Protecting Your Child From Measles

Dr. Lee Atkinson-McEvoy answered questions about how to protect children during the current measles outbreak in a live chat on our Facebook page. Read the transcript here.

A recent measles outbreak in the United States has alarmed many parents of young children, particularly those with infants too young to receive the measles, mumps and rubella, or MMR, vaccine. The outbreak started at Disneyland in December 2014 and by early February had spread to at least 17 states, sickening more than 120 people, according to the Centers for Disease Control and Prevention.

Dr. Lee Atkinson-McEvoy, a pediatrician at UCSF Benioff Children's Hospital San Francisco, answered some common questions about the disease and the current outbreak.

About Measles

Measles is a highly contagious respiratory disease that spreads through the air when infected people cough or sneeze. It starts with symptoms such as fever, cough, red eyes and runny nose. Later, a telltale rash forms on the sick person's head and body. Complications are more common in children younger than 5, and a very small percentage of cases result in death.

Infected people can spread the virus as soon as four days before the rash develops. The CDC recommends that children receive their first measles vaccination at 12 to 15 months of age and a second dose between 4 and 6 years old.

1. How worried should I be about the current measles outbreak?

While the U.S. declared measles eliminated in 2000, a growing number of families have declined to vaccinate their children. That is one of the important reasons we are seeing increasing outbreaks, with this latest outbreak being very concerning. However, we are not yet at the levels of infection you see in developing nations or in some areas of Europe. Because measles is very contagious, providers and the general public are concerned about protecting everyone, particularly those most vulnerable to infection.

Measles is very contagious, so I understand why people are really concerned.

2. Can my baby get vaccinated before age 1?

Young babies haven't yet developed the immune system response to ensure they'll make the proper antibodies after receiving this type of live-virus vaccine. From studies, we know that children who get the vaccine at the recommended age of 12 months respond well and have good protection. Infants 6 months and older who will be traveling to parts of the world with many measles cases can receive the vaccine early, but it will provide a lower level of protection before age 1.

When children receive the MMR vaccine on schedule, about 93 to 95 percent become immune to the virus after the first dose. The second dose can take you up to 97 or 98 percent immunity. The purpose of the two doses is to get to the point where most people have antibodies to measles and those antibodies are robust enough to keep them immune for the rest of their lives.

3. My baby is too young to get the MMR vaccine. Is there anything I can do to protect her?

Rather than living in a state of fear and staying away from public places, make sure the people who care for or socialize with your child are protected against measles. If your child goes to the playground with other children, find out the vaccine status of those families.

A patient's mother emailed me about an upcoming domestic trip with her baby and asked if she should cancel it because of the measles outbreak. I told her she should take the trip, but we discussed ways to minimize exposure in public.

4. Given the outbreak, should my child get a second MMR vaccine before age 4?

Not at this time, unless the child is almost 4 or will be traveling to a part of the world with a large number of measles cases. The current U.S. measles outbreak hasn't reached a level where the public health recommendations have changed, but we continue to monitor them and rely on the CDC and California Department of Public Health for updates.

If you're trying to boost someone's antibody levels to measles, it's good to wait the recommended interval, assuming there are no additional health concerns.

5. Do you expect measles outbreaks in the U.S. to worsen?

If people continue to refuse vaccines, we're going to continue to see years like this. On a positive note, I know colleagues with patients who previously refused vaccines or wanted to be on a modified schedule but have now come in for their MMR vaccine. This outbreak is driving home the point that measles is not an antiquated illness that no longer exists.

Even if you don't have the worst-case scenario, it can make your child quite ill and unhappy and the necessary quarantine can affect families negatively. It is just not worth it when there is a safe way to prevent this illness.


Reviewed by health care specialists at UCSF Benioff Children's Hospital.

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.

Related Information

UCSF Clinics & Centers

Pediatrics at Mount Zion
2330 Post St., Suite 320
(Suite 260 for Acute Care)
San Francisco, CA 94143-1660
Phone: (415) 885-7478
Fax: (415) 885-3790

Family Medicine at Lakeshore
1569 Sloat Blvd., Suite 333
San Francisco, CA 94132
Phone: (415) 353-9339
Fax: (415) 353-3450

Primary Care at Laurel Village
3490 California St., Suite 200
San Francisco, CA 94118
Phone: (415) 514-6200
Fax: (415) 514-6410