Pennsylvania Measles Outbreak Highlights Interconnectedness of Amish and Wider Communities
As measles cases surge in Lancaster County, both Plain communities and their neighbors are showing increased vaccine acceptance and caution.
Lancaster County, Pennsylvania, a region with the largest Amish population in the U.S., is at the center of the nation's most severe measles outbreak in 35 years. The contagious virus, which was declared eliminated in the U.S. in 2000, has spread significantly within the Amish and conservative Mennonite communities, often referred to as "Plain communities," as well as among the general population.
Pennsylvania has recorded over 1,350 measles cases this year, with more than a third concentrated in Lancaster County, according to state figures. Community leaders suggest the actual number of infections may be higher, as many individuals with measles do not seek medical attention. Three measles-associated deaths have been reported in Lancaster County, with two more in other counties.
While vaccination rates have historically been lower among the Amish than the general population, the current outbreak is prompting a shift. Many individuals within these communities are now demonstrating a greater openness to receiving vaccines, a sentiment echoed by the wider public, which is also taking increased precautions.
"We are all interconnected," stated Dr. Diego Hijano of St. Jude Children’s Research Hospital, emphasizing the shared vulnerability and the impact of declining vaccination rates nationwide. According to the Centers for Disease Control and Prevention, the percentage of U.S. kindergarteners receiving the required MMR (measles, mumps, and rubella) shots has decreased from 95.2% in the 2019-20 school year to 92.4% in 2025-26. In Pennsylvania, the kindergarten MMR vaccination rate fell to 93.2% last year, and in Lancaster County, it stands at 88%, with lower rates in private schools compared to public ones.
Officials and community leaders note that vaccine hesitancy in Plain communities is often rooted in habit rather than religious doctrine. "The overwhelming reason had nothing to do with being against vaccinations. It was simply, ‘Well, we never did before, and we came through all right,’" explained Allen Hoover, an Old Order Mennonite and former administrator of the Parochial Medical Center in New Holland. Building trust with medical professionals can take years in these communities, he added, suggesting that encouragement rather than aggressive promotion is the most effective strategy.
Dr. Anne-Marie Derrico, chief medical officer at Union Community Care, highlighted the constant interaction between Plain and "English" populations in Lancaster County, where urban and rural areas blend. Union Community Care has conducted outreach programs, including small-scale vaccine clinics that administered approximately 450 measles shots, and has offered early vaccinations for infants in response to the outbreak.
Despite the rising acceptance, some resistance persists. Ephraim Zook, an Amish farmer, remains opposed to vaccines, even after his young twins contracted measles. "We just felt that measles is a natural thing," he said. Conversely, a Mennonite market vendor reported no infections within his largely vaccinated community.
Some anti-vaccine groups have targeted the Amish with their messaging. In 2021, Robert F. Kennedy Jr. spoke at a Lancaster County fair, claiming the government was forcing the Amish to vaccinate. Health Secretary Kennedy has since engaged in disputes with Pennsylvania Governor Josh Shapiro over the scope of the outbreak.
Public officials are urging a unified message emphasizing the safety and efficacy of the vaccine. This approach proved successful during Pennsylvania's 1991 measles outbreak, which saw long lines of people from Plain communities seeking vaccination. Dr. D. Holmes Morton, founder of the Central Pennsylvania Clinic, noted a similar trend is occurring now, with increased success at organizing vaccine days.
Experts stress that vaccination is a communal act. "You will get protected yourself. But in truth, you are actually protecting everyone around you," said Dr. Hijano, underscoring the collective benefit of immunization in preventing the spread of highly contagious diseases like measles.