Measles cases are accelerating in the US, with twice as many confirmed cases as last year, and more parents are opting for earlier vaccination – especially with the second dose of the measles, mumps and rubella (MMR) vaccine, which can be given as soon as four weeks after the first. Giving the second shot soon after the first aligns with what some other countries, such as Germany, the United Kingdom and France, recommend – and the US Centers for Disease Control and Prevention (CDC) also says it’s an option. The CDC typically recommends giving the first MMR shot after age one and the second between the ages of four and six.
But Kass began recommending the MMRV shot, which combines the second MMR and chickenpox (varicella) into one, at 15 months of age when measles cases began increasing a few years ago. More parents are taking that recommendation now, he said, adding that their thinking is pretty straightforward: “There’s no reason to wait, measles is here now.” Margot Taylor, a mother in Chicago, has three young children with three different vaccination histories for the MMR vaccine. Measles “wasn’t on my radar”, Taylor said.
Chicago was battling a measles outbreak, so they went ahead with it. Her third child, born in 2025, received the first shot after her first birthday – and then the second shot only three months later, in June. Taylor worried the shots might not work as well if they were so early.
But evidence shows the vaccines still work well at earlier ages; the recommendation to give the MMR dose between four and six years is based more on logistical concerns, to ensure children have both shots before they enter kindergarten and to cut down on doctors’ visits because other shots are also typically given at those ages. And Taylor knows how vital the MMR vaccines are. When her third daughter was too young to get the first dose, she was exposed to measles at an airport during the west Texas outbreak.
When the baby, only a month old, developed a fever afterward, they rushed to the hospital and stayed in a negative-pressure room until the test was negative for measles. But she still wonders at the need to make these decisions at all. Germany had similar recommendations to the US until 2001, when an outbreak brought a wave of illness and death that led the country to recommend the first shot at 11 to 14 months and the second shot at 18 to 23 months.
In 2020, they moved the second dose to four weeks after the first. Her son was two and a half years old when he got his second measles vaccine – and that was delayed only because he was recovering from a case of chickenpox. The CDC should “absolutely” consider a stronger recommendation to give the second shot earlier, Becker said.
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