Just 25 years ago, the disease of measles was declared to have been eliminated from the U.S. Cases were sometimes imported from overseas, from people who traveled from Europe, Africa, or Asia. But not until this year did we have a measles death on U.S. soil; and not until this year have we had a notorious anti-vaxxer as the head of our Department of Health and Human Services.
That department head, Robert F. Kennedy Jr., has sorta-kinda acknowledged that vaccines have a role in preventing measles. This opinion piece that appeared under his name at Fox News carefully weaseled around the needed vaccine messages, saying that parents “should consult with their healthcare providers to understand their options” about the vaccine, and that “Good nutrition remains a best defense against most chronic and infectious illnesses.” Kennedy previously led an anti-vaccine propaganda organization that spread misinformation so egregious it got kicked off of Facebook.
Contrast his messaging with the World Health Organization, which is able to lay it out more plainly: “Being vaccinated is the best way to prevent getting sick with measles or spreading it to other people.” So far, the CDC’s website still has accurate information about measles, including yet another plain statement that RFK, Jr. couldn’t bring himself to say: “The best protection against measles is measles, mumps, and rubella (MMR) vaccine.”
While public health authorities in Texas and elsewhere are doing their best to contain the latest outbreaks, RFK Jr. is going on Fox News talking up the “benefits” of measles infection and making the vaccine sound as bad as the disease. So, with the people in charge of the measles response sending mixed messages, I want to make sure the correct information is getting out there. So here’s what you should know about measles and the measles vaccine.
The MMR or MMRV vaccines are the best protection against measles
This is the absolute first and best thing to know: The measles vaccine protects you against measles. It is the best protection we have against measles, as both the CDC and WHO will openly tell you. The World Health Organization estimates that measles vaccination saved 60 million lives worldwide between 2000-2023. Most measles deaths were among children under 5 who were not vaccinated, or who didn’t get the two recommended doses on schedule.
There are two types of measles vaccine available: the MMR vaccine that provides protection against measles, mumps, and rubella; and the MMRV vaccine that covers those three plus varicella, better known as chicken pox.
The recommended schedule for MMR or MMRV vaccination is to get the first dose at an age of 12 to 15 months, and the second dose at age 4 to 6 years. Infants who are traveling or who live in a place with a measles outbreak can get a dose at age 6 months, but this protection isn’t expected to last long, so they will still need two more doses on the usual schedule. Adults and older children can also get a two-dose series (four weeks apart) if they didn’t get it as kids or don’t remember whether they got it.
Measles is one of the most contagious diseases known, and can be deadly
Is it worth vaccinating against measles? Yes, very much so. Anti-vaxxers like to point out that measles used to be a common childhood illness, which is true. But that doesn’t mean it’s harmless. Before vaccination was common, according to a 2013 report from the CDC’s vaccine advisory board, there were 500,000 cases of measles in the U.S. in a typical year. Those resulted in 500 deaths, 48,000 hospitalizations, and 1,000 cases of permanent brain damage from encephalitis.
Measles is also horrendously contagious, perhaps the most contagious human disease known. For a comparison, the average person with the flu will give it to 1.3 other people. For ebola, that number is 1.8. For smallpox, before we eradicated it through vaccination, it was 3.5 to 6. Chickenpox is near the top of the list, with each sick person giving it to 10 to 12 others. But measles beats even that, spreading to 12 to 18 people, on average. I’m getting my numbers from this chart on Wikipedia. The exact number for each outbreak can depend on the specifics of the time and place it occurs, but these statistics are pretty widely agreed upon.
Measles is so contagious that, after an infected person leaves a room, the air and surfaces in that room can infect people for the next two hours. This is why just avoiding sick people isn’t enough, and why authorities announce where and when a person with measles was known to be in public, like two Philadelphia children’s hospital locations on March 7 and 10. Anybody who visited those places at those times is being told to find out if they are protected from measles and to talk to their healthcare provider about getting the vaccine if appropriate.
The measles disease is so, so much worse than the vaccine
Kennedy repeated a common and wrong anti-vaxxer talking point when he said that the measles vaccine “causes all the same illnesses” as measles. No, the vaccine does not give you measles. Even if he meant “all the same symptoms,” it’s still not true.
He specifically called out encephalitis, an inflammation of the brain that can lead to death or brain damage. The measles vaccine causes 1-2 cases of encephalitis per one million children vaccinated. Measles, on the other hand, causes encephalitis in 1-3 out of every thousand children who get the disease, according to Encephalitis International. In other words, measles the disease has 1,000 times greater encephalitis risk compared to the vaccine.
Kennedy also claimed that the measles vaccine “cause[s] deaths every year,” which isn’t true. The Infectious Disease Society of America says that “There have been no deaths shown to be related to the MMR vaccine in healthy people.” There have been a very few deaths from vaccine side effects in children who were immunocompromised, which is why the first step in getting a vaccine is talking to a healthcare professional who can determine whether it’s safe for you to get the vaccine.
The vaccine can be given after you’re exposed to the measles virus
The best time to get an MMR vaccine is when you’re young, at 12-15 months and 4-6 years old. The second best time, if you’ve just been exposed to measles, is now. A dose of the vaccine can be given within 72 hours of being exposed to the virus to provide last-minute protection.
If you think you need the vaccine for this reason, ask your doctor. There is another option, which is to get a dose of immunoglobulin instead. It has to be one or the other, not both; the globulin can cancel out the vaccine.
Vaccine immunity can fade, but not as much as RFK Jr thinks
After one dose of the MMR vaccine, you have a 93% chance of being protected against measles. After both recommended doses, that increases to 97%. This is exactly why two doses are recommended.
It’s probably true that immunity from a measles infection lasts longer than from the vaccine, but the vaccine still gives lifelong protection to the vast majority of people who got their two doses. Kennedy said that vaccinated people lose “4.5%” of their immunity each year. I don’t know where he got that number, but I did find a study that postulated a 0.04% waning per year—that’s about 100 times less than the number he cited.
For the love of god, you do not want “natural” immunity
In the 1950s and earlier, natural immunity—from getting infected—was the only measles immunity we had. Everybody still got the disease, because children without any measles immunity were constantly being born. Eventually they’d encounter the virus, and get sick. As I discussed above, this was fine for most kids and catastrophic for some. Read Roald Dahl’s letter about losing his daughter to measles, if you haven’t already. She was healthy, and then she had a routine case of measles, and then she felt “all sleepy” one day, and shortly afterward, she was dead.
The only way you get natural immunity is by rolling those dice. One child in every 1,000 died of measles. The other 999 carry that immunity with them for life, but only because they were lucky. The point of a vaccine is to give you the immunity without the risk of complications and death.
Which means, sorry, no measles parties. Or, as the Texas health department puts it, “No! DSHS strongly advises against intentionally exposing anyone to infectious diseases like measles.” As they correctly point out, you’d be risking severe complications and death for the attendees of the party, you can’t predict how severe the symptoms will be, and you’re creating a bunch of walking measles vectors who can then transmit the virus to the elderly, unvaccinated, and immunocompromised. Vaccination, on the other hand, provides protection for 97% of those who receive the vaccine, with far smaller risks of complications.
How to know if you need a measles vaccine
When I said that “everybody” used to get measles as a child, that’s true enough that the CDC and other health authorities rely on that fact to know who is immune. If you were born before 1957—meaning you are 69 or older in 2025—you are assumed to have already survived a bout of measles.
You can also assume you are immune if you have medical records saying that you got two doses of the measles vaccine, or that you had a laboratory-confirmed case of measles, or that you have had a blood test that confirms your immunity.
If you don’t remember whether you had the vaccine, you can get your immunity tested, but that’s not necessary. As the CDC states: “There’s no harm in getting another dose if you may already be immune to measles, mumps, or rubella.”
If you are in Texas, where the largest measles outbreak is currently occurring, this page from Texas Health and Human Services has information on staying safe, including where to get an MMR vaccine in Texas.
This articles is written by : Nermeen Nabil Khear Abdelmalak
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