The only way to prevent measles is to get the measles, mumps, and rubella (MMR) vaccine. One MMR vaccine provides around 93 percent protection against measles. A second booster dose, which started to be recommended in 1990, helps to improve the effectiveness of the measles vaccine to more than 97 percent. While it’s always important to make sure you and your family members are up-to-date on their vaccinations, it’s especially important—particularly when it comes to measles—to do so before traveling outside the United States.
Measles cases in the United States have declined by more than 99 percent since the measles vaccination program that started in 1963. Worldwide, measles vaccination through the Measles Initiative has led to an 84 percent reduction in measles deaths since 2000, though the disease is still a concern in many countries around the world (developing and otherwise).
Of course, the best way to avoid measles is to have immunity to this highly contagious disease by getting the MMR vaccine. Since children are normally vaccinated against measles with the MMR vaccine when they are 12 to 15 months old (first dose) and again at 4 to 6 years (booster dose), keep in mind that this means that infants are at risk for measles before they get their first MMR shot and that toddlers and preschoolers are also at risk for measles because they are only partially immune after they get their first MMR shot.
Who Should Get Vaccinated
The MMR vaccine is recommended for all children. The first vaccine should be given around 12 to 15 months, and the second one at ages 4 to 6 years, just prior to entry into kindergarten. A child who is going to travel abroad before being vaccinated should be seen by his or her pediatrician to get an early vaccine.
Adults who have not been vaccinated should receive at least one dose. Those who work in healthcare or in a school or university setting are at higher risk for exposure and should get two doses within 28 days of each other.
If you’re planning to become pregnant, you should check with your doctor to make sure you are immune to measles, since having measles while pregnant can be very dangerous for your baby. If you are not immune, you should get at least one MMR at least a month before you get pregnant. The CDC says it’s safe to get an MMR while you’re breastfeeding.
Measles Doctor Discussion Guide
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Parents who are keeping up with the latest measles outbreaks have likely observed that it isn’t just unvaccinated kids who are getting measles. Adults who are unvaccinated against measles, or, more likely, are not fully vaccinated, have frequently contracted measles while traveling outside the United States and have started outbreaks back home, too.
Just like kids, adults who were born in or after 1957 should receive two doses of MMR if they are exposed to measles or are going to travel outside the United States. People who were born before 1957 are thought to be immune to measles.
Since the measles vaccination plan to give kids booster doses of MMR didn’t become routine until 1990, it’s possible that many adults who were born before 1986 may not be fully vaccinated and protected against measles. Adults who were born after 1986 would likely have had the booster dose of MMR in 1990 when they were four years old.
Adults may need to do the following:
- Consider being revaccinated with two doses of MMR if you were vaccinated with the original inactivated measles vaccines between 1963 and 1967.
- Get a second dose of MMR if you are going to be a student in a postsecondary educational institution or work in a healthcare facility.
Remember, measles vaccination is a safe and effective way to help protect yourself from measles and to help prevent further measles outbreaks.
There are situations when it is recommended that children get their MMR shots earlier than the recommended immunization schedule, especially kids who will be traveling out of the United States. For those children, the Centers for Disease Control and Prevention (CDC) states that the MMR vaccine can be given to infants as young as six months of age. Children who are at least 12 months old should get two doses of MMR, separated by at least 28 days if they’re going to be traveling internationally.
If measles cases in the United States continue to rise, this could become a more general recommendation at some point. The CDC’s Manual for the Surveillance of Vaccine-Preventable Diseases states: “If many cases are occurring among infants younger than 12 months of age, measles vaccination of infants as young as 6 months of age may be undertaken as an outbreak control measure.”
Unfortunately, children who get the MMR shot before they are 12 months old will have to get it repeated once they are 12 months old since early doses are thought to be less effective.
Who Shouldn’t Get Vaccinated
Pregnant women and people with weakened immune systems should not get the vaccine because it’s made with live, attenuated viruses, meaning the viruses are in a weakened form and cannot survive in people with healthy immune systems. In people whose immune systems are weakened, the attenuated virus may be strong enough to survive and establish an infection. In pregnant women, it’s simply a precaution to wait until after you’ve given birth before getting an MMR vaccine.
Because of additional ingredients of the MMR vaccine, people with severe allergies to gelatin or the antibiotic neomycin should also not get the vaccine. People who have had a severe, life-threatening reaction to a previous MMR vaccine should not get their second shot. If you’re sick, talk to your doctor to make sure you have the go-ahead to get your vaccine.
Don’t plan any international travel if everyone in the family isn’t up-to-date on their measles vaccines. Most of the current measles outbreaks start with a single unvaccinated person traveling out of the country to an area with high rates of measles.
While that once meant traveling to third world or developing countries, there are now high rates of measles in many countries in Europe and other industrialized countries. This makes it important to get properly vaccinated before traveling out of the United States, no matter where your family plans to go.
Exposure and Outbreaks
If you or your child is exposed to measles or if there is a measles outbreak in your area, you should do the following:
- Double-check your child’s vaccine records to make sure he or she has had age-appropriate doses of MMR.
- Get your child caught up on any missed vaccines, especially the MMR, which can provide some protection if he or she is exposed to measles and has not been vaccinated yet—as long as he or she gets an MMR shot within 72 hours of exposure.
- Double-check your own vaccination records as you may not have had an MMR booster if you were born before 1990 when getting a booster dose of MMR became routine.
- Also double-check your own vaccine records to see if you were vaccinated with the original inactivated measles vaccines from 1963 to 1967, which was not as effective as the newer MMR and should be repeated.
- Be prepared for an unvaccinated child to be quarantined from school for up to 21 days if there is a measles outbreak and you don’t want to get him or her a post-exposure dose of the MMR vaccine.
The MMR vaccine is very safe. A small percentage of children will get a mild rash, fever, or soreness or swelling where the shot was administered. High fevers that cause seizures have occasionally been reported, but they’re rare and they haven’t been associated with long-term problems. Joint swelling may occur in a very small percentage of patients, usually older teens and adults.
The Autism Fallacy
A study authored by Dr. Andrew Wakefield that was published in The Lancet medical journal in 1998 implicated the MMR vaccine as a cause of autism. Widespread panic about this led to a significant decrease in the number of children receiving the MMR vaccine, which led to an increase in the number of cases of measles, mumps, and rubella.
A 2009 disciplinary hearing by the General Medical Council determined that Dr. Wakefield manipulated patients’ data and the study has been discredited. Numerous well-designed and very large studies have repeatedly demonstrated no association between MMR and autism. On February 12, 2009, a U.S. federal court ruled that vaccines do not cause autism.
Measles is a preventable disease. You cannot assume that widespread vaccination of others is enough to keep you safe if you have not been vaccinated against measles yourself.