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Measles outbreaks are becoming more of an issue confronting local health providers as vaccinations drop. Direct Relief has been supporting local health centers and clinics with protective gear, respiratory medications, pain relievers, and other requested medical aid to support patient care. (Adobe Image)
For decades, measles existed mostly as a memory in the United States, a disease largely consigned to textbooks and history lessons. After the measles vaccine was introduced in the 1960s, cases decreased from millions each year to near elimination. Parents could stop fearing the fever and rash that once defined a pervasive, sometimes deadly childhood illness.
But in recent years, measles has returned in the U.S., with a 25-year high last year of 2,144 cases. As of Friday, 1,136 confirmed cases have been reported so far this year.
According to experts, including Dr. Nicole M. Iovine, an infectious disease physician and hospital epidemiologist at the University of Florida, the resurgence is driven by a simple and dangerous reality: more people are no longer immune. As vaccination rates decline or families delay routine immunizations, even small pockets of vulnerability can allow the virus to spread rapidly.
“You only have to open the door a little bit,” said Dr. Iovine. “And it’s going to come in.”
The Danger of Declining Vaccination Rates
Measles is among the most contagious viruses known. If one infected person enters a room, the virus can linger in the air for up to two hours after they leave. Among unvaccinated people exposed to measles, roughly 90 percent will become infected.
The consequences can be severe, especially for children. About one in five infected children requires hospitalization, according to data from the U.S. Centers for Disease Control and Prevention. About one in 20 kids will develop pneumonia. Others suffer seizures from high fever. In rare cases, about one in every 1,000 infections, the virus causes encephalitis, a dangerous swelling of the brain that can leave permanent damage. Between one and three children in every thousand infected will die.
“It’s not the common cold,” Dr. Iovine said. “Measles is a serious illness. It can cause permanent harm, particularly in children.”
The MMR vaccine, which protects against measles, mumps, and rubella, is highly effective. Two doses provide about 97 percent protection. But when vaccination rates fall below roughly 95 percent of a population, the protective barrier known as herd immunity begins to weaken, allowing outbreaks to take hold.
That dynamic is now playing out in parts of Florida, where the kindergarten measles vaccination rate is 88.8%, as per the CDC. A recent outbreak at Ave Maria University, located in southwest Florida’s Collier County, infected at least 57 students.
Florida Health Center Responds
At Healthcare Network, a federally qualified health center that serves about 50,000 patients in Collier County, medical leaders moved quickly when measles cases began appearing nearby earlier this month.
“Our medical teams were caring for patients with symptoms consistent with measles,” said Dr. Jaime Khemraj, the network’s chief medical officer. “Because it’s so contagious, we wanted to ensure we were prepared for what could happen next.”
The health center activated an incident command structure, a system more commonly associated with disaster response, to coordinate staff, review treatment protocols and prepare for the possibility of a surge.
They reviewed how to protect healthcare workers, conduct educational outreach, and manage complications such as dehydration, respiratory distress and secondary infections. Children with measles often develop high fevers, sometimes exceeding 105 degrees, which can lead to dangerous fluid loss and seizures.
Healthcare Network was well-positioned to respond due to its preparation. Roughly 92 percent of its pediatric patients are vaccinated against measles, a rate higher than many surrounding communities. The organization also requires its staff to demonstrate immunity, either through vaccination or testing, ensuring that healthcare workers can safely care for patients during outbreaks.
“Our underserved population was well served by being vaccinated and protected,” Dr. Khemraj said.
Still, preparation did not eliminate uncertainty. Measles outbreaks can escalate quickly, and clinics must be ready to respond to needs beyond their usual capacity.
In anticipation, Healthcare Network requested additional medical supplies. Direct Relief responded with respiratory medications, antibiotics to treat secondary infections, over-the-counter fever reducers, protective equipment, and hydration products.
Direct Relief staff prepare a shipment of medicines, protective equipment, and other requested supplies on Feb. 6, 2026, to support a health center responding to a measles outbreak in Florida. (Shannon Hickerson/Direct Relief)
“The fact that organizations like Direct Relief can provide medications and supplies gives us the ability to respond almost overnight,” Dr. Khemraj said. “It allows us to care for patients and protect the community if cases increase.”
So far, the clinic has not experienced the overwhelming surge seen in some outbreaks. But physicians remain cautious. Measles spreads most easily in dense settings such as schools, dormitories or households where multiple generations live together.
Children are especially vulnerable. Infants cannot receive their first measles vaccine until 12 months of age, leaving them completely unprotected during their first year of life.
The resurgence of measles, physicians say, reflects not only biology but memory. As the disease became rare, its dangers became easier to forget.
One persistent misconception is that measles is a mild childhood illness. In reality, its complications can be devastating, even in otherwise healthy children.
“It’s a serious, serious illness and it can have really long -lasting permanent damage, particularly in children. I don’t think people know bad measles can be,” Iovine said.
Public health experts emphasize that vaccination remains the most effective tool for preventing outbreaks. When most people are immunized, the virus has nowhere to spread. But when immunity declines, even briefly, measles can reestablish itself with alarming speed.
“We’ve had more than 50 years of experience with this vaccine,” Dr. Iovine said. “It’s one of the safest and most effective vaccines we have. The risks of measles itself are far greater.”
frequently asked questions: measles
If you have had measles, can you get it again?
In most cases, no. If you had measles as a child, your immune system builds lifelong protection against the virus. Before the measles vaccine was introduced in the 1960s, almost every child worldwide caught measles and became immune for life. CDC That said, getting measles a second time is rare but not impossible. Studies have found that a small number of people — including some who were vaccinated — have been reinfected. When reinfection does happen, symptoms are usually much milder than the first time. PubMed Central
Can adults get measles?
Yes, adults can get measles — and when they do, they are more likely to have serious complications than children. If you were born in 1957 or later and have never been vaccinated or had measles, you should get vaccinated. NFID Most adults need at least one dose of the MMR (measles, mumps, and rubella) vaccine. If you are a college student, trade school student, or in another high-risk setting, two doses are recommended for the best protection. NFID
I had measles as a child — am I immune?
Almost certainly yes. If you were born before 1957, you most likely had measles as a child before the vaccine existed, and that infection gives you lifelong immunity. If a blood test shows you have measles antibodies (called measles IgG), you are protected and do not need the MMR vaccine. CDC However, if you have no written proof of immunity or past illness, it is a good idea to get vaccinated anyway. Getting an extra dose of MMR is safe and will not harm you if you are already immune. When in doubt, ask your doctor — they can run a simple blood test to check. CDC
Can you get measles if you are vaccinated?
It is very unlikely, but possible. In 2025, the U.S. reported 2,144 confirmed measles cases. Of those, 93% were in people who were unvaccinated or whose vaccination status was unknown. NFID Two doses of the MMR vaccine are about 97% effective at preventing measles. NFID If you received both doses on the recommended schedule starting at 12 months of age, you should be protected for life and do not need a booster. CDC On the rare occasion that a vaccinated person does get measles, their symptoms are typically milder, and they are less likely to spread the virus to others.
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