Let's Talk About Measles – by Dr. Brandon Greene, Chief of Pediatrics

We live in an age where information is everywhere and trust is hard to come by. If you've ever finished reading about a health topic and felt even less informed than when you started—you're not alone, and you're not doing anything wrong. The sheer volume of competing voices makes it difficult to know who to listen to. Recently, you may have seen headlines tracking measles outbreaks across the country. Some might be downplaying measles as “just a rash”. Others may be fearmongering or pointing blame. Still others may be offering to sell you something they promise to be protective or curative.

So, let’s talk about measles—a disease that many of us in pediatrics hoped was safely behind us.

A Disease We Once Put to Rest

Measles is not new. For centuries it was an unavoidable childhood illness. Until recently, almost every person on the planet could expect to be eventually infected. It killed millions worldwide every year, often the very young. The measles vaccine, which came out in 1963, changed everything. Case counts plummeted and by the year 2000, the U.S. Centers for Disease Control and Prevention (CDC) declared measles eliminated from the United States—meaning the disease was no longer spreading among us. “Herd immunity” had been achieved. It was an amazing feat, decades in the making.

Measles Is Back

Sadly, that triumph is now under serious threat. Vaccine coverage among U.S. kids starting school during the 2019-2020 school year was 95.2%. When that coverage falls below 95%, measles finds its footing again and will keep spreading. Since then, the vaccine rate has been falling, and in the 2024-2025 school year, the U.S. child vaccine rate fell to 92.5%. In fact, over three-quarters of U.S. states—39 of them—had MMR (or measles-mumps-rubella) vaccine rates below the 95% target for 2024-2025.

As a result, last year the U.S. recorded 2,284 confirmed measles cases. It was the highest single-year count in more than 30 years, and nearly eight times more than the 285 cases reported in the year prior. By the third week of March 2026, 1,487 cases had already been confirmed across 32 states. At that rate, we are well on our way to pass last year’s record-breaking case count before the end of April. The U.S. is now at risk of losing the measles elimination status it took 40 years to earn.

The Most Infectious Disease on Earth

To understand why measles is so difficult to contain, it helps to know just how easy it is to spread.

Measles is extremely easy to transmit. The virus travels through the air in tiny droplets—and it can remain in the air for up to two hours even after an infected person has left the room. A child with measles is contagious for four days before a single spot or rash appears, meaning they can spread it to another person long before anyone realizes they are sick. If that child goes to school, up to 90 percent of those who come in contact with them will become infected if they haven’t had it or the shot before. A single child with measles will infect on average between 12 and 18 others before they’ve fully recovered.

For these reasons, measles is widely considered to be the most contagious disease ever discovered—roughly 10 times more so than the flu and five times more than the original COVID-19 virus.

Natural Immunity Isn’t Better

We invite parents to bring their questions to us for open and honest discussion that’s based in the latest evidence, and not on the latest trend. In the past months, we’ve received many great questions from concerned families looking for up-to-date advice for their children about measles. We’d like to cover just a few of the most common concerns we’ve heard in this article.

Isn’t measles just a rash? 
Even in the United States, with access to modern medicine, about 1 in 5 children with measles will need to be hospitalized. Complications include pneumonia (lung infection)—the leading cause of measles-related death—and ear infections that can lead to permanent hearing loss. In about 1 in every 1,000 cases, measles causes encephalitis: swelling of the brain that can cause seizures, permanent disability, or death. Globally, about 2 to 3 children per 1,000 who get measles in developed countries will die from it.

Isn’t “natural” immunity better than vaccine immunity? 
This one deserves a longer answer. Measles infection does confer lifelong immunity from any future measles outbreaks. But so does the vaccine—without the 2-3 in 1,000 risk of death, 1 in 1,000 risk of encephalitis, 1 in 20 risk of pneumonia, or 1 in 5 risk in young children of needing to be hospitalized. But what many families don't know is that measles doesn't always end when the rash fades.

For more than a century, doctors had noticed something different about the children who survived measles. They were immune to future outbreaks of measles—but unusually vulnerable to other infections. It was called the “measles paradox”—many survived measles only to die from flu, pneumonia, or diarrhea, sometimes years later. In 2019, a landmark study in the journal Science finally showed why. The measles virus targets and destroys our immune system's memory, and not just briefly—but deeply—and for years. In that study, measles destroyed between 11% and 73% of children's pre-existing memory against other illnesses. The researchers called this immune amnesia.   This leaves children who “recover” from measles more vulnerable to illnesses they should have already had protection from—either through past infection or through a vaccine. This effect is not seen in children who received the shot. The vaccine protects not only against measles itself, but against many more illnesses that might follow it.

Then there is a second long-term consequence of measles that every parent deserves to know about, even though it is rare. It’s called subacute sclerosing panencephalitis (SSPE). SSPE is a progressive and universally fatal brain disease caused by a form of the measles virus that can lie hidden in the brain for years. SSPE can develop years to decades after the original measles infection. It may begin subtly with behavioral changes, memory problems, or declining school performance. But over weeks to months, it progresses to seizures, dementia, loss of body control, and eventually coma and death. The risk of SSPE is estimated at approximately 4 to 11 per 100,000 measles infections overall, but for infants infected before their first birthday, the risk is dramatically higher—with one estimate as high as 1 in 609. Importantly, SSPE is caused exclusively by the measles virus, and not the vaccine. A child who contracts measles today carries a quiet risk—silently—for decades following the illness. And there is no cure or effective treatment.

In the case of measles, “natural” immunity definitely isn’t better. The vaccine is the only way to prevent immune amnesia or SSPE.

Can Vitamin A prevent or cure measles? 
Many may have seen a Fox News editorial last year claiming that Vitamin A "can dramatically reduce deaths from measles" and discussed cod liver oil as a treatment. This one is a half-truth that has steered many away from the vaccine, unfortunately making the spread of the disease easier. Vitamin A can help reduce the severity of measles in those who have low Vitamin A levels (about 0.3% of people in the U.S.) and may be used in some who have been infected and are sick enough to be in the hospital. But some children hospitalized with measles in the most recent outbreaks had signs of too much Vitamin A. Too much Vitamin A is toxic and can be very dangerous. Vitamin A is neither recommended nor useful for preventing measles infection. It does not change how easy it is to catch or to transmit the virus. However, the vaccine does all of these things.

The MMR Vaccine: More Than 60 Years of Evidence

Most parents today—and even most grandparents—received the measles vaccine themselves. The first measles vaccine was licensed in 1963. The combined measles-mumps-rubella (MMR) vaccine was introduced in 1971. Since then, hundreds of millions of doses have been given worldwide, making it one of the most studied vaccines in the history of medicine.

Two doses of the MMR vaccine provide 97% protection against measles. Among those who contracted measles in the 2025 outbreaks, 97% were unvaccinated or had unknown vaccine status.

As your healthcare providers, it is always our responsibility to be honest about risk. No vaccine is entirely without risk, and the decision to vaccinate is always yours to make. But the data on the MMR vaccine are extensive and reassuring. The fraudulent 1998 claim attempting to link the MMR vaccine to autism has been studied rigorously—across millions of children, by independent researchers on multiple continents—and no scientific support could be found. Its author failed to disclose financial interest in its conclusion. He lost his medical license for scientific misconduct and fraud. His paper was formally retracted by its publisher. But the bell cannot be unrung, and his claim has without doubt put millions at risk of harm. The American Academy of Pediatrics, the American Academy of Family Physicians, and health authorities worldwide recommend the MMR vaccine as one of the safest and most effective tools in pediatric medicine.

Finally, for children who cannot yet be vaccinated—infants under 12 months, and those with certain immune conditions—getting their neighbors and families vaccinated is the only protection.

We’d Love a Conversation

We genuinely understand and empathize with the head-spinning that can result from trying to discern fact from fiction on social media or in the news cycle. Sources that were once dignified and reliably trustworthy now too often seem to have traded their well-earned authority for clicks and “likes.” What you can be sure of is that your pediatric providers at Bassett are reading and evaluating the latest scientific data so that you don’t have to. And we have only one goal—to empower you with the tools you need to make your child as healthy and as happy as possible.

So, if you have questions—about the MMR vaccine, its timing, children’s health history, or about anything you've read here or heard—please call us or bring them to your next visit. We’d love a conversation and we’re here to help.

About the Author
Brandon Greene, MD, FAAP, joined Bassett Healthcare Network in 2022 as the Director of Inpatient Pediatrics and practices as an Inpatient Pediatric hospitalist. He was appointed chief of Pediatrics in 2024. As chief, Dr. Greene oversees all of the network’s pediatric providers, including those who see patients at Bassett’s hospitals, outpatient clinics, and school-based health centers. Prior to joining Bassett, Dr. Greene practiced at Island Hospital in Anacortes, Washington. He is a 2012 graduate of Cornell Medical College and completed his residency at the University of Chicago Medical Center’s Comer Children's Hospital.