Immunocompromised children face risks as measles cases hit 35-year high in the US

As students head back to school, parents have all the usual worries about their kids, like remembering to pack lunch and making it to the bus stop on time. But parents of immunocompromised kids have a new one: How to deal with the resurgence of measles.

Cases of the highly transmissible disease have reached a 35-year high in the US, with nearly 3,000 confirmed infections in 2026 so far. The first two measles-related deaths of the year were recorded in Pennsylvania, right as the school year is getting going. With vaccination rates dropping across the country, parents of kids who aren’t able to get vaccinated or don’t mount a strong enough immune response due to weakened immune systems are weighing whether it’s safe enough to go to school.

Victoria Schiano, national community engagement coordinator for Little Lobbyists, a nonprofit that advocates for children with complex medical needs and disabilities, says the return of measles is “absolutely terrifying.”

While it’s not known exactly how many US children have compromised immune systems, a study by the Centers for Disease Control and Prevention estimated that 2.6 percent of children are immunocompromised. Immune deficiencies can have genetic causes or secondary reasons, such as chemotherapy for cancer treatment.

Schiano’s kid is among them. Her 10-year-old has mitochondrial disease. The family lives in Chester County, Pennsylvania, which has the second-highest number of measles cases in the state right now. Schiano has been closely monitoring the vaccination rates in her son’s school district, which have dipped below the 95 percent threshold needed for community protection against measles. Measles is breaking through in places where vaccination has dropped below that threshold. In neighboring Lancaster County, for example, just 87.6 percent of kindergartners are fully vaccinated against measles and 83.3 percent of seventh graders are.

Her son can’t be vaccinated, and he receives weekly infusions of immunoglobulin—concentrated antibodies from donated human blood plasma—to help his body fight infections.

“Measles is dangerous for anyone, but for him, this absolutely could be life or death,” she says.

The virus can cause severe, life-threatening complications such as pneumonia and brain swelling. Measles can also wipe out the body’s memory of past infections—a phenomenon known as immune amnesia—leaving people susceptible to other diseases.

Her son already wears a mask and uses a plexiglass screen at school, and the family is diligent about handwashing. Now, Schiano says they’ve had to make the difficult decision to limit her son’s time with friends and after-school activities like karate. She says it’s hard as a parent to balance his quality of life with his safety.

“He just wants to play and to do all the things that he sees other kids doing,” she says.

Her son did online school for a time during Covid-19, and she says she’s prepared to take him out of school if there’s even one confirmed measles case. That comes with a different set of risks, though. During the pandemic, remote learning was associated with an increase in social isolation and behavioral and mental health issues among students.

Amalia, a parent in South Carolina who asked to go by a pseudonym for privacy reasons, has already chosen to keep her 16-year-old son home this year and do online schooling due to concerns about measles. Her son has immunoglobulin A deficiency, in which the body doesn’t produce enough of an antibody found in mucous membranes, body fluids, and digestive tracts that help fend off germs.

“Even if there’s just a flu going around, he gets sicker than the average kid will,” she says.

Her son was able to get the measles vaccine, but doctors monitor his antibody levels regularly to check for waning immunity.

She lives in Spartanburg County, where measles broke out earlier this year and caused nearly 1,000 cases and 21 hospitalizations. About 91 percent of those cases were among children and teens, and most were among those who were not fully vaccinated or had an unknown vaccination status. Even though there was a 94 percent increase in the number of vaccines administered during the outbreak in Spartanburg County compared to the year before, she still wasn’t comfortable sending her son back to school.

“Covid happened, and then measles happened, and we just feel like it's not going to be the last time,” she says. “If it's not measles, it's going to be something else because rates for other vaccines have fallen, too.”

Before this year, her son shared a classroom with other students who have special accommodations. But outside of that setting, Amalia says it has been difficult for him to make friends because of his medical condition. She says it’s hard to talk to other parents about vaccination status because it can be such a hot-button issue. The family is thinking about moving because of what she views as an anti-vaccination sentiment in the community as well as “hostility” toward masking that she’s encountered.

“Some people don't want to take ownership of the responsibility of public health,” she says. “I think it's something we're supposed to share across humanity. It's not supposed to be carried by one person.”

Cortney, another South Carolina parent of an immunocompromised kid, says the state’s measles outbreak was highly concerning because the family needed to travel near the epicenter for medical appointments. Whereas before they might stop in town to eat lunch or do some shopping, they ended any unnecessary stops. “We planned to drive directly into that county, we go only to the doctor, and we leave,” Cortney says.

Her 17-year-old daughter Grace’s condition means that rhinovirus—the cause of the common cold—led to her getting hospitalized. During Covid, Grace and her brother were homeschooled, and that is something mother and daughter considered again for Grace’s senior year.

“At the end of the semester, we're going to reevaluate and see where things are,” Grace says.

Even though she is immunocompromised, Grace doesn’t wear a mask at school because of fear of being bullied. Cortney says her family’s preference would be to mask while in public, but she’s concerned about being ostracized. “You worry that your family could be targeted,” she says. “It’s unfortunate that we have to think about that.”