The United States has had at least 2,777 confirmed measles cases this year, the most on record this century and more than the country had in all of 2025. On Tuesday, Gov. Josh Shapiro of Pennsylvania, a Democrat, announced that there had been two measles-associated deaths in the state — the first such deaths this year. That’s when a new kind of trouble started.

Over the following 48 hours, the public received conflicting information about the deaths from the Pennsylvania Department of Health, the Lancaster County coroner, the Centers for Disease Control and Prevention and Robert F. Kennedy Jr., the secretary of health and human services. The parties disagreed about exactly what led to the two deaths. Much of their discord played out over social media, where a cacophony of voices amplified the acrimony and confusion.

The stakes of this moment — measles transmission is high, confidence in government and public health is low — require a standard of engagement, clarity and transparency that the initial Pennsylvania response failed to meet. We should be honest about what’s gone wrong here and try to correct course.

Pennsylvania is the country’s most recent measles hot spot, and Lancaster County, where there are large Mennonite and Amish communities with lower vaccination rates, has had a majority of those cases. On Aug. 25 the Pennsylvania Department of Health announced there had been two measles-associated deaths; “associated” is careful language that conveys that measles was detected but not confirmed as the direct cause of death. During a news conference, Mr. Shapiro emphasized that both “individuals were unvaccinated” and said that deaths from measles were “completely preventable.”

The governor went on to describe a phone conversation he’d had with Mr. Kennedy, during which Mr. Shapiro said he’d been “blunt” about the Trump administration’s anti-vaccine talk. “There’s real-life consequences to spreading misinformation,” he said he told Mr. Kennedy.

In response to inquiries from a Lancaster County commissioner, Josh Parsons, a Republican, the county coroner’s office reported that it had no current cases of people who had died of measles and only one who had tested positive for measles: a newborn with evidence of a measles infection acquired before birth whose immediate cause of death was a laceration to the spleen. Measles was listed on the baby’s death certificate as a factor implicated in the death; the coroner then made public statements saying he didn’t believe measles played a role in the baby dying. The other measles case was not in the coroner’s charge.

Mr. Parsons, Mr. Kennedy and a host of Kennedy supporters seized on these details to suggest that the state’s initial statements were misleading. And, indeed, they might have been — at a minimum, they were premature, and the apparent lack of coordination between the coroner’s office and state officials left room for doubt. The governor’s claim that the deaths were “completely preventable” was perhaps too definitive. And referring to the infant as an “unvaccinated individual,” without the context that a baby would not have been eligible for vaccination, could be seen as disingenuous and in service of an agenda to scare and shame people who are hesitant about vaccines.

A laceration to the spleen in a newborn implies injury. It’s plausible that the baby’s measles led the spleen to rupture and that birth trauma caused the laceration, but that is not yet confirmed, and other explanations are possible.

When pushed for details, state health officials declined to provide additional information, citing privacy concerns. That’s hard to justify. Confirming the age ranges of the people who died and providing general information about comorbidities, hospitalization statuses and exposures would not have made the cases identifiable. The state had already, of course, confirmed the vaccination statuses of the two individuals; vaccination opponents seized on what they perceived as hypocrisy, and recriminations escalated again.

Mr. Kennedy and Mr. Shapiro got into a social media dust-up. Mr. Kennedy wrote an essay-length post on X saying the governor had dismissed some Americans’ religious concerns about how the measles, mumps and rubella vaccine contains the tissue of aborted fetuses. (A component of it was developed in the 1960s on a fetal cell line, but the vaccine does not contain such tissue.) He accused the governor of “gaslighting” the public. In response, Mr. Shapiro posted an equally long response in which he challenged the secretary’s claims and accused him of stoking vaccine hesitancy.

Mr. Kennedy posited that perhaps the measles deaths had been completely fabricated. A coterie of anti-vaccine personalities with large follower counts echoed the accusation, seizing on inconsistencies and filling the void of official information with their own speculation. On Thursday the C.D.C. posted that “discrepancies” in what had been announced about the deaths “raise important questions.”

This is our low-trust, politicized public health reality, in which every ambiguity creates space for conspiracy. This means that there’s no room for error.

I understand why Mr. Shapiro, a decisive communicator who has demonstrated strong leadership during prior crises and who seems to have presidential ambitions, wanted to say that measles-associated deaths reflect badly on Mr. Kennedy and President Trump. But the governor made a mistake by not speaking carefully enough. In a polarized environment where vaccine-hesitant Americans lean Republican, his approach was geared toward the wrong public: affirming to liberals and alienating to the very people he needs to reach.

Mr. Kennedy, in turn, exploited a public health crisis to score points with his base. His approach for years has been to weaponize misstatements, inconsistencies and ambiguities about public health claims, and he has been employing that playbook here. As a result, Pennsylvania’s health leaders have seemed reluctant to share information with the C.D.C. at a time when they’d normally rely on the federal agency for maximum support.

The Pennsylvania measles outbreak does not appear to be ending any time soon, and there’s still time to rebuild confidence and trust. Luckily, the profession has a well-established crisis communications playbook to employ in just these situations. It’s time everyone started using it.

The C.D.C.’s longstanding crisis and emergency risk communication protocol is based on six core principles: Be first, be right, be credible, express empathy, promote action and show respect. To those tenets, I’d add four: Be transparent, be consistent, acknowledge uncertainty and stay apolitical.

A designated state health official should deliver all updates to the public. The updates should be frequent and, when possible, scheduled well ahead of time and should focus on the steps the state is taking to contain the outbreak. The official should err on the side of giving more information, not less, including when there is uncertainty.

Saying “This is what we don’t yet know, and here’s how we intend to find out” increases trust in the competence and integrity of a response.

The public is entitled to know about measles-associated deaths, but in this case the information provided would have better served a fractured ecosystem had it been more complete, honest and clear. For instance, an official could have said: “This is an unusual case. Measles was associated with an infant’s death, but we have yet to establish the role of the virus. We’re working with the coroner to establish what happened and will share additional updates as soon as we can.”

The Pennsylvania Department of Health is doing heroic work getting people vaccinated: Its staff members have administered over 2,100 doses of the measles, mumps and rubella vaccine this month, more than three times as many as they administered in July. Public health teams are tracking cases, advising sick families and supporting people who are unvaccinated, as well as those who are willing to get the vaccine. That necessary work is where attention should be focused — not on trying to score points against political opponents.