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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 a major outbreak affecting Amish and conservative Mennonite communities. Local clinics have administered about 450 measles shots to Plain-community members, while residents’ views remain mixed and the state’s case count may understate the outbreak.
Some Amish and conservative Mennonite residents in Pennsylvania’s Lancaster County are showing greater openness to measles vaccination as the state reports more than 1,350 measles cases this year, according to a MedPage Today report published October 31. More than a third of the reported cases are in Lancaster County, and local health workers say vaccine clinics have given about 450 measles shots to people in Plain communities.
The outbreak has affected Amish and conservative Mennonite communities, whose vaccination rates are generally lower than those of the wider population, though attitudes vary. Community leaders and health experts told MedPage Today that vaccine hesitancy often reflects custom and habit rather than a religious prohibition. Some people are now reconsidering vaccination after seeing relatives or neighbors become ill; others continue to oppose the shots.
Union Community Care, a nonprofit with clinics in Lancaster and nearby towns, has organized small-scale vaccination clinics and runs a mobile outreach service for Plain communities. Chief medical officer Dr. Anne-Marie Derrico said the clinics have administered about 450 measles vaccinations. The organization is also offering some infants an earlier first dose of the measles, mumps and rubella vaccine, following health guidance for areas experiencing outbreaks.
Pennsylvania’s reported case numbers have fallen from a September peak, but some doctors expect transmission could increase as winter brings more indoor gatherings. The state has recorded three measles-associated deaths in Lancaster County and two in other counties. Community leaders say official figures likely miss infections among people who do not seek medical care.
Vaccination Across Community Lines
The outbreak shows how measles transmission can cross the boundaries between Plain communities and the wider public. Amish and Mennonite residents regularly shop, work and interact with people outside their communities, while children from different families may attend schools and other programs together. Dr. Derrico told MedPage Today that patients from both Plain and non-Plain communities use the same spaces and services.
That shared contact means vaccination and access to trusted health advice can affect more than one community. Measles is highly contagious; while many cases are mild, the infection can cause serious complications, including pneumonia and encephalitis, and can be fatal. A shift toward vaccination among some residents could help limit spread, but the reporting does not establish the effect of the clinics on case numbers.
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Why Lancaster County Is Affected
Lancaster County, in central Pennsylvania, has the largest Amish population in the United States and is at the center of the country’s largest measles outbreak in 35 years, according to the report. Measles was considered eliminated in the United States in 2000, but outbreaks can occur when the virus reaches communities where vaccination coverage is low.
Vaccination attitudes in Plain communities have shifted over time, community leaders and scholars told MedPage Today. Some said trust declined after strict COVID-19 public health measures. Allen Hoover, an Old Order Mennonite and former administrator of a local medical center, said many people who did not vaccinate were acting from familiarity with past practice, rather than opposition to vaccines as an ideology. He said building trust takes time and that health workers should encourage vaccination without aggressive pressure.
“There’s no way to imagine that this is going to be an isolated community.”
— Dr. Anne-Marie Derrico, Union Community Care
The Outbreak’s Full Scale
The actual number of infections is unclear. Pennsylvania’s reported total is based on cases recorded by the state, while local community leaders say many people with measles do not see a doctor and may not appear in official counts. The report does not provide a revised estimate of the unreported cases.
It is also not yet clear whether the recent decline from September’s peak will continue through winter, or how much the local clinics have changed transmission. Vaccination views remain mixed: some residents have accepted shots, while others maintain that measles is a natural illness or continue to avoid vaccines. No single position represents all Amish or Mennonite residents.
Winter Cases and Local Clinics
Local health workers are continuing outreach and vaccination clinics, including earlier MMR doses for some infants in the outbreak area. Doctors will be watching for changes in cases as colder weather brings more indoor gatherings. The report does not give a specific date for a new state update or say how long the clinics will operate.
Readers should look for updated Pennsylvania case counts and guidance from local health authorities as the outbreak develops. The scale of unreported illness, the trend in cases over winter and the longer-term effect of outreach on vaccination remain open questions.
Key Questions
How many measles cases has Pennsylvania reported this year?
The state has reported more than 1,350 cases in 2026, according to the report. More than a third were in Lancaster County. Community leaders say the total may not include people who did not seek medical care.
Are Amish and Mennonite residents becoming more open to vaccination?
Some are, according to local health workers and community members interviewed by MedPage Today. Views differ within Plain communities, and some residents continue to oppose vaccination.
How many measles shots have local clinics given to Plain-community members?
Union Community Care said its small-scale clinics have administered about 450 measles vaccinations. The report does not establish how much those vaccinations have affected case numbers.
Why could the reported case count be an undercount?
Community leaders say some people with measles do not visit a doctor. Infections that are not diagnosed or reported may not be included in the state’s official total.
Could measles cases rise again during winter?
Some doctors expect cases could increase as winter brings more indoor gatherings, although Pennsylvania’s reported numbers have fallen from their September peak. The future trend is not yet known.
Source: medpagetoday.com
