Measles Prevention

Measles Should Be Prevented

Measles is highly contagious and before the first measles vaccine became available in the US in 1963, most children contracted the disease by age 15 years. Annually, about 48 000 people were hospitalized, and between 400 and 500 died.

Measles has resurged after it was eliminated as an endemic disease from the U.S. by widespread vaccination, with more than 1200 confirmed cases across 31 states in 2019. In 2023, there were 23 confirmed cases, most among children and adolescents who were not vaccinated but eligible for vaccination.

The World Health Organization estimated that compared with 2021, in 2022 there was an 18% increase in measles cases and a 43% increase in measles-related deaths worldwide. This is important because most U.S. infections are the result of travel by unvaccinated children and adults to countries where measles is still active.

According to infectious disease expert Paul Offit “Even one case of measles is worrisome because it’s highly contagious.” Direct contact isn’t necessary for measles to spread. The CDC notes that about 9 out of 10 unprotected people exposed to measles become infected, Measles is a serious illness, 1 in 5 cases in which the patient isn’t vaccinated results in hospitalization.

Vaccination Recommendations

The CDC recommends that children 12 months or older be vaccinated against measles; those traveling abroad can be vaccinated as early as 6 months. A single dose of the measles-mumps-rubella vaccine is approximately 93% effective at preventing measles; 2 doses boost protection to about 97% and immunity is lifelong.

Measles causes fever, malaise and the 3C’s: cough, congestion, and conjunctivitis and at days 3-5 a rash appears starting on the head and spreading downward to other parts of the body. Patients should be isolated at home for 21 days to avoid transmission to others.

To avoid the spread of cases within the U.S. population from cases in international travelers, it is important that the U.S. maintain herd immunity. Measles could make an even greater comeback as more kindergarteners have become exempt from school-mandated vaccines and vaccination rates are decreasing to below what is needed for population level protection through herd immunity. This requires about 95% of the population to be vaccinated.

Suran M. Measles Cases Are Spreading in the US—Here’s What to Know. JAMA. 2024;331(11):901–902. doi:10.1001/jama.2024.1949
Harris E. Measles Outbreaks Grow Amid Declining Vaccination Rates. JAMA. 2023;330(23):2242. doi:10.1001/jama.2023.23511




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