Measles cases for the calendar year surpassed 4,000 for the first time in decades, with as many as five deaths in Pennsylvania, as the federal government steps in with financial help for states but also fans vaccination fears and skepticism.

A weekly report from the Centers for Disease Control and Prevention showed 4,080 cases this year as of October 8, up 192 cases in a week.

Pennsylvania, which has reported five confirmed deaths from measles, alone had 142 new cases for the week — for a total of 1,105 for the year. The CDC has recognized just two of the state’s reported deaths.

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Pennsylvania Governor Josh Shapiro, a Democrat, has protested the CDC’s death count; his state’s five deaths would be more than the three deaths reported in 2025 for the entire nation.

Other states with large numbers of cases, more than 200, did not see their case numbers change for the week: South Carolina (670 for the year), Utah (535) and Wisconsin (207). States with more cases included New York, which declared a measles emergency, with 19 new cases for a total of 103 this year; and Iowa, up 17 cases to 39.

Kentucky reported separately on Friday that cases there had reached 104, up 10 from last week.

Pennsylvania, which has become ground zero for this year’s outbreaks, reported this week that a new awareness and pop-up vaccine clinics are leading to more measles vaccinations.

All but five states have had at least one measles case this year. The last time the United States had this many cases was in 1991, reaching 9,643 cases as the nation still struggled to roll out vaccinations for the disease, amid budget cuts that hit programs in big cities.

Pennsylvania’s health department this week announced “a surge of interest” in vaccinations as more residents become aware of the outbreak — more than 56,000 doses were given out in September, more than twice the usual monthly volume. The state has added pop-up clinics in the most affected areas. All but four of the measles cases were among unvaccinated people.

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The Lewistown Sentinel reported that an 18-year-old woman there died in September from brain swelling as a result of the measles virus after two of her brothers survived the disease.

While the federal government has offered states more funding to combat measles, Health and Human Services Secretary Robert F. Kennedy moved forward this week on plans to emphasize vaccine injury, announcing a new clinic and work to strengthen a database that tracks problems after a vaccination.

Federal funding cuts have drawn criticism before, as a May 2025 report showed Trump cuts hindering measles vaccination efforts as outbreaks grew.

“We must listen to patients and families who report vaccine injuries — not dismiss or gaslight them,” Kennedy said in a statement.

This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network which includes Colorado Newsline, and is supported by grants and a coalition of donors as a 501c(3) public charity.