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Measles 101: What You Need To Know

Medically reviewed on Jul 24, 2017 by L. Anderson, PharmD

Are Measles Outbreaks Still a Risk in the US?

A case of measles is only a plane flight away. Measles still commonly exists in other parts of the world. Outbreaks, like the one that originated in Disneyland in December 2014, can occur when unvaccinated people get the measles and then spread it to others. Measles can also be brought into the U.S. by unvaccinated Americans or foreign visitors who get measles while they are in other countries. Most Americans are now protected against measles through vaccination, but not all.

In 2000, measles was declared eliminated from the U.S. However, from 2010 until Sept. 10, 2016, over 1,400 cases of measles were reported by the CDC, with 667 cases in 2014 alone.

How Does My Child Get Measles?

Parents are naturally concerned about their children. Measles is a very contagious virus and is easily spread through the air when someone coughs or sneezes. One person who has measles may infect others when viral droplets spray into the air. The droplets can remain contagious on infected surfaces for up to 2 hours.

However, the measles vaccine is very effective. One dose of measles vaccine will prevent measles about 93% of the time; two doses are about 97% effective. Only about 3 out of 100 people who get two doses of measles vaccine will still get measles if exposed to the virus, and then the illness will probably be less severe and less contagious.

What Are the Measles Symptoms?

A case of measles is fairly easy to identify. Symptoms usually begin about 1 to 2 weeks after exposure to the virus and include fever (up to 104° F), cough, runny nose, and red, watery eyes. Two or three days after symptoms begin, tiny white spots, called Koplik spots, may appear inside the mouth.

The telltale measles rash usually breaks out on the third to fifth day. The spots start as a red, flat rash on the face and hairline and spread down to the neck, trunk, legs and feet. Raised areas on the spots may occur. The rash may or may not itch. After a few days, the fever subsides and the rash fades. However, complications can occur.

CDC: Measles Vaccine Recommendations

CDC recommends all children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

Students going to college without evidence of vaccination also need 2 doses. If you are an adult, you should get at least one dose of the MMR if you can't find evidence of your vaccination. It won't be harmful to get revaccinated even if you have been previously. For those traveling internationally, your vaccine requirements may be different; check with your doctor.

In July 2017, the CDC recommended that travelers to Europe obtain the measles vaccine if they have not been previously vaccinated or previously gained protection by having the measles. The vaccine will not only protect the traveler, but also those at home. Since January 2016, more than 14,000 cases of measles have been reported in Europe and 35 people across Europe have died. Multiple European countries have reported measles, including Spain, the UK, and France.

Is the Measles Vaccine Safe?

Most people have no reaction at all; 5 to 10 percent of recipients may get a rash or mild fever.

Research done by Kaiser Permanente over 12 years confirms that the measles vaccine is safe. The research, published in Pediatrics, included children ages 12 to 23 months. In total, researchers looked at over 700,000 measles vaccine doses. The vaccines didn't increase children's risk of seven types of neurological, blood or immune system disorders. As shown in previous studies, fevers and febrile seizures are possible, but the risk is small; seizures occurred in less than one of every 1,000 vaccine injections.

Why is the Measles Vaccine Necessary?

If vaccinations for measles were stopped, measles cases would return to pre-vaccine levels.

According to the CDC, prior to the vaccine program, an estimated 3 to 4 million persons in the U.S were infected each year. Of these, there were 48,000 hospitalizations, roughly 400 to 500 of these died, and 4,000 suffered encephalitis (brain swelling) due to measles.

Widespread use of measles vaccine has led to over a 99% reduction in measles cases in the U.S. However, foreign visitors to the U.S. and unvaccinated citizens who acquire measles from outside countries can infect unvaccinated people in the U.S.; that's why a measles vaccine is still needed.

Isn't it Safer to Build a Natural Immunity?

Measles has no treatment once it occurs, and for most, measles will run its course with a full recovery. Symptoms can be treated with acetaminophen (Tylenol) and plenty of rest. Some people believe exposing their child to an illness is a better way to boost immunity than vaccination. However, people may not realize these viruses can lead to serious complications.

Children with measles have been left blind or deaf. In 1 out of 1000 people the measles virus will move to the brain (measles encephalitis), and can be fatal. Weigh it up. Sore arm and slight fever from vaccination versus a risk to your child's life. Which do you choose?

Are Vaccines and Autism Related?

Some people claim there is a link between thimerosal-containing childhood vaccinations and the development of autism, but no properly conducted study has ever been able to back up these claims.

Thimerosal is a mercury-containing preservative that was commonly used before 2001 to prevent bacterial contamination. The quantities used were tiny and unlikely to be harmful, considering children are exposed to more harmful toxins in one day of play than in their lifetime of vaccinations. Thimerosal was removed over 15 years ago from most vaccines recommended for children younger than six. Studies show that the number of autism cases did not decline after removal of thimerosal, suggesting that exposure to this agent is not a primary cause of autism.

Your Vaccination Protects Others, Too

Although measles is thought of as a infrequent infection in the U.S., worldwide in 2015, there were 134,200 measles deaths globally – about 367 deaths every day or 15 deaths every hour, according to the latest World Health Organization (WHO) information.

Infants can't get their measles vaccine until they are one year old, and their immunity gained from the mother may wane even earlier. That's why it's so important for everyone to get their vaccine, to help protect those who cannot get the vaccine due to young age, severe allergy to the vaccine, cancer, or immunosuppression.

I'm an Adult. Do I Need a Vaccine?

That depends on your history. You do not need the MMR vaccine if blood tests show you are immune to measles, mumps, and rubella, OR were born before 1957, OR already had two doses of MMR or one dose of MMR plus a second dose of measles vaccine, OR already had one dose of MMR and are not at high risk of measles exposure.

You should get the measles vaccine if you don't meet any category above, AND you are a student beyond high school, OR you work in a medical facility, travel internationally, are a cruise ship passenger, or are a woman of childbearing age.

Check with your doctor to be sure. You can see CDC guidelines in more detail here.

The Measles Debate Gets Personal

The measles topic has become a hot personal debate. In 2015, the number of measles cases in the U.S. reached 189, with many cases linked to a Disneyland outbreak in California.

Many people believe that vaccinating their children is a personal choice and do not vaccinate if they live in a state that allows personal exemptions.

Some parents are distraught that they cannot send their children to daycare or school if they are too young to receive the vaccine, or if they have an immune disease and cannot receive the shots.

Many parents believe those who do not vaccinate, so called "anti-vaxxers", are in the wrong.

What Are the Vaccine Requirements for Schools?

No federal vaccination laws exist. The regulations surrounding vaccination for entrance to schools is solely determined by the states.

As of August 2016, 18 states allow students and parents to opt out of vaccination if it interferes with personal or moral belief. Reversal of this rule is now under debate in some states that allow it. California no longer allows exemption based on personal, religious or moral belief.

In some states, parents who want to claim any exemption must now get a doctor’s signature. The CDC has an interactive tool that can determine all required vaccines by state and grade level, but always check with your state and school for the latest updates.

Finished: Measles 101: What You Need To Know

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  • Travelers to Europe Need Measles Protection: US Centers for Disease Control and Prevention (CDC). July 20, 2017. Accessed July 24, 2017 at
  • US Centers for Disease Control and Prevention (CDC). Measles Cases and Outbreaks. Accessed July 20, 2017 at
  • New Law (SB 277) Effective in 2016. Accessed July 20, 2017 at
  • States with religious and philosophical exemptions from school immunization requirements. National Conference of State Legislatures. Accessed July 19, 2017 at