A surge of measles cases in the US is increasing criticism of the Trump administration's lukewarm endorsement of vaccines. There have been over 1,100 cases this year, largely in unvaccinated individuals, putting the US at risk of losing its measles elimination status. While top officials have stressed the MMR vaccine is the most effective protection, they have also ruled out new mandates. Senate health committee Chair Bill Cassidy (R-La) pressed President Trump's surgeon general nominee, Casey Means, on her willingness to encourage vaccination in response to outbreaks. Health Secretary Robert F. Kennedy Jr. has a history of vaccine criticism, which has fueled criticism that he could be doing more to combat outbreaks. The current focus of measles spread is in South Carolina.