Are You Vaccinated Against Measles? If Not, Now’s the Time 

In 2000, the United States declared measles eliminated in our country thanks to a highly effective vaccination program and better measles control.

However, on Jan. 25, 2024, the Centers for Disease Control and Prevention advised healthcare providers to be on alert for measles cases. That’s because measles cases have cropped up in 17 states, including Florida, which leads all states with 10 confirmed cases as of March 8.

Infectious disease expert Mary Beth Saunders, DO, System Medical Director, Lee Health Epidemiology & Infection Prevention, answers questions about what’s behind the rise of confirmed cases and what parents can do to protect their loved ones against this highly contagious and potentially serious disease.

Q: I thought measles was eliminated. Why are there more cases now?

A:  In 2000, measles was declared eliminated from the United States. That means the disease is no longer constantly present in this country. 

However, travelers continue to bring measles into the country, and it can sometimes spread and cause outbreaks among people who aren’t vaccinated. We have to remember that measles is still common in many parts of the world. Anyone who isn’t protected against measles is at risk.

Q: Why are we seeing more cases now?

A: People who are unvaccinated for any reason, including those who delay or refuse vaccination, risk getting infected with measles and spreading it to others. And they may spread measles to people who can’t get vaccinated because they are too young or have specific health conditions.

Q:  What are the signs and symptoms?

A: Measles symptoms appear 7 to 14 days after contact with the virus and typically include high fever, cough, runny nose, and watery eyes. The measles rash appears 3 to 5 days after the first symptoms. 

Measles typically begins with:

• high fever (may spike to more than 104°)
• cough
• runny nose (coryza)
• red, watery eyes (conjunctivitis)

Q: Isn’t measles just a little rash and fever that goes away in a few days?

A:  Measles can cause serious health complications, especially in children younger than 5 years of age. There’s no way to tell in advance the severity of the symptoms your child will experience. 

Measles is a very contagious disease. It spreads through the air when an infected person coughs or sneezes. In fact, the measles virus can stay in the air for up to 2 hours after an infected person was there. In other words, you can get infected by simply being in a room where an infected person once was. It is so contagious that if one person has it, up to 90 percent of the people close to them will also get infected if they aren’t protected or don’t have immunity. 

Here are some eye-opening facts from the CDC:

• About 1 in 5 people in the U.S. who get measles will be hospitalized.
• 1 out of every 1,000 people with measles will develop brain swelling, which could lead to brain damage.
• A late complication of measles infection is the development of Subacute Sclerosing Panencephalitis (SPEP), a rare form of progressive brain infection caused by persistent infection with the measles virus following the initial infection. The onset is 6 to 8 years following a measles infection, with progresses to death in about 3 years after diagnosis. 
• 1 to 3 out of 1,000 people with measles will die, even with the best care.

Q: What’s the best protection against measles?

A: Measles can be prevented with MMR vaccine. The vaccine protects against three diseases: measles, mumps, and rubella.

Your child needs two doses of MMR vaccine for best protection:

• The first dose at 12 through 15 months of age
• The second dose at 4 through 6 years of age
• If your family is traveling overseas, the vaccine recommendations are a little different:
• If your baby is 6 through 11 months old, they should receive 1 dose of MMR vaccine before leaving.
• If your child is 12 months or older, they will need 2 doses of MMR vaccine (separated by at least 28 days) before departure.

Another vaccine, the measles-mumps-rubella-varicella (MMRV) vaccine, which protects against 4 diseases, is also available to children 12 months through 12 years of age.

Q: Is the vaccine effective?

A: Both vaccines are safe and effective. Two doses of either vaccine are about 97% effective at preventing measles; one dose is about 93% effective.

Before the measles vaccination program started in 1963, an estimated 3 to 4 million people got measles each year in the U.S., of which about 500,000 cases were reported each year to the CDC. Of those cases, 400 to 500 people died, 48,000 were hospitalized, and 1,000 developed encephalitis (brain swelling) from measles.

Since then, the widespread use of the measles vaccine has led to a greater than 99% reduction in measles cases compared with the pre-vaccine era.

Q: Are the vaccines safe? 

Scientists in the United States and other countries have carefully studied the MMR shot. No studies have found a link between autism and the MMR shot..