If you’ve been following the dispute between Pennsylvania Gov. Josh Shapiro and Health and Human Services Secretary Robert F. Kennedy Jr., you probably know that it centers on the deaths of two infants in Lancaster County in late August 2026.

And you may be aware that despite the county coroner’s confirmation that one infant died due to measles, while the other’s death was “measles-associated,” the measles dashboard on the Centers for Disease Control and Prevention website counts neither death as of Sept. 10.

It’s easy to dismiss the squabble as political posturing between public officials. But as an epidemiologist who studies vaccine-preventable illnesses and health communication, I worry that for people seeking accurate information about how to keep their families safe – in this case, families in Lancaster County – there’s an enormous cost when health authorities no longer speak in one voice.

In the confusion that such rifts create, the public has no way of knowing which disagreements are about evidence and which are driven by ideology and narrative control.

The U.S. government issues a certificate for every death, confirming its underlying cause following a physician’s examination. The death certificate poses a narrow question: What single condition set in motion the chain of events that ended in this person’s death? This is recorded as the cause of death.

Because measles is what the CDC calls a notifiable condition, or a reportable disease, measles deaths get added to a national count. Contributing conditions go on a separate line in the document and are not counted.

Nobody disputes that both infants had measles when they died. The argument is which line on the death certificate “measles” belongs on. The Pennsylvania Department of Health has called both deaths measles-associated. This term is used when there’s evidence the person had measles, but there’s no settled official cause of death yet. It’s a holding category, not a verdict.

The job of determining the official cause – that is,........

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