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Nurses in rural Pennsylvania have begun entering Amish homes to vaccinate families against measles around kitchen tables as the state confronts its most severe outbreak since the early 1990s. The Pennsylvania Department of Health reported that the outbreak began in late April and has since spread through multiple counties with a significant concentration in Lancaster County where many Amish and Mennonite families reside. Dale Weiser a clinical supervisor has vaccinated around 100 people through these home visits according to the BBC which noted her efforts to remain respectful while improving access in areas where residents may avoid public clinics.
Pennsylvania Department of Health data places the statewide case count at 767 as of mid-September including 93 new infections in one recent week though officials and physicians believe the true number is substantially higher due to underreporting in Plain communities. The New York Times reported that two unvaccinated individuals died from measles complications in August marking the first such fatalities in the United States that year and that the outbreak has hospitalized at least 70 people with one third of confirmed cases involving children. A 2025 estimate cited by multiple outlets including The New York Times indicated that only about one quarter of Amish people in the Lancaster area had received the measles vaccine prior to the current surge.
The state health department told the BBC it has administered nearly 4,300 doses of the measles mumps and rubella vaccine at pop-up clinics near the outbreak’s epicenter since April. In Lancaster County alone the local health department has provided 538 MMR vaccines with 340 of those delivered in private settings such as residences according to Jeanne Franklin the department director. Franklin said people have called to request home vaccinations because they cannot reach clinics or prefer not to be seen changing their minds about immunization.
A similar large measles outbreak struck Amish communities in Ohio in 2014 when a missionary returning from the Philippines sparked a chain of infections that ultimately reached 382 people according to a Vox review of public health records from that time. In the current Pennsylvania situation the Pittsburgh Post-Gazette reported that vaccination rates have declined in Lancaster County with only 88 percent of kindergartners immunized in 2025 compared with 94 percent in 2019 while pockets within Amish groups remain far below the 95 percent herd immunity threshold. The New York Times noted an 84 percent increase in vaccinations across the state during August as awareness of the outbreak grew.
Health workers have adapted strategies from the COVID-19 pandemic including word-of-mouth promotion of discreet clinics in fire stations churches and front porches to avoid drawing attention or protesters the Anchorage Daily News reported. Local physicians have observed that while not all Amish or Mennonite families reject vaccines outright cultural preferences for alternative approaches and limited routine medical care have contributed to lower coverage. The Pennsylvania Department of Health has emphasized that two doses of the MMR vaccine prevent more than 97 percent of measles infections yet challenges persist in reaching every at-risk household.
RFK Jr. visited Lancaster County five years before the outbreak to speak with Amish residents about public health agencies according to a New York Times account that linked his remarks to heightened vaccine hesitancy in the region. A 2022 survey cited by LancasterOnline found that 30 percent of Amish families in the county reported vaccinating their children and viewing vaccines as safe while rates among Old Order Mennonites were higher though still below broader population levels. Officials continue to expand outreach through programs like Penn Medicine’s ChildProtect initiative which has operated vaccination clinics serving Amish and Mennonite groups since 1991 and has delivered immunizations to around 80,000 children overall.
