Measles is a grown-up problem, too.

Are you at risk?

Jess Steier, DrPh

On a recent rainy day, my kids and I were running through our list of rainy-day activities when laser tag came up. Then they asked, "Mama, will you play with us?" 

Huh? Laser tag is a kids' activity (or so I thought). I called the place to ask, and it turns out adults are allowed and it's apparently very popular with them. I had no clue, because every laser tag invitation that has ever come through my house had a cartoon on it and a request to RSVP for an 8-year-old’s party. It hadn't occurred to me that it was an option for me.

Measles has a similar problem. Nearly everything the public hears about it involves children, whether it's the childhood schedule, kindergarten vaccination rates, school exclusions, or babies who are too young for their first dose. Much of the media attention on Pennsylvania's outbreak has centered on the two infants who died in August. That attention is warranted, since those deaths are tragic, babies don't typically get their first measles, mumps, and rubella (MMR) vaccine dose until 12 months, and children under 5 are hospitalized at some of the highest rates of any age-group. 

When children are the only people we picture with measles, though, adults process it the same way I did laser tag, as something that isn't meant for them, and this year's data show otherwise. 

4 in 10 US measles cases this year are in adults

According to CDC's latest data, 38% of confirmed measles cases in 2026 (1,305 of 3,471) are in people 20 and older, up from 29% in 2025. Adults are being hospitalized at a rate of 12%, about the same as children under 5 years (13%) and three times the rate for school-aged kids and teens (4%). They account for 156 of this year's 301 measles hospitalizations, or just over half. In Pennsylvania, the hardest-hit state, the share is even higher. About seven in 10 cases this year are in people 18 and older, and the largest single age-group is 25 to 49. 

This week, Pennsylvania reported its third and fourth measles-associated deaths of the year, in a 40-year-old woman in Jefferson County and an 18-year-old in Mifflin County who died of acute disseminated encephalomyelitis, a rare neurologic condition that can follow measles. Neither was vaccinated. The last time the US reported four measles deaths in a single year was 1992. One of last year's three deaths was also involved an adult, in New Mexico, so three of the seven US measles deaths reported since the start of 2025 were in people 18 or older.

Nearly everything the public hears about [measles] involves children.

The Jefferson County coroner listed the woman's cause of death as respiratory failure due to measles, chronic obstructive pulmonary disease, and asthma. His office noted that many people think of measles as a childhood illness, when in fact it can cause severe complications at any age. Chronic conditions like hers are common among adults and become more so with age, and plenty of people are inside a higher-risk category without knowing it, because nobody has ever told them their condition counts.

Why more adults are getting measles, and why it can hit them hard

Before the vaccine arrived in 1963, measles was largely a disease of young children, because nearly everyone caught it early in life. Once vaccination became widespread, people who were never vaccinated could grow up without encountering the virus, since the vaccinated people around them kept it away. Kindergarten MMR coverage has fallen from 95.2% in 2019-2020 to 92.4% last school year, measles has been reported in 47 jurisdictions, and those still-susceptible adolescents and adults are now being exposed for the first time.

Adulthood is also a riskier time to have measles than most people assume. The risk of severe complications, including pneumonia and brain inflammation, is highest in children under 5 and adults over 20. Measles during pregnancy raises the risk of miscarriage, preterm birth, and low birth weight. Measles can also cause immune amnesia, a temporary loss of immune protection against infections the body had already fought off, that can last months to years. 

A 2019 case report from Dresden, Germany describes two adults who came to the emergency department with measles. A 40-year-old man with pneumonia recovered in 12 days. A 55-year-old woman improved quickly at first and then, within days, lost the ability to organize her daily activities, dress herself, or start a conversation, and she needed neurologic rehabilitation. Neither had vaccination records. 

The authors urged fellow clinicians to consider measles in adults who show up with a fever and a rash. That reminder is just as (if not more) important today with measles cases rapidly climbing.

Adults tune out messages that seem to be about someone else's kids

My last piece was about how a message focused on older adults and the immunocompromised signals to people outside those categories that the disease isn't about them. Framing measles as a childhood disease does the same thing to adults. 

Adults who hear measles news as a story about other people's children have no reason to look for their own records, to ask about a second vaccine dose before an international trip, or to think of measles when they come down with a fever and a rash and head to a crowded waiting room. Many adults also assume that whatever they received as kids still protects them, and for some of them, that isn't the case.

What to do if you're not sure you're protected

1. If you were born before 1957, you're presumed immune, because nearly everyone was infected during childhood before vaccines were available. Healthcare workers are the exception and should check with their employer.
2. If you have written records of two doses given after your first birthday (and at least 28 days apart), you're considered protected, and you don't need another dose or a blood test to confirm it. Two doses are about 97% effective, and one dose is about 93% effective. (Absolutely incredible.)
3. If you were vaccinated from 1963 to 1967, you may have received an inactivated (killed) version of the vaccine that was withdrawn because it didn't protect well. Fewer than 1 million people received it, but most don't know which type they received. If that's what you got, or you don't know, talk to your clinician about being revaccinated.
4. If you have one documented dose (which is common for people who were kids before the second dose was recommended in 1989), that's considered enough for most adults. Two doses are recommended for college students, healthcare personnel, international travelers, people with HIV, and close contacts of immunocompromised people. Health departments sometimes recommend a second dose for adults in outbreak areas, and yours will say so if it applies to you.
5. If you have no records and no idea, try your state's immunization registry, your parents, your childhood doctor's office, and old school, college, military, or employer files. If nothing turns up, CDC recommends getting an MMR dose and says there's no harm in getting another dose if you may already be immune.
6. A blood test for antibodies (a titer) is the other option, but for most adults the extra dose makes more sense. The titer adds a step (since a low result sends you back for the vaccine anyway), and it can add lab fees and copays. It also gives an incomplete picture, because it measures only the antibodies circulating in your blood and says nothing about the memory cells that are a big part of lasting protection. Commercial tests can also miss low levels of vaccine-induced antibodies, so a vaccinated person can get a low reading and still be protected. (Titers still have a place for people who can't get a live vaccine and for jobs or schools that require them.)
7. MMR is a live vaccine, so it isn't given during pregnancy or to people with severely weakened immune systems. If you're planning a pregnancy, check your status beforehand and wait a month after vaccination before trying to conceive. If you’ve been exposed to measles and can’t confirm that you’re protected, call your clinician right away. An MMR dose within 72 hours of exposure may give some protection, or at the very least, a milder illness. If you can’t be vaccinated, or if you’re at high risk of severe infection, immune globulin can lower your risk if it's given within six days of exposure.
8. If you think you have measles, call ahead so the clinic can keep you out of the waiting room.

The MMR vaccine is on the childhood schedule, and it's also available to adults at many pharmacies, often without an appointment. I found out laser tag was an option for me only because my kids asked, so consider this me asking you. 

As for laser tag, we ended up staying in, popping some popcorn, and watching Enola Holmes, because nobody felt like getting out of pajamas. It's in my future, though, and I'll let you know how badly I lose.