Staying in the Game: Protection Against Measles

Staying in the Game: Protection Against Measles. Do I need a measles vaccine? Should I take vitamin A?

Being infected with the measles virus can lead to serious long-term consequences and even fatalities. Two unvaccinated but otherwise healthy school-aged children and one adult have tragically lost their lives this year.

Children and adults with specific medical conditions are more susceptible to severe complications from measles. However, even those who are otherwise healthy can suffer greatly. Reports indicate that the two Texans, aged 6 and 8, were unvaccinated but had no other health problems before being infected with the virus. Paul Offit who was a pediatric infectious disease specialist in Philadelphia during the 1990-1991 outbreak has stated that all 9 of the kids that died of measles were previously healthy and well nourished (but not vaccinated).

Currently, effective treatments for measles are limited. The antiviral medication ribavirin shows potential in laboratory studies (in vitro), but clinical trials indicate its effectiveness in humans is limited. Vitamin A is used in certain situations. Individuals with a deficiency in vitamin A are at higher risk of severe disease and complications of measles. However, studies done in countries where vitamin A deficiency is rare show no benefit  (see “The Art and Science of Medicine: Vitamin A for Measles”).

While we lack effective treatments for measles, we do have a highly effective vaccine that prepares our immune system for potential encounters with the virus. The vaccine has been so successful that we had nearly eliminated illness caused by the measles for several years in the United States.

The standard practice is to begin vaccinations for children at one year of age. We usually wait until this age because infants receive antibodies from their mothers that provide protection for several months. In certain situations, such as during an outbreak or for infants traveling to areas with low vaccination rates, the measles vaccine can be administered earlier. A second dose of the vaccine is typically given when the child is between 4 and 6 years old, and a third dose may be provided under specific circumstances.

The measles vaccine is part of the MMR vaccine, which protects against measles, mumps, and rubella. Additionally, the MMRV vaccine can be administered, which includes the varicella (chickenpox) component. Currently, there is no standalone measles vaccine available in the United States.

Most but not all adults in the U.S. have some level of protection against the severe consequences of measles due to childhood vaccinations or past infections.

People born before 1957 likely had measles as a child; those who survived being infected have good protection against the measles virus. 

Individuals vaccinated between 1963 and 1968 may have received a version of the measles vaccine that did not ensure reliable immunity. Those who may have received this vaccine should check their records to confirm they’ve received the current version, which is a “live attenuated virus” vaccine, rather than the “inactivated virus” version. If you cannot verify that you received the current vaccine and lack laboratory evidence of immunity, you should visit with your primary care provider about testing for immunity or getting vaccinated.

Two doses of the measles vaccine (MMR) gives a person excellent protection against measles. A single dose of the vaccine provides protection but not to the same degree. In the United States we started giving 2 doses of the vaccine to children in 1989. If you only received 1 dose of the MMR vaccine there are certain situations in which you should consider getting a second dose now. Those who should make certain they have had 2 doses of the MMR vaccine include: students at post-high school secondary educational institutions, healthcare personnel, and international travelers. If in doubt, talk with your primary care provider about getting a blood test for immunity or getting a dose of the MMR vaccine.

The text above has been adapted from the CDC website. A chart that summarizes these recommendations has been shared by infectious diseases specialist Daniel Griffin, M.D., Ph.D.

People with compromised immune systems face a heightened risk of severe complications from measles. All family members and close contacts of individuals with compromised immune systems should ensure they have received two doses of the MMR vaccine or possess laboratory evidence of immunity.

The MMR vaccine is highly effective. If you have already received two doses, a third dose is generally unnecessary, with a few exceptions.

If you or your child needs to get a dose of the MMR vaccine – as with any vaccine it is expected that the injection side could be swollen and sore for several days. A mild fever, body aches and other symptoms that are a result of your immune system being ramped up are not uncommon. Some individuals will develop a mild rash a week or so after vaccination. Serious adverse effects are extremely rare. The vaccine has undergone extensive study and we have decades of experience. There is no evidence that the vaccine causes autism – for more information on claims that have been made about vaccines and autism see the Health Matters in 2025 article “Vaccines and Autism” (future article) and for more in depth information about the studies see “The Art and Science of Medicine: Studies on Vaccines and Autism” (future article). Stay tuned for more articles on autism over the next several weeks.

See Infectious Diseases Update: Measles, Not Just a Rash for more information about the signs, symptoms and complications of measles. The Art and Science of Medicine: Vitamin A for Measles goes into the science of vitamin A and measles and discusses how this science is applied through “the art of medicine”.

As part of the “Health Matters in 2025” series I introduce some points for conversation about the societal issues complicating measles. See Measles Outbreak and Religion the first article in what will be an ongoing series.

Thank you for listening and please share,

Russ

Please note I am not an infectious disease or public health expert. I am a PA in a rural family practice clinic where I also provide hospital and emergency medicine services. This article is intended for general information and not as personal medical advice. Please see my full listing of  Disclosures, Disclaimers and Context.

For more information specific to infectious diseases please see “Health and Medical Resources: Infectious Diseases and Public Health” . I have been building this page with a list of  resources and will continue to add more information in the future.