March 2026
We know that many parents and carers of children and young people with cancer will be concerned about the rise in measles cases recently, particularly in London and the West Midlands.
Immunosuppressed children are at higher risk than healthy children of developing prolonged and severe measles, and of suffering complications. We have worked with the UK Health Security Agency (UKHSA) to provide the guidance below.
What is measles?
Measles is a type of virus from the paramyxovirus family.
How is measles spread?
Measles is spread through coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.
Measles is one of the most highly communicable infectious diseases. Transmission is highest amongst close contacts, such as members of a household or individuals who have close contact with each other over a long period of time, or students in the same classroom. However, even limited exposure to a measles case should trigger an assessment of an immunosuppressed individual.
What are the symptoms of measles?
The earliest signs of measles infection include:
- high fever
- runny nose
- cough
- red and watery eyes
- koplik spots (small red spots with bluish-white centres) inside the mouth
After several days, a rash appears, usually on the face and upper neck. The rash spreads, eventually reaching the hands and feet and lasts 5 to 6 days before fading. Measles is commonly confused with other infections that can lead to a rash.
What is the current problem with measles?
There has been an increase in the number of confirmed measles cases and local outbreaks being reported across England since 1 January 2026, especially in London and the West Midlands. Unvaccinated children under 10 years of age have been particularly affected.
In 2024, there were 2911 laboratory confirmed measles cases, the highest number of cases recorded annually since 2012. The coverage of the MMR vaccine has fallen to its lowest level in a decade with national uptake of the MMR in 2 year olds at 89% and in 5 year olds at 84%. This is below the 95% uptake needed to protect the population and prevent measles outbreaks.
What can be done to avoid exposure to measles?
All family members and close contacts of children and young people with cancer undergoing treatment should be fully immunised against measles.
The measles, mumps, rubella and varicella (chickenpox) MMRV vaccine replaced the MMR vaccine in the routine childhood programme from 1 January 2026. The MMRV vaccine has been safely used for over a decade and is already part of the routine childhood vaccination schedule in several countries, including Canada, Australia and Germany.
Siblings and family members who need to be caught up with vaccination against measles should be given MMRV or MMR depending on their age. Children born on or after 1 January 2020 should be given MMRV. Children and adults born on or before 31 December 2019 should be given MMR. Everybody should have 2 doses of a measles-containing vaccine; it is never too late to catch up.
Siblings and family members who require catch-up MMR, but who are separately also susceptible to chickenpox and thus eligible for vaccination, can be given MMRV instead of two separate injections.
Can my child or young person receive the measles vaccine to protect them?
The MMR and MMRV are live vaccines and not recommended to be given to children while on active treatment. For children who have received standard chemotherapy, the MMRV or MMR vaccine can be given 3 months after completion of treatment. Please speak to your treating team about timing of vaccination.
For children who have received a stem cell transplant, the vaccine schedule is dependent on different factors so please speak to your transplant team about timing of vaccination.
Can we find out if my child or young person already has immunity to measles?
All children and young people undergoing treatment for cancer are recommended to have antibody testing for measles immunity. This is a blood test and will likely be combined with routine blood tests during treatment. Please speak to your treating team about this, who will be able to advise if your child or young person should be tested.
Your child may have had a test for measles immunity before starting treatment but we know from that some children lose immunity to measles during cancer treatment, even if they have been vaccinated before. Our study of children with cancer during the 2024 measles outbreak showed that nearly 1 in 5 children lose their immunity during cancer treatment. Knowing whether your child or young person has immunity to measles will help guide management in case of an exposure and provide advice around school attendance.
What should I tell my child or young person’s education setting or social groups?
Make sure education settings (nursery, school, colleges) and social groups are aware of your child’s compromised immune status and that they actively promote immunisation of healthy children. They should also be aware of the need to quickly alert you if a potential contact with a case occurs.
What should I do if my child is exposed to a potential case of measles?
You should make immediate contact with your specialist team. They will then contact the local Health Protection Team to assess the situation and decide whether your child should receive intravenous immunoglobulin.
What is intravenous immunoglobulin?
Immunoglobulin is made from donated blood and contains antibodies (proteins in the body) that help the body to fight infections such as measles. Intravenous immunoglobulin may be given to your child to prevent or reduce the severity of measles if your child is exposed and does not have immunity to measles already. A preventative dose of immunoglobulin is unlikely to offer additional benefit to children who have detectable measles antibody. Your treating team will advise on whether your child should receive immunoglobulin after an exposure.
Written by Dr Jessica Bate, Consultant Paediatric Oncologist, Southampton Children’s Hospital on behalf of CCLG with Dr Hannah Emmett, Dr Rebecca Cordery and Dr Vanessa Saliba, Consultant Epidemiologists, Immunisation and Vaccine-Preventable Diseases Division, UK Health Security Agency