The first dose of the measles-mumps-rubella vaccine is given when children are 12 to 15 months old. Some doctors and parents may opt for earlier doses.
More measles cases have been reported in the first three months of 2025 than in all of 2024.
Most of the 420-plus cases have been centered around the West Texas outbreak, which has spilled over to neighboring New Mexico and Oklahoma. Other cases in people returning from travel abroad have been reported in a handful of states.
Vaccination is the best way to protect against infection, but the first dose of the measles-mumps-rubella (MMR) vaccine usually isn’t given until a child is 12 to 15 months old. A second dose is given from ages 4 to 6.
That schedule leaves children under 1 vulnerable. Some parents, however, are opting to give their young children a dose of the vaccine ahead of schedule.
Dr. Ana Montanez, a pediatrician at Texas Tech Physicians in Lubbock — an epicenter of the current outbreak — said that parents are calling to request an early dose of the MMR vaccine.
“We’ve almost doubled the amount of vaccine we administer on a typical month,” Montanez said.
Both the Centers for Disease Control and Prevention and the American Academy of Pediatrics say that, in the case of an outbreak or international travel, children as young as 6 months can get a dose of the vaccine, and children under 4 years old who have gotten one dose can get their second one earlier. All doses must be separated by at least four weeks.
Dr. Shilpa Patel, a pediatrician at New Jersey Hackensack Meridian Health Medical Group Northern Valley Pediatrics, said that an early dose before 12 months is essentially a bonus dose, and doesn’t take the place of either of the two standard doses.
“It does not count for the total,” Patel said. “You still need two doses after the age of 12 months.”
Montanez said that’s because, “at this age of development, their immune system isn’t quite developed to where the vaccine would provide prolonged or lifelong immunity.”
“Therefore, we would have to give another dose at a year and essentially a third dose at 4 to 6 years,” she said.
While early doses are typically recommended when traveling abroad with children, Patel said she’s also starting to recommend the vaccine for kids traveling to some parts of the U.S., including Texas and Disney World in Florida. Theme parks have been the sites of measles outbreaks in the past.
Don Gibson, 36, and his wife considered early vaccinations for their two sons, now ages 2 years and 4 months, as they prepared in January to travel from California to Texas for an April wedding.
“We were really excited to go, and they invited our kids, too, so we were going to take the whole family, but, then, after we booked our travel, including lodging, flights, we saw the outbreak happening in Texas,” Gibson said.
This prompted a conversation with the family pediatrician, who said they could give an early second dose for their 2-year-old and a dose for the infant when he reached 6 months.
The wedding, however, would occur before the infant hit 6 months, and ultimately the family decided to cancel their plans.
Patel said that she’s even started offering an early dose to families who aren’t traveling, but who are concerned about rising measles counts in their neighborhood, pointing to the three measles cases recently identified in her home state, New Jersey.
For now, doses for domestic travel and for patients in places without active outbreaks are being given at the discretion of individual doctors and parents.
There’s currently no official recommendation for people traveling domestically to places experiencing outbreaks.
Some are calling for changing that to include a flexible third dose.
In an article earlier this month in the Journal of the American Medical Association, former CDC Director Dr. Rochelle Walensky and several other experts proposed codifying an extra dose for high-risk domestic travel.
Montanez noted that it’s unclear whether insurance will cover an extra dose of the MMR vaccine.
She said that 80% of her patients are on Medicaid and have their regular immunizations covered by the Texas Vaccines for Children program. But, because these particular doses are given outside of the standard schedule, it remains unclear whether they will be reimbursed.
Ultimately, the extra dose is the parents’ choice.
“If you decide you want to do this, you are welcome to,” Montanez said. “If you don’t want to do this, you don’t have to do this.”
