Immunity Status Based on Birth Year
For most adults, the question of measles immunity is linked directly to their year of birth. Before the measles vaccine was widely available in the United States, nearly everyone contracted the disease during childhood, which conferred lifelong natural immunity. The CDC uses 1957 as a benchmark year for this reason.
- Born before 1957: The CDC considers these individuals to have presumptive evidence of immunity to measles, mumps, and rubella (MMR). This presumption is based on the high likelihood of having been infected with the wild virus before the vaccine became available. For this group, a measles shot is generally not needed unless other risk factors are present.
- Born during or after 1957: These individuals are not presumed to have natural immunity and should have documented evidence of one or two doses of the MMR vaccine. If they lack written records, they should consult their doctor about receiving at least one dose of the MMR vaccine.
Exceptions to the General Rule
While age is a primary factor, it is not the only consideration. Certain situations and professions place individuals at higher risk, regardless of their birth year.
Healthcare Workers
For healthcare personnel born before 1957, the standard presumptive immunity is often not sufficient. Due to their increased risk of exposure and potential to transmit the virus to vulnerable patients, healthcare facilities typically require proof of vaccination or laboratory evidence of immunity. If these workers lack documentation or laboratory evidence, they should receive two doses of the MMR vaccine.
International Travelers
Measles remains common in many parts of the world, and unvaccinated travelers can contract the disease abroad and bring it back to the U.S.. The CDC recommends that adults who will travel internationally ensure they are fully protected. If an adult traveler does not have presumptive evidence of immunity, they should receive two doses of the MMR vaccine.
Living in an Outbreak Area
During a measles outbreak, public health officials may recommend additional vaccination for at-risk groups in the affected community. Even if you were born before 1957, local guidance could override the standard recommendation in this scenario. For instance, a person with potential exposure might be advised to get a dose of the vaccine.
Previous Ineffective Vaccination
Some older adults may have been vaccinated with an earlier, less effective version of the measles vaccine. Those who received the inactivated (killed) measles vaccine, which was used between 1963 and 1967, may not be fully protected. The CDC recommends that individuals who received this type of vaccine, or a vaccine of unknown type during that period, get revaccinated with at least one dose of the current MMR vaccine.
Making Your Decision
Deciding whether to get a measles shot requires considering your birth year, health history, and potential for exposure. Consulting with a healthcare provider is the most reliable way to assess your individual risk.
Steps to Consider
- Check your birth year: If born before 1957, you are likely immune unless you fall into a high-risk group.
- Review your records: If born after 1957, search for written documentation of your MMR vaccination. If you have had two doses, you are considered protected.
- Get a blood test: If records are unavailable, a blood test (titer) can confirm your immunity.
- Discuss with your doctor: Talk with your healthcare provider about your risk factors, especially if you are a healthcare worker, an international traveler, or have a compromised immune system.
Vaccination Options for Older Adults
| Feature | Assumed Immunity (Born Before 1957) | MMR Vaccine (Born After 1957) |
|---|---|---|
| Basis for protection | Presumption of natural infection and subsequent immunity. | Written documentation of vaccination or lab evidence of immunity. |
| Effectiveness | Provides lifelong immunity for most people who were naturally infected. | Two doses are 97% effective against measles. |
| Need for vaccination | Not typically needed, with exceptions for high-risk groups and outbreak situations. | At least one dose is recommended for those without evidence of immunity. High-risk groups need two doses. |
| Evidence of immunity | Acceptable evidence is typically a birth date before 1957, though this may not suffice in some occupational or outbreak settings. | Written vaccination records, lab confirmation of immunity (titer), or lab confirmation of prior illness. |
Conclusion
For most people aged 65 and older (born before 1957), a measles shot is not necessary because they are presumed to have natural immunity from childhood infection. However, this presumption is not foolproof, and certain groups—like healthcare personnel, international travelers, and those in outbreak zones—should still confirm their immunity through vaccination records or a blood test. Anyone born in or after 1957 who lacks proof of vaccination needs at least one dose of the MMR vaccine. Consulting a healthcare provider is the best way to determine your personal risk and ensure you have adequate protection. Even if you have prior immunity, receiving an additional dose of the MMR vaccine poses no known harm.
