As measles cases continue to spread throughout the U.S. — with 12 states reporting official outbreaks, according to the latest CDC data — concern is growing among high-risk groups.

Children under the age of 5 are most vulnerable to measles, health experts confirm.

The CDC recommends that children receive two doses of the MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 to 15 months of age, and a second dose at 4 through 6 years of age. 

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That means children under 5 may not have full protection.

Allison Croucher, DO, a pediatrician and doctor of osteopathic medicine with Duly Health and Care in Illinois, said she frequently gets questions from concerned parents looking to protect their children from the highly contagious virus.

Chroucher shared some of the most common inquiries she receives, along with her responses.

1. Should I be worried about measles where I live or where I’m traveling to?

Measles cases have been reported in 20 states so far (according to the CDC): Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, New Jersey, New Mexico, New York City, New York State, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia and Washington.

Even if you do not live in one of those areas, keep a close eye on local health alerts, since the disease is rapidly evolving. 

Your state’s Department of Health website, which should end in “.gov,” is a great place to start. If you plan on traveling to an area with reported cases, be sure to seek guidance from your doctor beforehand.

2. How do I know if my child is fully vaccinated?

A child is considered fully vaccinated for measles if they have received two doses of the measles, mumps and rubella (MMR) vaccine at least four weeks apart. 

The first dose is typically given to children between 12 and 15 months old, followed by the second at four to six years.

3. Can my infant get the vaccine early? 

In certain cases, yes. Infants who are high-risk or traveling to areas with active cases may be eligible to get the MMR vaccine between six months and 12 months of age. This depends on individual circumstances, so it’s important to talk with your pediatrician. 

Keep in mind that an early dose doesn’t count on the regular vaccination schedule — your child will still need two additional doses after their first birthday.

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4. What if my infant is too young to get the MMR vaccine? 

If your infant is too young for the vaccine, it’s important to take extra precautions to limit their exposure to others who are or might be ill. Don’t be afraid to decline travel or gatherings — you have every right to protect your child’s health.

5. How early can my child get their second MMR vaccine? 

For children over one year, the second MMR dose can be given as early as four weeks after the first. Once they’ve received both doses, children are considered fully vaccinated and don’t require any additional doses.

“One to three of every 1,000 children infected with measles will die due to complications from the disease.”

6. We have been around other people who recently traveled. What symptoms should we watch for?  

In the early stages, symptoms to watch out for include fever, cough, runny nose, and red, irritated eyes. 

These symptoms usually appear seven to 14 days after initial exposure. 

7. My child is showing signs of a cold. Could this be early-stage measles?

It’s not always easy to tell, since measles shares symptoms with many other illnesses. One key differentiator is that children with measles typically display very high fevers, around 104°F. They also tend to be very fussy. 

Around the second or third day of symptoms, many patients develop small, bluish-white spots on their inner cheeks, referred to as Koplik spots — though not every child will develop these spots. The telltale red rash typically develops three to five days into the illness.

8. What does the measles rash look like? 

This rash typically starts three to five days after the initial symptoms. It begins as small spots on the face near the hairline, then spreads downwards and can cover the entire body.

9. Why is measles dangerous? 

Measles can have many complications, ranging from mild to severe. About one in 10 people will develop ear infections or diarrhea. 

About one in five unvaccinated children with measles will require hospitalization. Up to one in 20 children will contract pneumonia, which is the most common cause of death from the disease. 

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About one in 1,000 children will develop encephalitis, or inflammation and swelling of the brain. This can lead to seizures, lifelong disability or even death. In all, one to three of every 1,000 children infected with measles will die due to complications from the disease.

10. Why aren’t some people getting their kids the MMR vaccine? 

There is a growing amount of misinformation and disinformation circulating about vaccines, which has led some parents to delay or skip them altogether. 

The MMR vaccine has been safely administered to millions of people and has an excellent safety record — and research has repeatedly debunked the myth that the vaccine is linked to autism. 

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11. What should I do if I think my child might have the measles? 

Don’t wait — contact your doctor right away. They can guide you through the next steps.

The above questions and answers were provided by Allison Croucher, DO, a pediatrician and doctor of osteopathic medicine with Duly Health and Care in Illinois.