FAQs Amid the Ongoing US Measles Outbreaks

This FAQ was fact-checked by Adam James, PharmD.

Measles activity in the US has continued to climb in 2026, putting the country on pace to exceed last year’s total and raising the real possibility that the US could lose its measles elimination status by the fall. For pharmacists, who are often the most accessible health care professionals that patients see, understanding the current outbreak landscape—and being ready to answer questions at the counter—has never been more important. This FAQ reviews where things stand, why cases are rising, and how pharmacists can support patients navigating concern, confusion, or vaccine hesitancy.

Q1: What is the current status of measles outbreaks in the US?

As of June 18, 2026, the CDC has confirmed 2104 measles cases across 41 jurisdictions this year, with the vast majority concentrated within 30 active outbreaks. That already approaches the 2288 cases reported for the entirety of 2025, which was itself the highest annual total in more than 3 decades.

Approximately 93% of this year's cases have occurred in people who are unvaccinated or whose vaccination status is unknown, and a sizable share of patients are children and young adults: about 1 in 5 cases are in children younger than 5 years of age, and nearly three-quarters are in people aged 19 years or younger. Hospitalization has been required in roughly 6% of cases this year. States with the largest outbreaks include South Carolina, Utah, Texas, Arizona, and Washington.

Because measles was declared eliminated in the US in 2000—meaning there was no continuous domestic transmission for over a year—sustained outbreak activity like this is a significant public health development, and officials have indicated the country could lose its elimination status when data is formally reviewed in November.

Operational takeaway for pharmacists: Most measles transmission continues to occur in unvaccinated populations and outbreak clusters, making vaccination screening at the pharmacy critical.

Q2: Why are measles outbreaks increasing now?

A few converging factors are driving the rise:

• National measles, mumps, and rubella (MMR) vaccination coverage among kindergartners has fallen below the 95% threshold needed for community immunity, dropping from about 95.2% in the 2019 to 2020 school year to roughly 92.5% more recently. This leaves a plethora of children without protection. Coverage varies widely by community, and pockets of low vaccination rates can exist even within states that have high statewide averages.
• Global measles activity has been rising, increasing the odds that an unvaccinated traveler will bring the virus back to the US.
• Measles is exceptionally contagious. Up to 9 of 10 unprotected people in a room with an infected person will become infected. Once the virus reaches an under vaccinated community, it can spread rapidly and sustain an outbreak for months.

Operational takeaway for pharmacists: Even small declines in vaccination can quickly lead to outbreaks.Travel screening and vaccination status checks remain highly relevant at the point of care.

Q3: What should pharmacists know about identifying and responding to measles in practice?

Pharmacists should be familiar with the classic measles presentation, including high fever (>104^oF) 7 to 14 days after exposure, cough, coryza, conjunctivitis, and the characteristic Koplik spots inside the mouth, followed by a maculopapular rash that typically starts at the hairline and spreads downward. Anyone presenting with these symptoms—especially with a recent travel history or known exposure—should be referred for prompt medical evaluation and tested before entering a waiting area with other patients, since measles remains infectious in a space for up to 2 hours after the contagious person has left. Pharmacists should be aware that patients are infectious before and after rash onset.

Pharmacists should also know their state's reporting requirements, as suspected measles cases are reportable to local or state health departments. In community and health-system settings, pharmacists can review patient immunization records during routine encounters to flag those who may be under-vaccinated, particularly before travel.

If measles is suspected in the pharmacy, a pharmacist can:

• mask the patient immediately (if tolerated);
• separate from other patients/customers, do not keep in standard waiting areas;
• advise urgent medical evaluation and call ahead to the receiving site;
• avoid prolonged exposure, as measles virus can remain in the air for up to 2 hours;
• and follow state/local reporting requirements for suspected cases.

Operational takeaway for pharmacists: Patients who present symptoms and/or risk factors of measles should be referred for medical evaluation and testing, segregated from other patients.

Q4: What is the pharmacist's role in measles vaccination and prevention?

Pharmacists are increasingly authorized to administer MMR vaccine, making them a frontline resource for closing immunization gaps. Two doses of MMR are about 97% effective at preventing measles, whereas a single dose offers about 93% protection. Pharmacists can proactively identify unvaccinated or under vaccinated patients—particularly prior to international travel, since most US cases originate with unvaccinated travelers—and offer or refer them for vaccination accordingly. For infants planning international travel, early MMR dosing as young as 6 months may be appropriate per current CDC travel guidance, followed by the routine 2-dose series. Pharmacists can also play a role in identifying breakthrough infections—which account for about 10% of cases and are not unexpected at the population level—but they shouldn't be mistaken as evidence that vaccination doesn't work.

Operational takeaway for pharmacists: Pharmacists should offer education to parents and patients on the effectiveness of vaccination.

Q5: How can pharmacists counsel patients who are anxious or hesitant about measles and the MMR vaccine?

This is where pharmacists can have significant impact. Patients arriving with concerns typically fall into 2 groups: those who are worried about exposure risk and those hesitant about vaccination itself.

For patients who are feeling anxious, pharmacists can provide grounding context—most US outbreaks remain regionally contained, and vaccination remains highly effective—while encouraging them to confirm their own and their family's MMR status.

For patients who are hesitant to get vaccinated, motivational interviewing techniques often work better than direct confrontation. Ask what specific concerns patients have, listen without judgment, and address misinformation with clear, evidence-based information rather than dismissal.

It is worth noting plainly that MMR is not associated with autism, a claim that has been repeatedly and rigorously disproven, and that the adverse events (AEs) of measles infection itself (eg, pneumonia, encephalitis, and, in some cases, death)—are far more serious than vaccine-related AEs for the overwhelming majority of patients. Pharmacists should also remind patients that community immunity matters: a small drop in vaccination rates can produce a disproportionately large rise in cases, which is part of why the current outbreaks are unfolding the way they are.

Operational takeaway for pharmacists: Pharmacists can provide education to dispel misinformation to help guide parents and patients to make informed choices about their vaccines.

Q6: Where can pharmacists direct patients for more information?

The CDC's measles pages (cdc.gov/measles) are updated weekly with current case counts and outbreak locations and include a “Plan for Travel” resource specifically for patients with upcoming international trips. State and local health department websites often provide more granular, real-time outbreak information for pharmacists practicing in affected areas. For patients seeking vaccination, the CDC's vaccine finder tools and the patient's own immunization registry record (where accessible) can help confirm prior doses and identify gaps.

Summary for Practice

With measles cases in 2026 already approaching last year’s record total and outbreaks active across dozens of states, pharmacists are positioned to make a meaningful difference, both by administering MMR vaccine directly and by serving as a calm, credible source of information for patients navigating fear or misinformation. Staying current on outbreak data, knowing state reporting requirements, and being ready for empathetic, evidence-based counseling conversations will remain essential as the situation continues to develop through the summer travel season.