technicalities that may spare the country’s measles-free status. “This is the wrong thing to pay attention to. Our attention has to be on stopping the outbreaks,” she said.
“If we keep our status, it should be because we have stopped the spread of measles,” she said. “It’s like they’re trying to be graded on a curve.”
The Trump administration impeded the CDC’s ability to assist West Texas during the first critical weeks of its outbreak and slowed the release of federal emergency funds, according to KFF Health News investigations. However, the agency stepped up its activity last year, providing local health departments with measles vaccines, communication materials, and testing. Abraham said HHS would give South Carolina $1.5 million to respond to its outbreak, which began nearly four months ago and had reached 646 cases as of Jan. 20.
If the CDC’s genomic analyses show that last year’s outbreaks resulted from separate introductions from abroad, political appointees will probably credit Kennedy for saving the country’s status, said Demetre Daskalakis, a former director of the CDC’s national immunization center, who resigned in protest of Kennedy’s actions in August.
And if studies suggest the outbreaks are linked, Daskalakis predicted, the administration will cast doubt on the findings and downplay the reversal of the country’s status: “They’ll say, who cares.”
Indeed, at the briefing, Abraham told a reporter from Stat that a reversal in the nation’s status would not be significant: “Losing elimination status does not mean that the measles would be widespread.”
Data shows otherwise. Case counts last year were the highest since 1991, before the government enacted vaccine policies to ensure that all children could be protected with measles immunization.
Lauren Sausser contributed reporting.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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