Two unvaccinated Amish infants infected with measles died in August in Lancaster County, Pa., the nation’s first measles-associated deaths this year.

The county was the center of a rapid measles outbreak, with 45% of the state’s cases in early September. Its large population of Amish and conservative Mennonites has a low rate of vaccination.

County coroner Stephen Diamantoni said that an infant, who died shortly after birth on Aug. 14, had tested positive for measles. He said the cause of death was a ruptured or lacerated spleen, though the death certificate listed measles. Most deaths associated with measles are due to other illnesses and infections after the disease weakens the immune system.

On Sept. 4, Diamantoni confirmed that a 6-week-old Amish girl with the neurological genetic disorder Amish lethal microcephaly died from measles at home in mid-August. Children born with microcephaly typically live 5 or 6 months.

An article in the national magazine The Atlantic revealed details about the Amish family of the infant who died Aug. 14. Writer Tom Bartlett visited the family and reported that they didn’t know their newborn son’s death had become national news. They confirmed that the circumstances reported in the media matched the death of their child.

Plain Anabaptist groups in the U.S., Canada and Mexico have been identified as sources of measles outbreaks in numerous media reports for more than a year. This year’s deaths join the deaths last year of two Mennonite children in Texas and at least one Mennonite man in Mexico.

Last year the Pennsylvania State Health Department estimated about 25% of Lancaster County’s Amish population had received the measles, mumps and rubella vaccine. The Centers for Disease Control and Prevention reported the 2025-26 school year vaccination rate for U.S. kindergartners was 92.4%, below the recommended 95% target.

Across Pennsylvania, the measles outbreak had infected over 570 people and hospitalized at least 87 by Sept. 4, according to media reports. Many health experts considered these numbers a vast undercount because Plain groups avoid some traditional healthcare.

Allen Hoover, an Old Order Mennonite who worked in healthcare with Plain groups for two decades as an administrator at Parochial Medical Center in New Holland, agreed that many measles cases are never reported.

“That is absolutely true,” he told Anabaptist World. “We vaccinate all our children — most of our family and extended family did — so there was very little measles in our circles. But our next-door neighbors did not. Two of them ended up at the doctor, so they were reported. There were at least 20 or 30 that got the measles that were not reported, and that is pretty typical. . . .

“Most of the people are not anti-vaccine; it’s just too much bother, and dad didn’t get it, and that’s enough for them.”

Hoover told The New York Times that families began to get vaccinated in previous decades as they saw children spared from the worst diseases. But the Covid pandemic brought mask mandates, business closures and church gathering restrictions. Public trust eroded, giving stronger voice to those promoting vaccine alternatives.

Bartlett’s report in The Atlantic stated that the unidentified Amish parents have 13 older children and that they learned about a month before their child’s death that measles was spreading in their community. Only the father was vaccinated. The mother worried about the effect measles could have on the baby but didn’t think she could avoid exposure.

“I saw we can’t even get away from it because so many people have it,” she said.

A few weeks later one of their children got sick and the rest followed. Two required treatment for dehydration, and the mother was hospitalized for dehydration Aug. 13. She went into labor the next day. The infant was born with a pulse but wasn’t breathing and died in less than 30 minutes.

“There’s nothing we can do about it,” the mother told Bartlett.

The father said the death was part of God’s plan, and other parents lose children.

“I guess he chose us this time,” he said, adding they assumed the mother’s severe measles case contributed to the death.

The parents said they didn’t have strong feelings about vaccination, and their immunization decisions were not political statements.

U.S. Health Secretary Robert F. Kennedy Jr. cast doubt on measles as a cause of death for the two Lancaster County residents, suggesting they “may even have been altogether fabricated,” The Washington Post reported.

The New York Times reported that Kennedy promoted vaccine skepticism five years earlier during a speech attended by an estimated 1,500 Amish people at a farm fair in Lancaster.

“The cure for measles is chicken soup and vitamin A,” Kennedy said, adding that when he got the disease, he had to stay home and watch TV for a week. The crowd responded with applause and laughter. At the time, he was the leader of Children’s Health Defense, an anti-vaccine organization.

In Wisconsin, Radio Plus reported a health official connected the spread of measles in the Amish community in the southwest part of the state to Pennsylvania. Fond du Lac County health officer Kim Mueller said in early September all 92 confirmed measles cases in Grant, Iowa and Lafeyette counties at least initially started with travel to Pennsylvania.

The CDC updated its national measles case count to 3,134 people on Sept. 4, with 94% occurring in people with unvaccinated or unknown vaccination status. Last year’s U.S. total was 2,289 measles cases.