With nearly 150 cases of measles in Texas and New Mexico, last week Texas health officials confirmed their first death in an ongoing outbreak. It is believed that almost all of the infected people have not been vaccinated, but five of them told the Texas Department of Health that they received at least one shot of measles.
In 2000, the United States declared measles that had been eradicated. Because the disease has not spread locally (for most of the following years it was linked to travel to countries where the virus is still prevalent), but in recent years, measles outbreaks have continued to increase as people across the country are prevented from being vaccinated. Even among those vaccinated, recent incident reports added another layer of anxiety to the crisis. Over 90% of Americans were shot with measles as children. Given this news, how reliable is the protection exactly?
First of all, there's no need to panic. It is not clear whether the five people who signed up for measles have been vaccinated as children. The Texas Department of Health told me they were investigating, but they wouldn't “classify” these as breakthrough infections. Division spokesman Lala Anton said people exposed to measles who have not been vaccinated are being given the vaccine within 72 hours if possible, as it can reduce the severity of their symptoms.
“We are considering that many of these cases received a dose of MMR after exposure to the virus,” Anton said.
To be clear, groundbreaking cases could arise. But today's risk remains very low. Only about three out of 100 people who receive two vaccine doses will get sick. Aaron Millstone, an infectious disease pediatrician at Johns Hopkins University School of Medicine, put it on me, so if you don't live in West Texas or eastern New Mexico, you really don't have to worry.
“We don't want everyone to go out and think. You need to boostMillstone said.
However, if you live in those areas, or if you don't know what your vaccine status is, or if you just want to be proactive about your health, there are some easy things you can do to confirm your immunity to measles. This is what you need to know.
Why groundbreaking measles cases occur
Measles protection strategies have evolved over decades. It is generally believed that people born before 1957, shortly before the first measles vaccine was introduced, are born before 1957, as they were usually exposed to the virus as children, and therefore are generally thought to be innate immunity. Those born before 1989 may have received at least one dose, which was guidance during that period. Since 1989, recommendations have increased to two doses. One was my first birthday and my age was around 5.
That change was made because a small percentage of people did not respond to only one measles shot. But “almost everyone” responded to two doses, Millstone said.
When measles outbreaks become more common and more vaccinated people become naturally exposed for the first time in a long time, a small number of people may get sick, Millstone said.
And since then, measles vaccination rates are very high, with experts above the 95% threshold saying it's necessary to keep the disease at bay. As a result, measles has not spread widely in the US, with zero or at most deaths caused by the virus in most years.
However, measles vaccination rates have fallen. There has always been a small island community with few vaccinations. The current Texas outbreak is reportedly concentrated primarily in the Mennonite community. However, vaccine hesitancy has become more mainstream, especially as it has been accepted by some Republican leaders. Several GOP-led states have been acting in recent years to allow more vaccine exemptions. The proportion of Republican voters who believe that they need routine childhood vaccinations to attend public schools have fallen dramatically since the pandemic.
In the 2019-2020 school year, 20 states still exceeded the 95% vaccination rate threshold, with only three below 90%. However, in the 2023-2024 grades, more than 95% of school children were vaccinated against the disease, with over 95% of 14 states exceeding 90%.
It's no surprise that measles outbreaks are on the rise. The Texas outbreak alone accounted for more than half of the total number of measles in the United States in 2024. This was in itself one of the most active years in recent memory.
Measles immunity in some people can fade over time. When measles outbreaks become more common and more vaccinated people become naturally exposed for the first time in a long time, a small number of people may get sick, Millstone said.
What you can do to make sure you are protected
As Millstone told me, unless you get close to an aggressive outbreak, this remains a hypothetical risk for the majority of Americans. For now, there are quite a few outbreaks that extend across the Texas-New Mexico border.
Still, we live in a world where you are likely to see measles outbreaks in your community. Others may simply want to be tempered or exercise some form of institution about their health. Especially if you have a higher risk from a viral infection, for example, due to immunodeficiency or chronic health conditions.
This is what you can do. First, check if you can find a vaccination record. If I received two doses, I almost certainly had an immune response. If you received a single dose, you probably did, but there's a little more chance you've never been immunized with measles, Millstone said. For the people in this group, it is reasonable to consider a measles booster.
In any case, if you want to investigate further, the next step is to talk to your doctor (as always, regarding your health). They can administer a “titer test” to measure measles antibodies in your body. If they are still present – great, you are protected. If not, you can talk to your doctor about getting an additional shot of measles.
This is a new era of public health. Millstone said he and his fellow infectious disease doctors couldn't believe it when they heard the news of the death of a child from measles in the United States.
It remains completely preventable by receiving the vaccine. Also, if you are unsure about vaccinations, you can follow these simple steps to understand your status. Unfortunately, the interests are too clear as a school-age child died last week.
“I hope that no one else has to die to take this seriously,” Millstone said.
