Ask PolitiFact: Who can get the measles and is the vaccine safe?

Texas reported the first measles death Feb. 26, in an unvaccinated school-aged child, related to an ongoing outbreak in the state. It’s the first U.S. measles death since 2015.

The U.S. Centers for Disease Control and Prevention has reported three measles outbreaks, including in Texas and New Mexico, in 2025. Public health experts said weakening vaccination rates and rising vaccine skepticism have left some communities at greater risk for measles outbreaks.

PolitiFact dug into some common questions about the ongoing outbreaks and the measles, mumps and rubella (MMR) vaccine. Here’s what you should know.

Measles is an infectious disease caused by the measles virus. It usually causes a fever, rash, a runny nose and red, watery eyes. More serious complications can include pneumonia, ear infections and encephalitis, or brain swelling. 

Measles is highly contagious. Without a vaccine, 9 out of 10 people exposed to measles will become infected, the CDC said. About 1 to 3 of every 1,000 children with measles will die, usually from pneumonia or neurologic complications.

People who have had measles before are unlikely to be reinfected and presumed to be immune, the CDC said.

People of all ages can contract measles, and cases are overwhelmingly reported in people who have not been vaccinated against the disease, CDC data shows.

Of the 285 people in the U.S. who contracted measles in 2024:

• 89% were either unvaccinated or their vaccination status was unknown. 

• 7% had received one vaccine dose.

• 4% had received two vaccine doses.

"Those unvaccinated and exposed to measles virus have a 90% chance of infection," said Patsy Stinchfield, a past president of the National Foundation for Infectious Diseases. "Those vaccinated with 2 doses of MMR have a 3% chance of infection as they may have not built protective antibodies to measles. MMR vaccine substantially lowers your risk for disease." 

When outbreaks occur, they’re usually in pockets of communities with low vaccination rates, Johns Hopkins University Institute for Vaccine Safety Director Daniel Salmon said. 

Serious complications from measles are most common in children under age 5 and adults over age 20, according to a Yale Medicine blog post. In 2024, more than half of people under 5 with measles were hospitalized, the CDC reported.

Before the vaccine’s introduction in the U.S. in 1963, nearly everyone contracted measles in childhood. In the decade before the vaccine’s availability, 400 to 500 people died from measles each year in the U.S.

In a meeting with President Donald Trump’s Cabinet Feb. 26, Health and Human Services Secretary Robert F. Kennedy Jr. said the CDC was closely monitoring measles outbreaks. 

"It’s not unusual," he said. "We have measles outbreaks every year."  

There were 16 measles outbreaks reported in 2024 and four outbreaks reported in 2023, the CDC said. Its website lists at least one measles outbreak every year from 2022 to 2013, except in 2020.

As of Feb. 28, there were at least 146 cases related to the outbreak in West Texas, where the child died. 

The CDC said measles was declared eliminated in the U.S. in 2000, meaning it was not regularly spreading. But it can be brought into the U.S. when people travel internationally and contract the virus. Public health experts said the frequency of measles outbreaks in the U.S. has been growing since 2000.

Cases were becoming more common until COVID-19-related isolation measures and travel restrictions drove cases down in 2020, Salmon said. 

"The increase in vaccine hesitancy, and more specifically some parents refusing vaccines, leaves us very susceptible to widespread measles outbreaks," Salmon said.

In the 2019-2020 school year, 95% of kindergarteners had received the MMR vaccine, the target to achieve herd immunity. The number fell to 93% for the 2023-24 school year, the CDC reported.

The MMR vaccine is safe, and the vast majority of people who get the vaccine will have no side effects; it is much safer than having measles, mumps or rubella, the CDC said.

The CDC recommends children receive the first vaccine dose between 12 months and 15 months of age, and a second dose at ages 4 through 6. 

The vaccine has been linked with a very small risk of fever-related seizures and allergic reactions, the CDC said. The risk for fever-related seizures is not associated with any long-term effects, and the risk for seizures related to the vaccine increases as children get older, the CDC said. 

During his Senate confirmation hearing, Kennedy denied questions about his role in promoting vaccine skepticism that led to a deadly measles outbreak in Samoa and said he supports measles vaccination. 

"I support the measles vaccine," he said. "I support the polio vaccine. I will do nothing as HHS secretary that makes it difficult or discourages people from taking either of those vaccines." 

Kennedy has long argued that childhood vaccines are linked to autism, despite numerous studies finding no support for that stance.

People who receive both recommended doses of the MMR vaccine are generally considered to be protected against the diseases for life. The CDC said evidence indicates that "measles immunity appears to be long-term and probably lifelong in most persons."

"For those of us who are fully vaccinated against measles, the risk, a lot of people are worried about, what’s your risk in the community? Your risk is extremely, extremely low, of having any issues at all with measles," said Lara Johnson, a pediatric hospitalist and chief medical officer for Covenant Health in Lubbock, Texas, in a recent press conference.

Because a small portion of vaccinated people can still be infected, high community vaccination rates are key to preventing measles from spreading, experts said.

Most people who received one or two MMR vaccine doses in childhood do not need to be revaccinated, the CDC said. 

Some people vaccinated in the 1960s may need to be revaccinated. That’s because the inactivated MMR vaccine, which was available from 1963 to 1967, was not effective. People who received an inactivated vaccine should get at least one dose of the live vaccine, the CDC said. 

People born before 1957 are presumed to have natural immunity because they are likely to have had the disease as a child. 

People who aren’t sure and don’t have records of being vaccinated should be vaccinated, the CDC said. If you don’t know your vaccination status, the CDC said you should talk with your doctor about getting vaccinated. 

"If it’s uncertain, we would still go ahead and recommend that you get vaccinated again," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "There’s not a problem with having had more than two doses of the vaccine, if in fact you’re not sure if you had one at all."