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Second Opinion: With Measles Cases Popping up Nationwide, What Should I Do to Be Safe?

Dr. Nina Birnbaum talks about the importance of measles vaccinations and your risk of infection.

This story is also available in Spanish.


Measles is spreading nationwide, with cases dispersed all over the country like we haven’t seen in decades. So much so, that the Centers for Disease Control (CDC) warns this outbreak could threaten our status as a nation where the disease is eliminated.

As of mid-April, 121 cases had been reported in the U.S. according to the Centers for Disease Control and Prevention. Only 58 cases were reported nationwide for all of 2023. In California, six cases have been reported so far, according to the California Department of Public Health.

However, the real number is probably much higher in both instances, notes Dr. Nina Birnbaum, medical director of Health Transformation at Blue Shield of California, as many cases go unreported, and there’s a time lag between onset of symptoms and diagnosis. The uptick is a reminder to make sure you and your family are immunized.

Nina Birnbaum headshot
Dr. Nina Birnbaum, Blue Shield of California

“Get yourself vaccinated,” Dr. Birnbaum urges. “Get everyone you love vaccinated. Convince people who are hesitant to go, because that's the one simple thing that makes a difference.”

We spoke with Dr. Birnbaum to learn more about the measles surge:

What is measles?

Measles, also known as “rubeola,” is caused by a virus. People infected typically have symptoms that start with a fever, tiredness, cough and watery eyes. After a few days, a blotchy rash typically forms on the face, then spreads to the rest of the body. Most people who get infected get better, but the disease can cause much more serious complications, such as pneumonia and/or encephalitis, which is a swelling of the brain.

How contagious is measles?

Measles is so contagious that up to 90% of people who are close to someone with the disease — and are not immune — will become infected, according to the CDC. The virus can live for up to two hours in airspace after an infected person leaves the area. And those with measles spread the disease before and after the rash appears, for roughly four days on each end.

How concerned should I be about the recent rise in cases?

You’re most vulnerable if your community’s vaccination rate is below 95%, because a small outbreak can spread rapidly — above that level, most people are protected. Coverage varies by state and county, the CDC noted in a recent health alert.

I can’t recall if I was vaccinated as a child. How can I check? Should I get vaccinated (potentially again) if unsure?

This is a great question for your primary care doctor. They may recommend a booster vaccination or a blood test to see if you are immune.

I haven’t had the vaccine, but I know someone who had the measles and they did fine. Is the vaccine really necessary?

Most people who get measles aren't going to have serious complications. But one in five unvaccinated people in the United States who get measles ends up hospitalized, according to the CDC. One in 1,000 children who contract measles will develop encephalitis, which can lead to convulsions, and leave a child deaf or with an intellectual disability. One to three out of 1,000 kids will experience fatal respiratory or neurologic complications.

I’m planning to travel overseas and had the vaccine as a kid. Do I need another?

Consult your doctor. Outbreaks are occurring in various countries, and usually it's unimmunized people who bring back the disease to the United States. Adults who don’t have evidence of immunity should get up to two doses of the shot, which covers you for measles, mumps and rubella (MMR). (See this page for more on proving immunity.) Doses should be separated by at least 28 days, the CDC says.

If I’m willing to take my chances and avoid the vaccine, why does it still matter?

Aside from your health, and that of your children, the vaccine will prevent you from spreading measles in your community. This goes for most vaccines. What about your neighbor? What about your community? Getting a vaccine is an individual thing, sure — but more importantly, it also serves the greater good.

For more on Blue Shield's preventive care and vaccine coverage, visit here.