The figures land as the U.S. confronts its worst measles outbreak in 35 years — more than 5,000 cases so far in 2026 — and as the Pan American Health Organization's Regional Verification Commission meets for the sixth time to review whether the country still qualifies for measles elimination status. That designation carries no formal penalties but is widely read as a barometer of the public health system; it is granted when there are no large outbreaks and transmission is considered controlled.

"I feel concerned," said Talibah Johnson, a mother of four and community engagement manager at EverThrive Illinois, a nonprofit focused on health equity and access to quality care. "Other parents should feel concerned as well because this is a very contagious disease, and it is preventable."

Dr. Ravi Jhaveri, division head of infectious disease at Lurie Children's Hospital, called it "almost a foregone conclusion" that the U.S. will lose the elimination designation. "Over the last 10 to 15 years, I think many of us have recognized that across society, we've had a bit of complacency. We've taken our success for granted," he said.

The erosion is visible across the Chicago region. Requests for nonmedical exemptions in suburban Cook County have jumped 400% since 2019, according to the data. Lake County is up 75%, McHenry County 71%, and Will and DuPage counties each 50%. Statewide, nonmedical exemptions rose 24% within a single school year, per the Illinois Department of Public Health's public vaccination dashboard.

The pattern is national. Since 2019, vaccine exemptions have increased in 86% of U.S. counties, and 66% saw an increase in the latest recorded year, according to an analysis by the NBC News Health and Medical Unit and Stanford University. The same review found childhood vaccination rates declined in 83% of counties and jurisdictions over that period.

IDPH said in a statement that it "continues to work closely with health care providers, schools, community organizations, and local health departments to increase vaccination access and coverage in communities with lower immunization rates."

Access barriers remain a major factor, Johnson said — transportation, time off work, language hurdles and the difficulty of scheduling appointments around school and jobs. EverThrive Illinois connects Chicagoans with free vaccine clinics in the city and Cook County, work Johnson described as personal. "It makes me nervous as a parent and as a community member," she said. "If you have the power to protect your family, you should use it."

Others point to misinformation and mixed messaging. Jhaveri noted that states which have tightened the exemption process have seen requests fall. "The concern that many of us have is that [exemptions] are being used as an excuse for perhaps other concerns related to safety and other stories that are being told about vaccines, whether it's on social media or public media," he said.

Stand for Health Freedom, a national nonprofit that opposes vaccine mandates and promotes medical freedom, said in a statement that "true informed consent, not incomplete information, scare tactics, or coercion, must be at the base of every medical encounter and every single medical intervention." The group said that approach is "the only way to maintain public trust, honor parental rights, and ultimately secure positive health outcomes for people for the long term."

Two doses of the MMR vaccine provide 97% protection against measles, according to the CDC. In all but nine Illinois counties, childhood immunization rates remain above 95%, the level health professionals consider optimal to prevent the spread of infectious disease.

Still, clinicians warn that gaps matter for a virus as transmissible as measles. "We are still vulnerable when there are pockets of 10 or 20 people in a church or in a school or somewhere else that have not gotten vaccine," Jhaveri said. "And certainly we are still at risk where a vulnerable person walks through O'Hare Airport or is in some other Chicago indoor venue. So, hopefully this will be a prompt to people to remember the importance of vaccines."