A dispute over two deaths linked to measles in Pennsylvania has intensified after Health and Human Services Secretary Robert F. Kennedy Jr. questioned the state's account and suggested the fatalities might have been fabricated. The challenge followed public comments from a county coroner about one of the cases.

The Pennsylvania Department of Health confirmed two deaths associated with measles on Tuesday and said both individuals were unvaccinated. According to the department's release, they were the first deaths related to measles reported in the state in 35 years.

The questions emerged after Lancaster County coroner and physician Stephen Diamantoni said a newborn died shortly after birth from a lacerated spleen. The newborn had also tested positive for measles acquired before birth, according to The Philadelphia Inquirer.

Diamantoni's office was still investigating the newborn's death, Axios reported, and the coroner said he was unaware of the second reported fatality. The state health department said Pennsylvania law does not require every death to be referred to a coroner.

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The department said it applies the designation of a death associated with measles when laboratory or epidemiologic evidence of the infection exists. That designation can be used even when a coroner or medical certifier does not list measles as the immediate cause.

Dr. Marc Siegel, Fox News senior medical analyst, said measles can affect the spleen, potentially causing enlargement and, in rare cases, rupture. He also said pregnant women, newborns and young infants can face a higher risk of serious complications, while infants too young for the MMR vaccine can be especially vulnerable.

Kennedy questioned whether Pennsylvania officials had supplied enough information to support the two reported deaths. In a Wednesday post on X, after the coroner's comments became public, he alleged that Pennsylvania had not provided relevant information to the Centers for Disease Control and Prevention.

"The announcement appears to have been premature, and the deaths may even have been altogether fabricated by one of the Governor's hopeful staffers," Kennedy wrote. "The Lancaster County Coroner says that it has no record of any measles deaths."

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Kennedy also accused Pennsylvania Gov. Josh Shapiro and his office of using infectious disease fears for political gain. Meanwhile, at a Tuesday press conference, Shapiro said the deaths showed consequences of misinformation about the measles vaccine.

In a later X post, Shapiro said Kennedy had created confusion among parents and others, leading to less protection from measles and more cases. The two officials therefore offered sharply different accounts of the dispute and its implications.

The CDC responded on X by thanking Kennedy for efforts to clarify conflicting information surrounding the reported causes. "CDC is working to determine what actually occurred," the agency wrote, adding that the discrepancies raised questions because the Governor's Office had not supplied relevant outbreak information and had declined offers of help.

The agency also said it would follow the facts and tell the public the truth under President Trump and Kennedy's leadership. Pennsylvania Health Secretary Dr. Debra Bogen disputed the CDC's version.

In a post from the Pennsylvania Department of Health account on X, Bogen said the deaths were reported to the CDC's measles response team early Tuesday morning. She said she had reviewed the case investigations and that state epidemiologists had thoroughly investigated both deaths.

Bogen confirmed that both individuals had tested positive for measles. However, Lancaster County Commissioner Josh Parsons said he did not believe enough evidence existed to confirm that measles caused the deaths, citing information he said came from the county coroner's office, according to Local21 News.

Siegel said measles weakens the immune system and raises the risk of pneumonia, which can result from measles itself or a secondary bacterial infection. He said specialists consider whether measles itself caused the immediate death or whether damage to the immune system led to secondary infections or other diseases.

He also said that if measles affected the immune system or placed stress on other major organs that led to death, it would qualify as a death associated with measles. This distinction sits at the center of the public disagreement.

Lancaster County is the center of Pennsylvania's current measles outbreak. As of Friday, the state had recorded 424 confirmed cases and 73 hospitalizations.