What will the average number of measles cases be during Trump's term?
The current measles surge already sets a very high floor for the term average, and the most likely path is that elevated case counts persist enough to keep the final average in the Yes range. I put the independent probability at 64%, above the market’s 33% price.
Analysis
The key fact is that 2025 closed at 2,289 confirmed cases and 2026 is already at 2,231 by early July, putting the year on track to exceed last year and likely become the worst U.S. measles year in more than three decades. Because the measure is an average across the Trump term, two unusually high years early in the term create a substantial built-in burden that later years would have to offset with a very steep decline to pull the final average back down materially.
The strongest arguments for Yes are structural rather than temporary. Measles outbreaks are driven by vaccination gaps, exemption clusters, and local public health capacity, and those are not quick fixes. If vaccination hesitancy remains elevated and health departments stay stretched, the post-2026 years may improve somewhat but still remain above the pre-2025 baseline, which is enough to keep the term average elevated.
Compared with the current market price of 33%, this looks too pessimistic if the market is assuming that 2026 is a one-off spike followed by a rapid normalization. That is possible, but the evidence so far points to a multi-year outbreak environment rather than a single isolated year, so I think the market is underpricing the chance that the term average stays high through 2028.
Arguments
For
- 2025 and 2026 already appear to be near-record measles years, creating a high floor for the term average.
- The drivers of the resurgence look structural, so later years may not fall enough to offset the early spike.
Against
- Measles incidence can drop quickly if vaccination campaigns and outbreak control improve.
- Only two years of the term have largely played out, so there is still enough time for the average to revert downward.
Key drivers
- Two consecutive high-case years would heavily anchor the term average even if later years improve.
- Persistent vaccination gaps and weakened local public health capacity make a fast return to low case counts less likely.
Risk factors
- A major public health response or behavioral shift could sharply reduce cases in 2027 and 2028.
- Measles outbreaks can be noisy, so one or two concentrated years could distort the average in either direction.
Scenarios
Best case
Outbreaks continue or remain elevated through 2027 and 2028, leaving the Trump-term average clearly in the high range and making Yes a comfortable win.
Most likely
2026 exceeds 2025, later years improve only partially, and the final term average stays elevated enough to support a Yes outcome.
Worst case
2026 proves to be an exceptional spike, with rapid vaccination gains and stronger containment driving cases sharply lower in later years and pulling the average below the threshold for Yes.
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