PHILADELPHIA β€” Two unvaccinated Pennsylvania residents have died after being infected with measles, the first U.S. deaths this year related to the contagious virus.

State health officials announced the deaths Tuesday. They did not reveal any details about the people who died, other than that they lived in Lancaster County, west of Philadelphia.

β€œMy deepest sympathies are with the loved ones who are facing this unimaginable loss,” said state Health Secretary Dr. Debra Bogen. β€œBecause measles was largely eliminated in the Commonwealth for more than three decades, people are not familiar with this disease and don’t fully understand the potential severity of the illness.”

The U.S. has now seen five measles-associated deaths in the last two years β€” more than the combined total of reported deaths over the previous three decades β€” and is enduring its worst year for measles since 1991.

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With 2,777 cases as of Thursday, according to the Centers for Disease Control and Prevention, this year already has surpassed 2025’s measles count.

Maryland health officials declared a measles outbreak in three counties on Monday after 14 new cases were reported, bringing the total this year to 31.

The new cases in St. Mary’s, Carroll and Cecil counties represent a stunning increase for a state that has had relatively high vaccination rates.There were three cases in all of last year β€” and just 10 cases total in the prior decade.

In November, international health officials will meet to determine if the U.S. and Mexico have lost their measles-free status. The U.S. eliminated local measles spread in 2000 by maintaining high vaccination rates, which have fallen in recent years to below the 95% coverage needed to prevent outbreaks.

Governor suggests Trump administration could do more to promote vaccines

The measles surge has coincided with moves by President Donald Trump’s administration to scale back childhood vaccinations, based on concerns β€” unfounded, according to scientific studies β€” about vaccine safety.

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Trump earlier this month signed an executive order calling for revamped childhood vaccine recommendations. He also advocated separating the measles, mumps and rubella (MMR) vaccine into three different shots, and administering all childhood immunizations at separate appointments whenever possible.

Doctors have raised concerns that Trump and U.S. Health Secretary Robert F. Kennedy Jr. are stoking confusion and hesitancy.

In a media briefing Tuesday, Gov. Josh Shapiro said he had spoken with Kennedy, who offered the assistance of federal health staffers. Shapiro declined the offer, saying Pennsylvania’s health department was able to handle the current situation.

β€œI was very, very blunt with him,” Shapiro said. ”I made very clear that his actions and the rhetoric that’s coming from this administration are having a negative impact on communities across America, particularly right here in Pennsylvania.”

He added: β€œThere’s real-life consequences to scaring people and not relying on actual doctors and actual medical professionals to provide unbiased information to parents so that we can make reasonable decisions for our kids.”

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Federal health officials did not comment on Shapiro’s account, but they issued a statement extending condolences to the families and affected communities.

β€œThe MMR vaccine provides the most effective protection against measles and helps prevent its spread,” the statement said, adding that federal health officials will continue to support Pennsylvania’s response.

Vaccination rates are declining nationwide

Decades of widespread vaccinations turned measles cases and deaths into a rarity, causing people to forget that the very contagious virus can be deadly, said Dr. David Margolius, director of Cleveland’s health department and a leader in a coalition of big city health departments.

He said that some Cleveland residents have expressed irritation with vaccine-promotion campaigns.

β€œThey say, β€˜Oh, that’s not a big deal. I mean, do people even die from measles? And, you know, why do you care so much? Why do you keep calling me about this?’” he recounted.

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Margolius said the Trump administration has reacted to outbreaks with offers of assistance.

β€œBut the time to prevent measles is before the outbreaks happen,” he said. β€œAnd the way to do that is clear and consistent and very visible messaging” about the importance of vaccinations.

The overall U.S. kindergarten vaccination rate inched down last year and the share of children with exemptions rose to an all-time high, according to federal data posted last week.

Lancaster County, located about 80 miles northeast of Baltimore, is known as the heart of Pennsylvania’s Amish community, a religious group that is sometimes reluctant to embrace modern medical interventions such as vaccines. About 88% of kindergartners in the county were up to date on their measles vaccines during the last school year, according to state data.

Pennsylvania has counted nearly 400 measles cases this year, state officials said.

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The state has been promoting measles vaccinations as cases have risen, and about 35,000 people have been vaccinated, up from the usual pace of about 25,000 per month, officials said.

Banner reporter Meredith Cohn contributed to this article.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.