By: Sean T. O’Leary, MD, MPH, FAAP
Measles is wildly contagious. Nearly 1 out of every 3 children under the age of 5 who catches measles ends up in the hospital.
Are some young children at a greater risk from the measles virus during an outbreak? What, if anything, can parents do to protect their little ones?
Here are some answers from the American Academy of Pediatrics.
The recommended age for the first dose of measles, mumps and rubella (MMR) vaccine is 12 to 15 months of age.

If you live in a community experiencing an outbreak, or if you travel internationally, your baby may be vaccinated as early as 6 months of age. Talk with your pediatrician if this applies to you. (See International travel tips for families with young children below.)

Babies who get one dose of MMR vaccine before their first birthday should get two more doses (one dose at 12 through 15 months of age and another dose at least 28 days later).

If there is not measles circulating in your community, thanks to vaccines, the risk to your baby is low. Good hand hygiene is always a good idea. So, just as you would to prevent germs at any time, wash your hands using soap and water and scrub for at least 20 seconds or use alcohol-based hand sanitizer. Remind others in your home or anyone who is near your baby to do the same.
Limit your baby’s exposure to crowds, other children, and anyone with a cold.
Prevent germs at home. Disinfect objects and surfaces in your home regularly.
Feed your baby breastmilk. It has unique antibodies to prevent and fight infections.

That depends on if measles is circulating and the level of community immunity to measles. At most risk for severe disease are: unvaccinated people, especially children under age 5 years; people who have weakened immune systems; and anyone who is pregnant or severely malnourished.

Infants and children can be contagious four days before they even show any symptoms!

Measles typically starts like a bad cold with symptoms such as fever, cough, runny nose and conjunctivitis (pink eye). A rash then starts to develop on the head and spreads down to the rest of the body. Many children also get ear infections.

While the main symptoms of measles are bad enough, the reason we vaccinate against measles is to prevent the complications associated with it―such as pneumonia and encephalitis (an infection of the brain).
Not good. Measles can cause serious health complications, especially in young children. In the United States, 1-2 out of every 1,000 children who get measles die from it. A similar number of children will have infection of the brain and many go on to have long-term brain damage. The disease is even more severe in developing countries, where as many as 1 out of 3 children who get measles die from it.

The MMR vaccine is a live vaccine, which means it contains weakened forms of the viruses. In order to work, those weakened forms of the virus need to multiply to create an immune response.
Since the natural protection newborns get in the womb wears off gradually over a period of months, the viruses may not be able to multiply the way they would when the baby is a little older. That’s why we recommend the first dose of MMR vaccine starting at 12 months of age. Not because it’s dangerous, but because that’s the age at which the vaccine works best.
Most people of child-bearing age have been vaccinated against measles, mumps and rubella―and so are protected against these diseases.
If a pregnant person was not previously vaccinated against measles, they cannot receive the MMR vaccine until after delivery. This is because the MMR vaccine is prepared with weakened live viruses (in contrast to many vaccines that are prepared with killed viruses). Doctors usually advise people to avoid getting pregnant for at least one month after receiving the vaccine to reduce the risk of becoming infected.
If a non-immune pregnant person is exposed to measles, it may cause health problems to them and their unborn baby. In a CDC study, the most common effect to pregnant people was pneumonia, and the most common fetal/neonatal effect was premature delivery. If the pregnant person is exposed within 10 days of delivery, it likely will cause a serious infection in their newborn.
Anyone born before 1957 is generally considered immune to measles. This means they are fully protected from measles for life and no additional vaccination is necessary.

The CDC also considers people who received two doses of measles vaccine as children protected for life. They do not ever need a booster dose.
If you’re unsure whether you’re immune to measles, you should first try to find your vaccination records or documentation of measles immunity. If you do not have a record of measles immunity, you should get the MMR vaccine. There is no harm in getting another dose of MMR vaccine if you may already be immune to measles (or mumps or rubella).

All About the Recommended Immunization Schedules

Can vitamin A prevent or cure measles?

How to Protect Your Child During a Measles Outbreak

Sean T. O’Leary, MD, MPH,FAAP, is a pediatric infectious diseases expert at the University of Colorado. He is the chair of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases.

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