A Rutgers Health expert discusses the myths and realities of the measles outbreak and the vaccine gap that is putting Americans at risk
The rate of measles outbreaks in the United States is rising: Last year, there were 16 outbreaks, up from four in 2023.
So far in 2025, there have been three outbreaks of measles with cases reported in 12 states and confirmed deaths of an unvaccinated child and unvaccinated adult. With kindergarten vaccination rates declining nationwide, more communities may be at risk for contracting a disease that was declared eliminated in the United States in 2000.
Measles, a highly contagious respiratory infection - up to nine out of 10 people who come into contact with the disease contract it - that causes serious complications, has been grabbing headlines with outbreaks in Texas, New Mexico and Bergen County in New Jersey. Most of the 222 cases are among children who hadn't received the measles, mumps and rubella vaccine.
Margaret Quinn, a clinical professor specializing in pediatrics at the Rutgers School of Nursing, discusses the myths and facts about measles and its vaccine and how to protect yourself and your family.
According to current Centers for Disease Control and Prevention reports, 94% of the current measles cases we are reading about were in unimmunized people; 80% of current cases are children under 19 years old.
Margaret Quinn
Clinical Professor, Rutgers School of Nursing
How does an outbreak occur after measles was considered eradicated in the United States?
Outbreaks of measles occur as we are a worldwide community. We are easily connected by travel, and other countries do not have the vaccination requirements or compliance rates that we have in the United States. Add an at-risk individual - an unvaccinated child who contracts measles - and you can see how this can easily spread in communities.
Many parents are choosing to not immunize their children, which causes a vulnerable gap for measles to spread. Statistics show if 90% of the population are not immunized with the measles vaccination, infections can occur and spread. Even those who are immunized have a small risk of contracting the measles virus - just not as severe.
According to current Centers for Disease Control and Prevention reports, 94% of the current measles cases we are reading about were in unimmunized people; 80% of current cases are children under 19 years old.
There are certainly pockets of vulnerability in New Jersey. According to data from the New Jersey Department of Health, the five counties that have the highest proportion of children who have not been vaccinated due to religious exemption are Atlantic, Cape May, Monmouth, Ocean and Sussex. A parent's decision not to vaccinate a child against measles puts infants everywhere at risk for this killer disease.
How contagious is measles compared with other diseases?
Per the CDC, measles is one of the most contagious viruses on the planet. One infected person can transmit measles to 12 to 18 people. To put it in perspective, one person with the flu can transmit to three people. The measles is spread through small droplets and can remain in a room for up to two hours in the air after the infected person leaves the room.
Who is most at risk, and what are the complications of contracting measles?
Those who are most at risk are children under 12 months of age as they have not had their measles vaccine yet. Children over 12 months of age who are not immunized are also at highest risk. Those with compromised immune systems from cancer treatments, radiation or other immune treatments are also at highest risk.
Complications from a measles infection can cause serious illness requiring hospitalization - even in previously healthy children. There are risks of bacterial infections such as pneumonia or encephalitis (an inflammation on the brain). We are most concerned about permanent brain damage as well as death from these outbreaks, which can be very severe. Ear infections causing hearing loss and eye infections causing blindness also can occur.
I have taken care of children from the 1989 outbreak, and to this day, I remember how sick these children were.
Measles is one of the most contagious viruses on the planet. One infected person can transmit measles to 12 to 18 people … up to nine out of 10 people who come into contact with the disease contract it.
Margaret Quinn
Which are the common misconceptions about the vaccine that prevents people from giving it to their child?
Current myths and beliefs that the measles vaccination "causes autism" are not true and have been disputed and proven incorrect. The measles vaccination has been safe and reliable for over 60 years. Unfortunately, the internet and social media have sparked distrust in the safe and effective vaccination schedule that has been in effect for decades.
Are adults vulnerable?
Most people born before 1957 are immune to measles. Adults vaccinated between 1963 and 1968 should check their immunization status to see if they have the most current vaccination formulation. Most born after 1968 have received the current vaccination formula and are protected. Certain adults may need a booster. Anyone living in a group setting, health care personnel or international travelers may need a booster.
Pregnant women are also at risk due to the stress on their immune system.
Measles vaccination protection does not decrease over time so most who are immunized are safe from contracting the disease.
Should vaccinated adults check their immunity with titer tests, which measures a person's level of antibodies in a blood sample?
This is a discussion to have with your primary care provider. As stated, most adults are appropriately vaccinated, but there may be individual health concerns or risks that can best be decided by your PCP. It is not routine to check titers.
Do adults need booster shots?
After the measles outbreak in 1989, the recommendation for two measles vaccinations was started, providing 97% effectiveness in protection for those born after that time. If you do not have your vaccination records with proof of measles immunization, you can receive a booster vaccination without harm. Currently, there is no advisory for adults to receive boosters.
