Measles may seem like a disease of the past. Indeed, the highly contagious virus was declared eradicated in the United States in 2000 after a full year had passed without any infections. But times have changed. Texas is now experiencing the largest measles outbreak in nearly three decades, and the virus is spreading across the country.
The good news is that most people are protected against measles, as two doses of the MMR (measles, mumps, rubella) vaccine are standard practice in the U.S. for children. A single dose of this vaccine is 93% effective against measles, while two doses are 97% effective, according to the CDC.
However, not everyone has the protection they need — including some who have received a vaccine. Here's what you need to know about who requires extra protection to reduce the risk.
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Where measles is spreading
As of April 11, the CDC reported 712 measles cases in 25 states. Of those sickened, 11% 979 people) have been hospitalized. Of those who contracted measles, 97% were unvaccinated.
Even if your state is not listed here, there may be active measles cases in your area. For example, Maryland recently reported that an individual with measles had traveled through Dulles International Airport, potentially spreading the virus beyond the state.
There have also been two confirmed deaths from measles, and another is under investigation, according to the CDC.
Measles vaccine boosters are recommended for some groups
While modern measles vaccines are highly effective, older versions of the vaccine may provide inadequate protection.
If you were vaccinated in the 1960s
"Some people who received the old, inactivated measles vaccine between 1963 and 1967 may benefit from a booster with the live MMR vaccine," advised Dr. Elizabeth Hammershaimb, an infectious disease pediatrician with the University of Maryland Children's Hospital and an assistant professor at the University of Maryland School of Medicine.
About 600,000 to 900,000 people in the United States received the inactivated vaccine, according to Johns Hopkins. Still, anyone vaccinated during that period should check their vaccine records to confirm which version of the shot they received.
Note that some institutions also recommend people immunized in 1968 get the booster. That's because the rollout of the improved vaccine may not have started on the first day of that year.
Immune-compromised people and other groups
Certain other groups may also benefit from an additional dose of the MMR vaccine as well. "People with a history of immune-compromising conditions, and nonpregnant women of childbearing potential without evidence of immunity, may also benefit from a booster on a case-by-case basis," Dr. Hammershaimb said.
Born before 1957
Johns Hopkins also explains that older adults born before 1957 are presumed to have natural immunity as they were likely exposed to measles before vaccines became available. However, Yale Medicine recommends that high-risk individuals, including healthcare workers born before that time, consider a booster if they do not have proof of immunity.
Can you check your immunity? Should you?
If you are concerned about whether you have the necessary protection against measles, there are steps you can take to find out.
"You can get measles titers done and that will show if you are protected," explained Dr. Amy Edwards, FAAP, an associate professor of pediatrics at Case Western Reserve University School of Medicine.
MMR titer tests are simple blood tests that confirm whether you are immune to measles due to other vaccination or prior infection. Titer tests are quick and affordable and can be obtained through your healthcare provider or through third-party labs like Labcorp.
"A measles titer test, which checks for immunity to measles, can typically cost around $83 to $129," advised Dr. Peter Zimmerman, PhD, professor of pathology at Case Western Reserve University. Unfortunately, Dr. Zimmerman said that health insurance typically does not cover titer tests.
Dr. Hammershaimb also explained that "antibodies may not represent the full picture of a person's immunity against measles. Low titers may be a clue to low immunity to measles, but there are other pieces of the immune system that are more difficult to measure and that may provide some protection even if antibody levels are low."
Because of these downsides, Dr. Edwards believes titer testing is more hassle than just getting the shot, especially as data has shown that "people who (for various reasons) get more than 2 doses of the MMR aren’t at increased risk of adverse reactions to the vaccine so it appears to be safe, though those studies are small."
How much does the measles booster cost?
If you are concerned about your immunity levels and want to get an MMR booster, the good news is that most private insurance policies cover the vaccine with no out-of-pocket costs, even if you have not met your deductible. Medicare Part D will also cover the vaccine for those enrolled.
For the uninsured, vaccines are widely available at walk-in clinics, including at drugstores like CVS and Walgreens. These vaccines are relatively affordable, as Bettercare reports the average cost per dose is around $90 to $125, making the cost for the complete series of two shots $180 to $250.
Get your measles booster ASAP if you need it
If you doubt your immunity to measles, do not wait to act. Before the introduction of the vaccine, an estimated 48,000 people were hospitalized annually, with 400 to 500 measles-related deaths each year. There's no reason to take that chance when you can virtually eliminate your risk with a simple, wildly-available shot today.
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