Texas is facing the country’s largest measles outbreak in decades. As of Tuesday, 124 cases have been reported, and the state’s health department expected that number to grow.
The outbreak is primarily affecting West Texas, but officials in San Antonio, New Braunfels and San Marcos are monitoring cases after an infected person recently visited the area, according to the Texas Department of State Health Services.
Measles is highly contagious and can easily spread through the air. The disease can lead to severe complications like pneumonia, swelling of the brain and even death, according to the Centers for Disease Control and Prevention (CDC). Measles is especially dangerous for young children, pregnant women and those with weakened immune systems.
At least 18 Texans have been hospitalized, including five who were vaccinated. State health officials say the remaining cases involve unvaccinated individuals or those with unknown vaccination status.
Common symptoms
Measles usually starts with a fever, cough, runny nose, red eyes and a sore throat. Within a few days, tiny white spots may appear in the mouth. Around days three to five, a rash spreads from the face downward to the rest of the body. As the rash appears, fever can spike above 104°F.
The vaccine
Health officials say immunization is the only way to prevent measles. Two doses of the measles, mumps and rubella (MMR) vaccine provide about 97% protection against measles, according to the CDC. While breakthrough infections can occur, they’re uncommon and typically result in milder symptoms. The CDC says about 3 out of 100 people who get two doses of the vaccine will get measles if exposed to the virus, but they’ll be less likely to spread the disease to other people.
Children are eligible for their first dose at 12 to 15 months of age and the second dose at four through six years of age, according to the CDC. Kids between 12 months through 12 years of age are also eligible for the MMRV vaccine, which protects against measles, mumps, rubella and chickenpox.
According to the CDC, those who are unvaccinated are at a significantly higher risk of contracting measles and about one in five people who aren’t vaccinated are hospitalized after being infected.
However, the CDC does not recommend the vaccine for people with a weakened immune system due to another illness like cancer or HIV/AIDS, or due to medical treatments like radiation, immunotherapy, steroids or chemotherapy.
Risk to infants
Children under 12 months are generally too young to receive the MMR vaccine, making them particularly vulnerable during outbreaks. According to the World Health Organization, immunization rates across the globe have declined since the COVID-19 pandemic, leaving millions of unvaccinated children vulnerable to preventable diseases like measles.
“Areas with low immunization encourage the virus to circulate, increasing the likelihood of outbreaks and putting all unvaccinated children at risk,” according to the organization's website.
But according to Dr. Sapna Singh, the chief medical officer of Texas Children’s Pediatrics, infants from six to 12 months can still get a dose of the vaccine – it just won’t count toward the child’s recommended two doses. A vaccination within these early months is recommended when the child is traveling internationally or if they’re living in or near a community with a high infection rate, Singh said.
“You want to be very careful when there is a concern for an outbreak or the possibility of exposure in the community,” Singh said. “Children who are unvaccinated have no protection.”
Singh added that protecting infants relies heavily on herd immunity, which is when high vaccination rates among the population help prevent the spread of measles to those who can’t be vaccinated.
The vaccine and pregnancy
Health officials say the vaccine is not safe for pregnant women, as it contains a live virus that could pose a risk to the baby. Pregnant individuals who are not immune – either by previous exposure or immunization – should take extra precautions to avoid exposure, per CDC recommendations.
However, the CDC says it’s safe for breastfeeding women to get the vaccine.
When to get a booster, if needed
People born before 1957 are generally considered protected against measles, likely due to natural exposure during childhood. The CDC says people who received a live measles vaccine in the 1960s don’t need another dose.
However, those vaccinated before 1968 with either an inactivated – or killed – vaccine or an unknown vaccine type should get at least one dose of the live, attenuated measles vaccine. This is because the killed measles vaccine, used from 1963 to 1967, was ineffective, according to the CDC. Boosters are not recommended for people who got the vaccine after 1968.
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