Should You Be Worried About Measles?

Measles cases are on the rise across the United States. And while the number of cases may sound low, the risk of full-blown outbreaks are significant, says Amy Edwards, MD, a pediatric infectious disease specialist at University Hospitals Rainbow Babies & Children’s Hospital.

“One of the things that makes measles particularly difficult to contain is you’re contagious for as many as four to five days before you have symptoms,” says Dr. Edwards. Measles can spread with lightning-quick speed among people who are unvaccinated and lead to severe complications, including death.

What Makes Measles a Threat?

For the vast majority of U.S. adults and children who have been vaccinated, there’s no reason to panic about catching measles. Two doses of the MMR (measles, mumps, rubella) vaccine – typically given starting at age one – are 97 percent effective against measles. You’re very unlikely to contract the disease if exposed.

Nine out of 10 people exposed to measles who aren’t vaccinated will catch it. Common symptoms include high fever, cough, runny nose, pink eye and a rash over the face and body. A child usually will recover in a couple weeks. But complications are not uncommon. “About 20 percent of unvaccinated children will require some amount of hospitalization before they're able to recover,” she says. “And one in 1,000 unvaccinated children will have long-term disabilities even if they survive. Measles is a very common cause of encephalitis, which is inflammation or swelling of the brain.”

Measles can also lead to secondary bacterial infections, which can be fatal, Dr. Edwards says. “Measles overwhelms the immune system,” she says. “Because of this, it's easier to get other serious infections like bacterial pneumonia, which can lead to hospitalization or even death. For some kids, that damage to the immune system is permanent.”

Measles Vaccination Rates Are Declining

Most children receive two doses of MMR vaccine starting at age 1. When 95 percent of the population is vaccinated it provides herd immunity, which protects infants who are too young to be vaccinated and children who can’t tolerate vaccination because of a severely weakened immune system.

Vaccination rates have been on the decline since the start of the COVID-19 pandemic. At last count, 93 percent of kindergartners were vaccinated with 2 doses of the MMR vaccine in 2021-22. That’s down from 94.7 percent in 2018-19. Schools across the country also are loosening vaccine requirements.

Before the first vaccination program started in the 1960’s, an estimated 3 to 4 million people got the measles every year in the United States. In 2000, measles was declared eliminated in the United States, thanks to vaccines. However, an increasing number of children have not been vaccinated.

The growing number of children at risk is alarming, says Dr. Edwards. “Measles requires a very high vaccination rate to keep outbreaks under control because it’s so contagious. Any increase in cases is a massive red flag when it comes to a virus that is this contagious and this deadly.”

“It’s all of our responsibility to make sure that our children are vaccinated to protect everybody else. That is the basis of herd immunity,” says Dr. Edwards. “We've dropped below that threshold and there are regions of the country where the uptake is much, much lower. So, we are basically just waiting for an outbreak that will harm children.”

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University Hospitals Rainbow Babies & Children’s has the region’s largest coordinated network of pediatric primary care providers, committed to delivering the very best care to children of all ages, including routine immunizations. Find a UH Rainbow pediatric practice near you.