Measles Outbreaks on College Campuses

The American College Health Association (ACHA) is monitoring recent measles outbreaks on several college campuses. Measles is one of the most contagious infectious diseases, and even a single case can lead to rapid spread in campus environments. Because measles can cause severe complications and outbreaks can escalate quickly in congregate settings, ACHA has the following recommendations to safeguard the nation’s 19 million college students and the broader campus communities in which they live, learn, and engage in close proximity.

Institutions should promote high vaccine coverage by implementing, if possible, vaccine requirement/recommendation programs and policies. Institutions should ensure timely collection of student vaccination records and make recommended vaccines readily accessible to students who need catch-up vaccination. Patient education is a critical component of disease prevention efforts; campuses should clearly communicate immunization expectations and help address misconceptions, clarify risks, and support decisions through individualized, nonjudgemental conversations.

ACHA also emphasizes the importance of outbreak prevention and response. Effective outbreak planning includes maintaining immunization surveillance systems, applying consistent evidence‑informed exemption processes that balance respect individual autonomy with the responsibility to protect campus and community health, and establishing partnerships with on- and off-campus resources including local public health departments.

ACHA’s Vaccine-Preventable Diseases (VPD) Advisory Committee has created and maintains ACHA’s Immunization Recommendations for College Students that is grounded in evidence from federal public health agencies, medical professional societies, international health organizations, and peer‑reviewed literature. ACHA remains committed to supporting colleges and universities in reducing the spread of vaccine‑preventable diseases and responding effectively when outbreaks occur.

Measles on College Campuses

Campuses are especially vulnerable to measles outbreaks because they combine an extremely contagious, airborne virus, dense congregate living and learning environments, and exposure risk from travel to measles-endemic or high-incidence countries with potential immunity gaps.

• High transmissibility: Measles is highly contagious; ~90% of susceptible close contacts may become infected after exposure.
• Congregate living/learning: Dense, prolonged indoor contact (e.g., residence halls, classrooms, dining halls, events) increases exposure opportunities.
• Travel-associated introduction + immunity gaps: Travel to measles-endemic or high-incidence regions can introduce measles, and clusters of unvaccinated or under-vaccinated individuals allow rapid spread.

Preparing for Measles Cases

• Pre-plan with public health: designate a state/local health department point of contact; align campus procedures with current health department guidance/regulations; keep emergency operations plans current.
• Optimize measles immunity: promote high MMR coverage; ensure timely collection/verification of vaccination records; maintain an immunity roster (including exemptions); make MMR vaccination readily accessible (e.g., on-campus clinics with local partners).
• Standardize rapid clinical triage: if measles is suspected, mask immediately, isolate (home/residence hall preferred), and arrange medical evaluation; student health services should follow infection control procedures and coordinate testing with the health department.
• Pre-identify isolation capacity: a designated isolation space (private room, door that closes; window if available) and isolation housing for students who cannot go home; plan food delivery, necessities, and well-being checks.
• Environmental controls: keep the isolation space vacant for 2 hours after use, then clean/disinfect; staff monitoring/cleaning should have evidence of immunity and use a respirator (preferred) or disposable mask.
• Exposure management: work with public health to define exposures across classes/events/housing, implement exclusions and post-exposure measures as directed, and instruct exposed persons to monitor for symptoms for 21 days.

Preparing for a Measles Outbreak

• Maintain high MMR coverage and reliable records: strengthen immunization information systems, ensure timely documentation, and apply consistent, evidence-informed exemption processes.
• Keep response systems “always ready”: surveillance and response protocols, trained clinical/operations staff, and immediate access to masks, isolation space, and isolation housing.
• Coordinate with the health department as the lead authority: use public health guidance for testing, isolation duration, exposure definitions, exclusions, and vaccination/post-exposure prophylaxis (PEP) operations.
• Communicate clear clinical expectations: stay home/room when ill; seek evaluation before returning; 21-day symptom monitoring after potential exposure; protect privacy/confidentiality.
• Ensure continuity and support: plans to continue education during isolation/exclusion and to meet basic needs during isolation (healthcare, food, necessities, welfare checks).