Measles in Adults: Symptoms, Risks, and Vaccination Advice

As of March 20, 2025, the Centers for Disease Control and Prevention (CDC) has reported 378 confirmed measles cases and two deaths in the United States. While nowhere near the current number of cases of flu (2,600+), the number already exceeds the total for all of 2024.

Manju Mathew, RN, Senior Director and Chief Infection Prevention Officer at Baystate Health says, “There’s no need for widespread panic but there is cause for concern.”

She explains, “Measles is highly contagious—even more contagious than the flu, COVID, and even Ebola. It can stay alive for up to two hours after an infected person has left an area and you can contract it by breathing contaminated air or touching an infected surface.”

What Causes Measles Outbreaks

According to Dr. Jacob Smith, also with Baystate Infectious Disease, “It’s important to note that measles was considered eliminated in the U.S. in 2000, thanks in large part to high vaccination rates. ”

Significant outbreaks occurred in the greater New York metro area, Chicago, and the Minneapolis area as recently as 2023.

“But even with the small window for breakthrough cases,” says Dr. Smith, “vaccines are the best possible defense against measles. In fact, in 95% of this year's cases, people who were infected were either unvaccinated or their vaccination status was unknown.”

Further compounding things is the fact that vaccination rates for measles and other diseases are declining across the country. Dr. Smith notes, “Vaccine rates dropped off during the COVID pandemic in 2020 and, in many areas, have remained in decline. Now you have the unvaccinated babies of the pandemic entering kindergarten, leaving pockets of the population vulnerable to mass outbreaks.”

To Dr. Smith’s point, the Centers for Disease Control and Prevention (CDC) estimate 280,000 U.S. kindergartners are currently unvaccinated against measles.

But the concern around lack of immunity isn’t restricted to children.

Measles Vaccination Recommendations for Adults

While most of this year’s measles cases have been among children, some adults are not immune. Some adults who were vaccinated prior to 1968 received a less effective form of the vaccine.

Dr. Smith explains, “Adult immunity depends upon when you were born and what vaccine you received. If you were born before 1957, you most likely were exposed to measles as a child and have natural immunity. But if you were born after 1957, it’s a little trickier. That’s because, between 1963 and 1967, about one million people received a version of the vaccine that was found to be less effective. While the problem was addressed by 1968, people who got the vaccine in that window may not be protected against the virus.”

He continues, “As most adults born between 1963 and 1967 likely don’t remember or have access to records of which vaccine formulation they received or when, they should get at least one dose of the current MMR (measles, mumps, and rubella) vaccine. Even if you got an effective vaccine as a child, there’s no risk associated with getting another one now.”

Dr. Smith adds, “The reasons to not get the MMR vaccine are current pregnancy or severe immunocompromise.”

Symptoms of Measles in Adults

As the number of cases and risks for exposure continue to rise, it’s important to be mindful of the earliest symptoms of measles so that you can quarantine and contact your doctor. Symptoms typically appear within five to 21 days of exposure and include:

• A high fever
• Cough
• Congestion
• Runny nose
• Watery eyes, especially in children

After four days of the onset of the first symptoms, a rash develops on the head and face and progresses down the body. Notably, people with compromised immune systems do not always develop a rash.

“If you suspect you might have measles or that you’ve been exposed to the virus, the most important thing to do is to call before going to the doctor’s office or the ER. Instead, contact your doctor from your home to discuss the symptoms and mention the concern for measles,” says Manju. “The virus is highly contagious, and you don’t want to spread it to others, especially those who are already sick.”

Virtual health appointments, like those offered by Baystate, make it possible to connect with a doctor using video and audio to assess your symptoms and prescribe a treatment.

For the latest information about measles outbreaks, consult your local health authority or the CDC's measles cases and outbreaks tracking.