An brought a grim milestone this week, when officials reported — a school-age child in Lubbock who was unvaccinated.
Nationally, as of Wednesday, according to the Centers for Disease Control and Prevention. All but 5% of those cases are in people who are unvaccinated or whose vaccination status is not known. The Texas outbreak, , makes up the majority of the national total.
The outbreak has grown quickly since it was first reported in early February, renewing concerns about and who is safe from infection. NBC News solicited audience questions about the outbreak and the virus via the @NBCNews Instagram broadcast channel; the answers are below.
What are the steps to control a measles outbreak?
The standard response to a measles outbreak is to isolate infected people, find out whom they’ve been in contact with and provide vaccines to people in the area who aren’t up to date on theirs. Anybody exposed should be tested and monitored for symptoms for up to 21 days after exposure. For those who are not vaccinated, receiving a measles, mumps and rubella (MMR) shot within 72 hours of exposure can prevent or lessen the severity of the disease.
Normally, the first dose of the measles vaccine is given to babies when they are 12 to 15 months old, followed by a second at 4 to 6 years old. But during an outbreak, doctors sometimes administer a dose to infants as young as 6 months. Babies younger than that and people who are severely immunocompromised can get an antibody injection within six days of measles exposure.
What are health agencies doing to address this? Are there any changes in the Trump administration’s response compared to Biden’s?
The CDC to Texas health officials at their request, but state officials have not asked the CDC to send experts to assist on the ground. Kush Desai, a White House spokesperson, said the White House is coordinating with Texas health authorities and monitoring the situation closely.
The CDC on Friday referred NBC News to from Robert F. Kennedy Jr., the secretary of health and human services. Kennedy said the agency has provided lab support to track the virus and communicated with public health officials in affected areas. Those are standard response measures.
Kennedy also noted a change to the CDC’s measles website: It now states that may be administered to infants and children with measles under a health care provider’s supervision. Kennedy, who has a history of anti-vaccine activism and spreading misinformation about the measles vaccine, was “chicken soup and vitamin A.”
At a news conference with Lubbock County health officials on Friday, Ron Cook, a professor of family medicine at Texas Tech University Health Sciences Center, noted that although studies on vitamin A and measles have shown some benefit for the acutely ill, high doses can be dangerous.
“Most people have normal vitamin A levels, and we’re not in a third-world country,” he said.
Can measles spread like Covid?
Measles is far more contagious than Covid — as well as just about all other infectious diseases, including Ebola and smallpox. If one person gets measles, they can spread it to up to 9 out of 10 people around them if those people aren’t vaccinated.
An infected person transmits measles by coughing, sneezing, talking or breathing. (Covid spreads in a similar manner but is far less transmissible.) Measles can linger in the air for up to two hours, meaning people can get infected from simply being in a room where someone with measles was recently. People can also spread the virus before symptoms start — an infected person is contagious for roughly four days before the disease’s signature rash appears and four days after.
Is there a particular age group most affected?
Measles is especially dangerous for children under age 5 for two reasons: First, kids in this group may not yet be eligible for both shots so may not have full protection. Second, their immune systems aren’t always developed enough to fight an infection, making them vulnerable to severe complications such as pneumonia and swelling of the brain.
Pregnant people and others with weakened immune systems are also vulnerable to , particularly if they’re unvaccinated. A measles infection in a pregnant person can lead to a premature birth or a baby with a low birth weight.
What is it like to get measles? How deadly is it?
Measles typically starts with a high fever, followed by a cough, runny nose and pink or watery eyes. One of the disease’s hallmarks — white spots on the insides of the cheeks near the molars — typically shows up about two to three days after symptoms start. Then a blotchy rash of flat, red spots, also characteristic of the illness, breaks out between days three and five.
Roughly 1 to 3 out of every 1,000 children with measles die from respiratory and neurological complications, according to the CDC.
“We can provide oxygen if they have pneumonia, or antibiotics, but if it goes to the brain, that’s where we really struggle, because when that happens we just don’t have a great way to treat it,” said Dr. Paul Kilgore, a professor at Wayne State University’s Eugene Applebaum College of Pharmacy and Health Sciences.
How does the U.S. measles situation compare to other countries?
The U.S. eliminated measles in 2000, meaning the disease is no longer constantly present, though there are occasional outbreaks. More than 80 other countries have also , but the disease is still common in parts of Africa, the Middle East and Asia.
The majority of measles cases in the U.S. are introduced from other countries, but declining vaccination rates have allowed the virus to spread locally. The share of U.S. kindergartners who had received two doses of the MMR vaccine fell from 95% in the 2019-20 school year to . Maintaining measles elimination status requires vaccination coverage to exceed 95%.
The U.S. recorded 285 measles cases last year — the highest number since 2019, according to CDC data — and is on track for more this year.
With Texas seeing a major outbreak right now, “we have kind of fallen back from our elimination goal,” Kilgore said.
Is the measles vaccine safe? How effective is it?
The MMR vaccine has been available in the U.S. since 1971 (though the measles portion was first distributed as a stand-alone vaccine in 1968). Two shots are 97% effective against measles and typically offer lifelong protection.
The vaccine has been shown to be overwhelmingly safe. Most people don’t have any side effects, though some people may experience a fever, rash or joint pain and stiffness afterward. Despite misinformation that originated in the 1990s, the MMR vaccine is not linked to autism. That false idea came from a paper that has been retracted, and whose author, Andrew Wakefield, lost his medical license.
I’m fully vaccinated — do I need to worry or get a booster?
Measles infections in vaccinated people are rare. Up to 3 out of 100 fully vaccinated people can have a breakthrough infection, which tends to be mild. For that reason, doctors generally don’t recommend extra booster doses.
“If a person 6 years and older has received their two doses, they should be immune,” Dr. Carla Garcia Carreno, the director for infection prevention and control at Children’s Medical Center Plano. However, adults who received the vaccine prior to 1968 may choose to get an additional dose, she added, because the formulation back then wasn’t as effective as the current one.
“All the adults that were born before 1957, because measles was so widespread at that time, can be considered immune as well,” she added.
People who aren’t sure if they were vaccinated can or reach out to clinics they visited as a child, which may have it on file. If still in doubt, talk to your health care provider about the possibility of a blood test to check for measles antibodies.
Will lower trust in vaccines lead to a rise in other childhood diseases in addition to measles?
Doctors worry that vaccine hesitancy could allow several childhood diseases to proliferate. More than 30 states saw declines in vaccination rates for polio, varicella and diphtheria, tetanus and pertussis during the 2023-24 school year. Last year, the U.S. saw a rise .
“These are extremely alarming trends that are really undermining our herd immunity,” said Dr. Syra Madad, an epidemiologist and fellow at the Harvard Belfer Center for Science and International Affairs. “Today it’s measles. Tomorrow it could be pertussis. The next day it could be another vaccine-preventable illness.”
