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Now, Texas is experiencing the largest measles outbreak in nearly three decades, and the virus is spreading across the country.

The good news is that most people are protected against measles, as two doses of the MMR — measles, mumps, rubella — vaccine are standard practice in the U.S. for children. A single dose of this vaccine is 93% effective against measles, while two doses are 97% effective, according to the CDC.

Where is measles spreading?

As of March 13, the CDC reported 301 measles cases in 15 states: Alaska, California, Florida, Georgia, Kentucky, Maryland, New Jersey, New Mexico, New York City, New York State, Pennsylvania, Rhode Island, Texas, Vermont and Washington. Of those sickened, 17% were hospitalized.

Even if your state is not listed, there may be active measles cases in your area. For example, Maryland recently reported that an individual with measles traveled through Dulles International Airport, potentially spreading the virus beyond the state.

One death from measles was confirmed, and another is under investigation, according to the CDC.

Who should get the shot?

While modern measles vaccines are highly effective, older versions of the vaccine may provide inadequate protection.

“Some people who received the old, inactivated measles vaccine between 1963 and 1967 may benefit from a booster with the live MMR vaccine,� advised Dr. Elizabeth Hammershaimb, an infectious-disease pediatrician with the University of Maryland Children’s Hospital and an assistant professor at the university's School of Medicine.

Anyone vaccinated during that period should check their vaccine records to confirm which version of the shot they received.

Note that some institutions also recommend people immunized in 1968 get the booster, as the rollout of the improved vaccine may not have started on the first day of that year.

“People with a history of immune-compromising conditions, and nonpregnant women of childbearing potential without evidence of immunity, may also benefit from a booster on a case-by-case basis,� Dr. Hammershaimb said.

Johns Hopkins also explains that older adults born before 1957 are presumed to have natural immunity, as they were likely exposed to measles before vaccines became available. However, Yale Medicine recommends that high-risk individuals, including health care workers born before that time, consider a booster if they do not have proof of immunity.

Proof of immunity?

There are steps you can take to find out if you have the necessary protection against measles.

MMR titer tests are simple blood tests that confirm whether you are immune to measles because of vaccination or prior infection. These tests are quick and affordable and can be obtained through your health care provider or third-party labs like Labcorp.

“A measles titer test, which checks for immunity to measles, can typically cost around $83 to $129,� advised Peter Zimmerman, Ph.D., professor of pathology at Case Western Reserve University. Unfortunately, he said health insurance typically does not cover these tests.

Dr. Hammershaimb also explained that “antibodies may not represent the full picture of a person’s immunity against measles. Low titers may be a clue to low immunity to measles, but there are other pieces of the immune system that are more difficult to measure and that may provide some protection even if antibody levels are low.�

Dr. Amy Edwards, FAAP, an associate professor of pediatrics at Case Western Reserve University School of Medicine, believes titer testing is more hassle than just getting the shot, especially as data showed that “people who (for various reasons) get more than 2 doses of the MMR aren’t at increased risk of adverse reactions to the vaccine so it appears to be safe, though those studies are small.�

How much does it cost?

If you are concerned about your immunity levels and want to get an MMR booster, the good news is that most private insurance policies cover the vaccine with no out-of-pocket costs, even if you have not met your deductible. Medicare Part D also will pay for the vaccine for those covered.

For the uninsured, vaccines are widely available at walk-in clinics, including at drugstores like CVS and Walgreens. These vaccines are relatively affordable, as Bettercare reports the average cost per dose is about $90 to $125, making the cost for the complete series of two shots $180 to $250.

Don't wait

If you doubt your immunity to measles, do not wait to act. Before the vaccine, an estimated 48,000 people were hospitalized annually, with 400 to 500 measles-related deaths each year. There’s no reason to take that chance when you can virtually eliminate your risk with a shot.