Coroner and CDC dispute state attribution of newborn's death to measles

Shapiro and Kennedy trade accusations over vaccination policy

The Pennsylvania Department of Health has counted the newborn’s death as one of two measles deaths in the state. But Dr. Stephen Diamantoni, the Lancaster County coroner for two decades, said in an interview that a forensic pathologist in his office determined the infant died from a ruptured spleen, not measles. On the death certificate, Diamantoni said, measles is listed as a contributing condition unrelated to the underlying cause.

“We were completely unaware of who they may have been referring to,” Diamantoni said of the state health department’s announcement of two measles deaths at a press conference held a half-mile from his office.

The Centers for Disease Control and Prevention initially extended condolences for what it called “measles-associated” deaths. Two days later, the agency said it was “working to determine what actually occurred.” On the CDC’s website where measles deaths are tallied, there is no number — only an asterisk. In a footnote, the CDC said it will not include “measles-associated” deaths pending further investigation by federal health authorities.

The infant’s lung tissue tested positive for measles at a lab, but some infectious disease doctors have criticized the details shared by the coroner because, they say, measles can cause the spleen to enlarge.

Diamantoni, a practicing family medicine doctor who said he strongly recommends vaccines to his patients, rejected the framing of his findings as a contribution to either side of the vaccination debate. “I don’t personally look at it as a pro-vaccine or an antivaccine debate,” he said. “I’m concurring with our forensic pathologist that the laceration is the cause of death, but that has nothing to do with my stance on immunization.”

Gov. Josh Shapiro, a Democrat, has accused Health Secretary Robert F. Kennedy Jr. of promoting antivaccine conspiracy theories he blames for outbreaks like the one in Pennsylvania. Kennedy has questioned whether the deaths could have been fabricated for Shapiro’s political gain. The new CDC director has been criticized for not attributing the baby’s death to the illness.

The Pennsylvania Department of Health said its definition of “measles-associated deaths” includes individuals who had measles even if the disease is not determined by the coroner to be the immediate cause of death. Under state law, the department said, it does not have to report deaths to coroners.

Diamantoni said his office is now looking into another death of an infant who had measles and died in mid-August. He attributed that baby’s death to measles. The infant, a 6-week-old, was born with a rare genetic condition that made the child more susceptible to dying from measles, Diamantoni said. It remained unclear whether that death was the second reported by the state health department or a third death discovered by the county coroner.

The Lancaster County outbreak began this spring, and the county has recorded the most measles cases of any county in the state. Its vaccination rates fall below statewide averages. About a quarter of the county’s Amish community were vaccinated against measles as of last year, according to a 2025 state health department report. Public health authorities generally cite around 95% coverage as the threshold for herd immunity.

Dr. Jessica Ericson, a pediatric infectious disease physician at Penn State Health Golisano Children’s Hospital, said she had not seen a measles case in her 15 years in medicine until this June. Since then, she has had at least 10 patients — mostly younger children, newborns, and infants — with measles. Over the last five years, she said, more families have expressed hesitation around vaccination.

The Trump administration has shifted the nation’s vaccine policy, backing away from vaccine recommendations and raising questions over their link to autism, a connection scientists say is unfounded. In a recent executive order, the White House called for children to receive fewer vaccines and specifically to separate the measles, mumps, and rubella vaccine into individual shots rather than the combined injection given in the United States for decades.

Public health experts have criticized the Trump administration’s approach to vaccines and how it handles measles outbreaks. Back-to-back years of decades-high measles case counts now threaten the country’s measles-elimination status — a designation the United States earned more than two decades ago when widespread vaccination efforts ended persistent spread of the disease. Two children in West Texas and one adult in New Mexico, all unvaccinated, died last year, the first measles-related deaths in the United States in a decade. All of those were logged as deaths in the CDC’s database.