Amid rising measles cases, and one death from the disease, some ask 'Do I need an MMR booster?'

Caption

A sign reading "measles testing" is seen as an outbreak in Gaines County, Texas, has raised concerns over its spread to other parts of the state, in Seminole, Texas, U.S., February 25, 2025. REUTERS/Sebastian Rocandio

There was an measles outbreak when Candace DeMatteis was in college — back before cellphones were ubiquitous and the idea of photographing and texting a copy of vaccination records was unheard of.

"I literally was kicked out of class, had to go to the infirmary and get my vaccine, my MMR, updated or, you know, a booster, even though I'd been vaccinated," she said. "No ill effects whatsoever."

DeMatteis, who is now vice president of policy and advocacy for the Partnership to Fight Infectious Disease (PFID), said she needed that proof to go back to class without fear of spreading a potentially fatal disease.

For every 1,000 children who get measles, one or two will die, according to the Centers for Disease Control and Prevention. 

A school-age child, who was not vaccinated against measles, was confirmed by state and local health officials to have died of the preventable disease, weeks into an outbreak that spans Texas and New Mexico.

• MORE: A child has died in the Texas measles outbreak

It's the first reported U.S. death from the illness since 2015.

"It's predictable, when measles occurs in unvaccinated children and adults," said Dr. Carol Baker, a pediatrician and infectious diseases specialist who's retired from the Baylor College of Medicine, "I'm not surprised, but I am so sad."

How do I know if I'm vaccinated? Do I need a booster?

Vaccines against measles, mumps and rubella work. That's why cases are rarely reported and deaths from measles have been almost unheard of in the United States, until this week when an unvaccinated child died in Texas.

"We're not as worried about the risks of diseases that we just don't experience," DeMatteis said. 

Credit: Centers for Disease Control and Prevention

Measles is one of the most contagious human viruses but it is almost entirely preventable through vaccination. Herd immunity, when 95% or more members of the community are immune, protects those who cannot be immunized. 

But the world is well below that, with an estimated 81% of children receiving their first measles-containing vaccine dose, and only 71% of children receiving their second measles-containing vaccine dose, according to a joint publication by the World Health Organization (WHO) and CDC.

The 2022 report showed the lowest global coverage rates of the first dose of measles vaccination since 2008, although coverage varies by country.

"For many diseases, immunity wanes over time," DeMatteis said. "So, with a very high vaccination rate in the U.S. against measles, your risk of contracting it, even if your immunity had lessened somewhat, is low."

Vaccination status is a conversation DeMatteis strongly recommends people have with their health care provider, especially those who may be undergoing cancer treatment or have an autoimmune condition.

• MORE: Measles case reported in Atlanta; DPH seeks those who may have been exposed

The recent rise in measles outbreaks has people questioning whether they had a measles vaccination as a child. 

When immunization records aren't available from your health care provider, every state, as well as the District of Columbia and most U.S. territories, maintains an immunization registry called an immunization information system (IIS).

Medical and religious exemptions

Vaccine mandate recommendations come from the federal level, which is where the new Health and Human Services secretary and other public health officials can have a pretty profound influence, DeMatteis said.

Mandates and allowing exemptions from those mandates happens on a state level. So, by not requiring childhood vaccines to attend public school, more students are at risk, she said.

"We're already seeing some states broadening the opportunity for exemptions," she said. "The measles outbreak that I mentioned in Texas, that county in Texas has one of the highest exemption rates from mandatory vaccines for children."

More than one-third of children in the United States do not receive vaccines on schedule as recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP), leaving children vulnerable to preventable infections, diseases, and their complications, a study published in Pediatrics suggests.

That's an increase from about 16% in 2019, before the COVID-19 pandemic, said the senior author, Robert Bednarczyk, Ph.D., assistant professor in the Department of Global Health in Emory’s Rollins School of Public Health.

“It is notable that even for children who did not adhere to the recommended schedule, some did reach up-to-date status in childhood, but at the cost of additional vaccination visits — approximately 3 additional visits were needed to get to up-to-date status,” Bednarczyk said.

Most U.S. children are vaccinated against 14 potentially serious illnesses by age 2, as recommended by the ACIP.

That could change.

HHS Secretary Robert F. Kennedy Jr. said he plans to investigate the childhood vaccination schedule that prevents measles, polio, and other dangerous diseases, despite promising not to during his confirmation hearing.

In a public opinion poll from PFID, the majority of people recognized the public health benefits and supported continued availability of FDA approved vaccines, and that included parents, 88% of whom said they follow their health care providers recommendations when it comes to getting their children vaccinated.

"We found in our poll, 70% of those polled are concerned about the lower rates of childhood vaccines and want to be able to continue to have that access," DeMatteis said. "And that is one thing that the new HHS secretary has promised: that if you want to get vaccinated, you will be able to have those vaccines and have access to those vaccines."

Medicare covers flu vaccines, pneumonia vaccines and others at no cost, DeMatteis said, and there is a vaccine program for children that helps to subsidize the vaccine costs for children.

"Many people get their health care access through Medicaid, particularly children, and vaccination is a major part of that," she said. "So, if it becomes more expensive, if access is harder to find, that certainly will depress our vaccination rates and unfortunately could lead to more outbreaks."

As of Feb. 20, 2025, one school-aged child died of measles and a total of 93 measles cases were reported by eight jurisdictions: Alaska, California, Georgia, New Jersey, New Mexico, New York City, Rhode Island and Texas.