Measles cases are on the rise, but the disease is almost entirely preventable.
“The best protection for children 12 months or older is to get them vaccinated,” says Dartmouth Health Children's Pediatrician Erik M. Shessler, MD.
“Vaccinations are not only very safe, but they are highly effective, and children under a year are largely protected by maternal antibodies,” he says.
Measles cases are rising
Despite the vaccine’s success in eliminating the virus from the United States in 2000, measles cases are up.
Most infections are among the unvaccinated.
In early March, an unvaccinated adult died in New Mexico. That followed an unvaccinated child’s death in Texas in February.
Those deaths have come amid three recent outbreaks and more than 200 cases total this year, as reported on March 7, 2025 by the Centers for Disease Control and Prevention (CDC). Only six percent of the infected were reported to have been vaccinated.
“The current spike in cases highlights why getting vaccinated is so important,” says Shessler.
The MMR vaccine is the best defense
The measles, mumps, and rubella (MMR) vaccine is the best form of protection against this highly contagious virus and it has few risks or side effects,
Children should receive their first dose of the vaccine between 12 and 15 months of age. That first dose is 93 percent effective in protecting children from the virus.
Children are recommended to get the second dose at four to six years of age, or earlier as long as the second dose is at least 28 days after the first.
Together, these two doses are 97 percent effective.
That means if children are exposed to the virus and they have had one or two shots of the vaccine, they have a 93 or 97 percent less chance of getting measles than if they did not have one or two doses of the vaccine.
Once more, when children are vaccinated, the virus is likely milder. They also are less likely to spread it.
Vaccination rates are falling
But putting children more at risk is the reported drop in vaccinations.
States are now falling below the 95 percent vaccination threshold needed to provide community immunity or what is often called herd immunity.
New Hampshire’s vaccination rate for kindergarteners was about 89 percent for the 2023-2024 school year, and Vermont’s was 92.9 percent.
On March 11, Vermont Department of Health reported that they had confirmed a case of measles in a school-aged child in Lamoille County. That was the first case of measles in Vermont in 2025, following two cases in 2024 and two cases in the decade prior, one in 2011 and one in 2018.
While New Hampshire has not yet reported a measles case, the New Hampshire Department of Health and Human Services last year identified an outbreak of measles infections that began when an international traveler visited the Hanover, New Hampshire area.
How measles spreads and common symptoms
Understanding how measles spreads can help keep infection rates down.
The virus is usually transmitted through respiratory droplets in the air or on surfaces, often after an infected person coughs or sneezes.
The virus can remain active and contagious in these droplets for up to two hours after the infected person leaves an area.
That said, you might not know when someone is infected.
Typical symptoms include a fever above 100.4 F degrees or as high as 105.5 F, a cough, runny nose, red and watery eyes (conjunctivitis), and a rash.
But people often do not show symptoms for 10 to 14 days, though symptoms can emerge anytime between seven and 21 days after infection.
The first symptom is usually a fever followed by a rash three to five days later. The rash typically begins on the face and neck before spreading down to the body, arms and legs.
Measles patients are therefore advised to wear masks and be isolated while contagious, which is typically four days before the rash starts and four days afterward.
Treatment
What the science says
As measles cases increase, new focus is being put on treatment. But measles is caused by a virus and there's no specific medical treatment for it. Medical care is considered supportive only, meaning it can help relieve symptoms and address complications such as bacterial infections. Discuss with your healthcare provider the risks and benefits of the best supportive care for your child.
Vitamin A: “We have been receiving questions about vitamin A supplementation for treating measles. This is based on studies in other countries showing a significant observational association between vitamin A deficiency prevalence and measles mortality,” says Dartmouth Hitchcock Chief Quality Officer Michael A. Calderwood, MD, MPH. “But the evidence in support of vitamin A supplementation has not reached statistical significance.” The CDC stresses that administering vitamin A needs to be done under medical supervision because overdosing can lead to hypervitaminosis A or vitamin A toxicity, which has dangers of its own.
Clarithromycin: Antibiotics do not treat measles, which is a virus. Clarithromycin does have anti-inflammatory properties. “So far, it is an unproven treatment strategy,” says Calderwood.
Steroids: “We saw a benefit from steroids in the management of COVID-19. Their role in severe cases of measles requiring hospitalization is worth studying,” says Calderwood. Right now, though, the science does not support the use of steroids to treat measles.
There is also no specific treatment or antiviral therapy. Medical care is considered supportive only, meaning it can help relieve symptoms and address complications such as bacterial infections.
Most measles patients recover within a week, but measles can lead to serious complications, says the CDC
“About one in five will have complications,” says Shessler. These complications can include pneumonia, encephalitis, and death.
More on protecting children under one year old
Because maternal antibodies start to wane at six months, susceptibility to the disease can increase until children receive their first vaccination.
If your child under the age of 12 months has a known exposure to measles, post-exposure prophylaxis can help protect your child if administered early enough. This may be in the form of an injection.
If you are concerned about your baby or unvaccinated child having been exposed or your child is showing symptoms, contact your pediatrician right away.
“Yes, measles is very contagious,” says Shessler. “With national and regional vaccination rates dropping and people traveling, there will be more exposures. But remember, it is almost entirely preventable through vaccination.”
New Hampshire and Vermont vaccination resources
The NH Immunization Program (NHIP) is a vaccine resource for healthcare providers, schools, childcare providers, families, and the general public. The New Hampshire DHHS (Department of Health & Human Services), through the NHIP's Vaccines for Children (or "VFC") program, provides all the recommended vaccines for every child in the state, regardless of insurance or income. DHHS urges individuals and caregivers to talk with their healthcare provider about which recommended vaccines are right for them.
The Vermont Department of Health provides this information about measles, reminding people that measles is preventable when people get vaccinated. It points out that even though measles was declared eliminated in the United States in the year 2000, outbreaks can happen in communities with low immunization rates.