What to know about vaccinations, boosters, babies, and travel.
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Measles. Measles, measles, measles! After decades of not having to worry much about the most contagious virus on record, it suddenly seems to be everywhere. The outbreak in South Carolina is nearing 1,000 cases, overtaking last year’s largest outbreak, in Texas, which ended in August with 762 cases. Twenty states are currently reporting infections. Canada recently lost its measles elimination status. And the current administration is bringing its non-science-based approach to the vaccine that protects us from it. (The White House’s suggestion is to break up the MMR vaccine, for measles, mumps, and rubella, into three different shots, a move that has no clear health benefits but plenty of potential to lower overall vaccination rates.)
Americans have been lucky enough to live in a relatively measles-free world for the past several decades. Which means you probably need a refresher (or a primer) on the disease. Let’s get into it.
I’ve never had to worry about measles before. Is it really that big of a deal?
Before the development of a vaccine, measles was a huge public health issue. Almost every kid would get infected. Nearly 50,000 people were hospitalized every year. Hundreds died. It took huge coordinated public health efforts to get to the point where we “eliminated” measles in the U.S., which finally happened in 2000. To be precise, measles never completely went away—we’ve seen cases every year since then, as well as some outbreaks—but we effectively stopped the continuous circulation. That means that a lot of people haven’t encountered this nasty virus before. And it is nasty: A whopping 20 percent of (unvaccinated) people who are infected will be hospitalized, and some of them will suffer potentially lifelong complications.
Lately, public health experts have become concerned about the recent outbreaks because of their large size and rapid growth. Last year’s U.S. case numbers were the highest since 1991; this year is well on track to beat that. Plus, three people died last year. Before that, there had been three deaths total since 2000.
OK, I’m worried. What should I do?
Despite the fear factor of measles—its high hospitalization rate, how contagious it is—we’re actually in a good spot in terms of fighting back against this disease: We have an incredibly effective vaccine. If you want to stay safe against measles, all you need to do is make sure you’ve gotten both doses of the MMR vaccine. It’s that simple.
How do I know if I’m fully vaccinated? Should I get a booster anyway?
That’s a little less simple. But the recommendations are straightforward. In short, the MMR vaccine in its current form provides lifelong immunity. So if you were born after 1989, you don’t need to get a booster.
Before that, though, there were less-effective shots being handed out, so people born between 1957 and 1989 should consider getting a booster. Those born before 1957 earned their immunity the natural way (by getting measles) and thus don’t need to worry about a booster.
If you’re unsure—you don’t have access to your vaccination records or were born in a transition year—then it doesn’t hurt to get another boost. But there’s absolutely no need to do so if you know you’ve already received the full protection.
I’m vaccinated. Do I still have a chance of getting measles, or am I fully protected?
The MMR vaccine is highly, highly effective. And the really cool thing about this vaccine is that for roughly 97 percent of people, those two shots completely prevent infection. That’s different from flu and COVID vaccines, both of which can ease symptoms and shorten illness duration but don’t necessarily prevent infection. In the case of measles, only 3 percent of vaccinated people will experience those breakthrough infections, along with milder symptoms and a reduced ability to spread the virus.
So … if I’m vaccinated, is it safe to gather in big groups? To fly in a plane? What about traveling somewhere with a known outbreak? All good?
In general, if you’ve received the MMR vaccine, then, yes, it is safe to do these things. Again, that’s thanks to the remarkable efficacy of the vaccine. It makes it incredibly unlikely to get infected. And even if you do, your symptoms are likely to be mild.
As far as travel goes, the most important thing is to be mindful of who you’re traveling with, particularly if you’re going to a state with an outbreak. For instance, if you have a 3-month-old baby who hasn’t been vaccinated yet, they would face an elevated risk.
Speaking of people in my life who are unvaccinated, should I be careful around them?
There are many people who cannot get vaccinated, including infants and severely immunocompromised populations. Also, those who are vaccinated but later become immunocompromised may have reduced immunity. These groups are more vulnerable—which makes it all the more important that everyone else get vaccinated. It’s extremely rare for vaccinated people to transmit measles, even if they do get infected, so you can feel comfortable about being a low risk to others. That’s different from how it was during COVID times, when it was relatively common to get a breakthrough infection, be asymptomatic, and infect other vulnerable people. Measles isn’t like that.
If you are close with someone who is unvaccinated by choice, it’s still extremely unlikely that you could infect them or they could infect you, but consider talking to them about their choice, and telling them why you made a different one.
What if I’m unvaccinated because I’m severely immunocompromised? What should I be doing?
Measles is a respiratory illness, so people in this situation can turn to the same arsenal of protections that guard against flu and COVID, like well-fitting N95 masks. Make sure that your close contacts are all fully vaccinated. Avoid traveling to areas with outbreaks.
What if I’m unvaccinated because I’m a baby? What should my parents be doing?
It’s typically recommended that kids receive their first dose of MMR at 12 to 15 months and their second dose at 4 to 6 years—which means they’re vulnerable to infection for that whole first year. Parents can, however, opt to give their infant an early dose at 6 months. This would not be considered one of the two standard doses, so they’d still need the full regimen later on, but it can provide protection during a critical time. Also, a child over the age of 1 could receive their second shot sooner than age 4, as soon as a month after the first shot, to get maximum protection earlier.
These earlier doses are generally recommended for young children traveling overseas or to parts of the U.S. with outbreaks. If you’re living in an outbreak area, it’s a good idea to talk with your pediatrician about the timeline for vaccination. Some pediatricians recommend getting an early dose before going to heavily touristy places like Disney World.
Also, prebaby tip: If you’re trying to conceive, consider asking your doctor to check your MMR titers to measure your immunity and determine if you need a booster. Moms can transfer measles antibodies to their fetuses, and those can stick around for a few months after birth.
Speaking of traveling overseas, why do so many other countries have outbreaks right now? I thought this was part of America’s uniquely bad partisan approach to vaccination.
The U.S. is far from alone here. Canada saw over 5,000 cases last year—peanuts compared to Europe, where there were over 127,000 cases in 2024. While low vaccination rates are the main culprit across the board, anti-vax sentiment is actually less to blame than we tend to think, even in the U.S. In Canada, for example, officials have pointed to issues of vaccine access and regional health care differences, especially in rural communities. In Europe, measles still circulates somewhat regularly in some countries, increasing the chance of a large outbreak.
Reaching herd immunity for measles is hard—roughly 95 percent of people must be vaccinated—and when it’s not reached, even just barely, measles outbreaks will come and go in waves. That’s the thing about measles: Because it’s so contagious, it doesn’t take much of a drop in vaccination rates to lead to increased transmission. It’s often one of the first diseases to spring back when there are any gaps in vaccination coverage.
Yikes. So what else should I be looking out for?
Whether we’ll have a measles epidemic on our hands in the years to come is still uncertain. But we’re teetering on a precipice, experts say. Public health experts will keep an eye on that (perhaps those who are, er, employed by states rather than the federal government). In the meantime, you can help by making sure you’re vaccinated, and encouraging others to do the same.
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