Everything You Need to Know About Measles and the MMR Vaccine

With recent measles outbreaks in Texas and cases popping up across the country – including the first measles death since 2015 – there are a lot of questions floating around about the disease and the vaccine that largely helps to protect people from it.

Tallahassee Memorial HealthCare (TMH) is here to help make sure everyone in our community understands this disease, the context surrounding the recent outbreaks, what to expect if you’ve been exposed or become sick, as well as the benefits and risks of vaccination.

If you have personal questions about measles, exposure to it, or how to best protect yourself or your loved ones against it, you should speak with your healthcare provider.

What is measles?

Measles is a rare and serious childhood viral infection, that can also infect adults, that causes fever, cough, rash and other symptoms. It can be fatal, especially for young children and immunocompromised adults. Like many viruses and respiratory illnesses – such as flu, RSV or COVID-19 – measles spreads through the air by respiratory droplets produced from coughing, talking or sneezing.

Also, similar to other respiratory illnesses, the virus can spread through contact with contaminated surfaces. For example, if you touch a contaminated doorknob and then touch your nose, mouth or eyes, you can become infected.

Measles is one of the most contagious infections. Up to 9 out of 10 people susceptible people with close contact will develop measles.

Where exactly are people getting measles and where are the outbreaks occurring?

As of February 27, 2025, there have been a total of 164 measles cases throughout 9 states: Alaska, California, Georgia, Kentucky, New Jersey, New Mexico, New York (New York City), Rhode Island and Texas.

There have been three (3) measles outbreaks (which the CDC defines as 3 or more related cases) reported in 2025. Of the total cases, 93% (153) are outbreak-associated. Of these cases:

• 35% occurred in children under 5 years old
• 48% occurred in people 5-19 years old
• 18% occurred in people 20+ years old

Roughly 1 in 5 of these cases have required hospitalization, and the majority of hospitalizations were among children. There has been one death from measles in 2025 so far, a child from Texas.

Out of the 164 total reported measles cases in 2025, 95% of the cases were in the unvaccinated or individuals whose vaccination status was unknown.

How does the current outbreak compare to the past?

It may be too early to tell how large this outbreak could become. While there were 284 cases in 2024, that was throughout the entire year, whereas there have already been 164 cases in the first two months of 2025.

To give some context to the largest outbreaks over the past few decades, there were more than 1,200 confirmed cases of measles in 2019 and more than 660 cases in 2014.

Before the vaccine was introduced in 1963, about 48,000 people were hospitalized each year with measles, and about 400-500 people died of measles complications each year. The decades after the vaccine started being used, those numbers decreased, with only a few spikes in cases seen until the late 1980s, when there was a measles outbreak among vaccinated school-aged children. At that point, a second dose was recommended and measles cases declined steadily, and in 2000, measles was declared eliminated from the United States.

What is the measles vaccine?

The measles vaccine, known as the Measles, Mumps and Rubella (MMR) vaccine, is a live attenuated vaccine, meaning it includes an extremely weakened live virus vaccine that helps to protect your body from the three viruses that cause measles, mumps, and rubella.

When this weakened virus is introduced to your body, it triggers an immune response. This process teaches your immune system to protect your body against the real full strength virus if you were to be exposed. After exposure with the vaccine, your body produces antibodies (fighter cells) to specifically target the measles, mumps, and rubella viruses, and your immune system develops memory cells that quickly respond if you’re ever exposed to these viruses again.

Is the MMR vaccine safe?

The MMR vaccine is considered safe for those who are not immunocompromised or pregnant. Those who are unsure if they are immunocompromised should contact their primary care physician. Side effects are rare and most resolve within a few days. These side effects generally include fever, rash, joint pain, headache, nausea and soreness at the injection sight.

Serious side effects are very rare and may include seizures, allergic reactions, low platelet count and encephalitis (inflammation of the brain).

Are autism spectrum disorder (ASD) and other conditions associated with these vaccines?

There’s no scientific evidence linking autism spectrum disorder (ASD) to the MMR vaccination. This means that through many studies, it has been determined that the chances of developing autism is not significantly different for those who’ve received the vaccination compared to those who haven’t.

There’s also no evidence to support claims that vaccines cause Sudden Infant Death Syndrome (SIDS), inflammatory bowel disease (IBD), attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), multiple sclerosis (MS) or Guillain-Barre syndrome (GBS).

Who needs the vaccine?

The Centers for Disease Control and Prevention (CDC) recommends:

• All children get two doses of the MMR vaccine, beginning with the first dose at 12 – 15 months and the second dose at 4 to 6 years of age.
• Students at post-high school educational institutions who do not have presumptive evidence of immunity should get two doses of the MMR vaccine, separated by 28 days or more.
• Adults who do not have presumptive evidence of immunity should get at least one dose of the MMR vaccine. For those who may be in a setting that poses a high risk for measles or mumps, they should have two doses separated by at least 28 days. This could include college students, healthcare personnel and international travelers.

In some cases, the MMR vaccine may not be recommended for those who are pregnant, have a weakened immune system, have a history of severe allergies or are severely ill. If you or someone you care for falls in this category, you should speak with your primary care provider about vaccination and whether it’s right for you or your loved one.

How effective is the MMR vaccine?

The MMR vaccine is very effective, protecting those who have received it against measles, mumps and rubella when exposed, by preventing severe complications from those diseases.

People who receive the vaccination are generally considered to be protected for life against measles and rubella. However, immunity against mumps wanes over time and an additional dose may be needed if you are at risk because of a mumps outbreak.

According to the CDC, one dose of the MMR vaccine is 93% effective against measles, 78% effective against mumps and 97% effective against rubella. Two doses of the MMR vaccine increase protection even further and are 97% effective against measles and 88% effective against mumps.

Does the vaccine cost money?

Most health insurance plans cover the cost of vaccinations, but you should check with your health insurance provider to confirm.

If you don’t have insurance or your insurance doesn’t cover the cost of vaccinations, there may be other resources available to help you cover the costs of vaccines, especially if it’s for your children.

Can I still get measles if I’ve had the vaccine?

Yes, you can still get measles (or mumps, or rubella) if you’ve received the vaccine. It could be because your immune system didn’t respond as well as it should have to the original vaccine, or your protection has decreased over time. However, those who are vaccinated and still contract the disease generally experience milder illness than those who are completely unvaccinated.

With the recent cases of measles across the U.S. in 2025, it’s been determined that only 2% of those who’ve contracted the disease were fully vaccinated.

What if I don’t know if I’ve had the vaccine?

If you’re unsure whether you’ve had the vaccine, you should check your medical records with your current and past primary care providers. You may also be able to find out through your local or state public health department.

If you’ve checked with those resources and are still unsure whether you’ve been vaccinated for measles, you should speak with your doctor about getting vaccinated. There is no harm in receiving another dose, even if you have previously been vaccinated or have immunity to measles.

According to the CDC, if you received a measles vaccine in the 1960s, you may not need to be revaccinated. People who have documentation of receiving live measles vaccine in the 1960s do not need to be revaccinated. People who were vaccinated before 1968 with either inactivated (killed) measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine. This recommendation is intended to protect those who may have received the killed measles vaccine, which was available in 1963-1967 and was not as effective as the current live attenuated vaccine.

Aside from the vaccine, how else can I protect myself against measles?

Similar to other common respiratory illnesses, other good ways to protect yourself against measles are through frequent handwashing, avoiding touching your eyes, nose or mouth, and staying away from others who may be infected.

Do I have immunity if I’ve previously had measles?

Yes. If you’ve had measles before, your immune system will protect against measles as it’s not possible to get measles twice unless you become immunocompromised. Most people born before 1957 are immune to measles because they’ve already had the disease.

What do I do if I’m exposed to measles?

If you believe you’ve been exposed to measles, you should contact your healthcare provider, determine if you’ve been vaccinated, monitor yourself for symptoms and isolate yourself if you’re not fully vaccinated.

If you’ve been exposed to measles, mumps or rubella and do not have immunity, you should speak with your doctor about getting the MMR vaccine. If you get the MMR vaccine within 72 hours of exposure to measles, you may get some protection against the disease or experience milder illness.

In some high risk cases, you may be given a medicine called immunoglobulin (IG) within six days of exposure to protect against the disease and severe illness.

What are the symptoms of measles?

Measles is highly contagious, and symptoms usually begin 7 to 14 days after exposure to measles, typically beginning with:

• High fever
• Cough
• Runny nose
• Conjunctivitis

As the disease begins to run its course, tiny white spots known as Koplik spots may appear inside the mouth within a few days of the initial symptoms. Some people may also experience additional symptoms, such as diarrhea and ear infections.

One of the most notable measles symptoms is a rash, which appears 3-5 days after the initial symptoms. It usually begins as flat red spots on the face at the hairline before spreading downward toward the neck, trunk, arms, legs and feet. The spots may become raised and join as they spread – and a fever typically accompanies the rash.

Children younger than 5, adults older than 20, pregnant women and those with weakened immune systems are often the most likely to experience severe complications from measles, such as:

• Pneumonia
• Respiratory failure
• Encephalitis
• Blindness
• Deafness
• Subacute sclerosing panencephalitis (SSPE)

SSPE is a rare, but fatal brain disease that develops years after an initial measles infection.

What do I do if I get measles?

If you have measles, you should treat it similarly to other viral illnesses. You should rest, drink fluid and take fever-reducing medication.

You should also avoid contact with others, isolate at home and wash your hands frequently.

If you or someone you care for experience life-threatening symptoms, such as a very high fever (greater than 105 degrees Fahrenheit), difficulty breathing, seizures, confusion, signs of pneumonia or other life-threatening complications, call 911 or visit your nearest emergency center. If possible, call ahead to discuss your symptoms and determine how to proceed to your emergency center safely.