More than 74,000 older adults seek measles immunity tests amid US outbreaks
Measles was surging in West Texas as Nancy Churnin eagerly awaited the birth of two grandchildren. She was sure she had been vaccinated decades ago, but she wanted to confirm she was still protected.
She didn鈥檛 want to risk spreading the highly contagious disease to vulnerable newborns, so she got a simple blood test last year.
鈥淚 wanted to double-check my immunity,鈥 said Churnin, a children鈥檚 book author who lives in Plano, Texas, near Dallas.
Churnin is among more than 74,000 U.S. adults over age 50 who have received blood tests checking their measles antibody status from January 2025 through March of this year, according to an exclusive analysis of medical records data conducted in response to questions from .
The rates of older adults seeking measles immunity tests spiked across the country during last year鈥檚 West Texas measles outbreak and again earlier this year as South Carolina鈥檚 measles outbreak became the nation鈥檚 largest in decades, , a healthcare data and analytics company that receives patient care data that serve about 1 in 3 U.S. residents.
Truveta鈥檚 research team said its analysis suggests that public awareness of high-profile local measles outbreaks might be influencing more people across the country to seek the immunity tests, which are called titer tests.
Nina Masters, the principal applied research scientist at Truveta who led the analysis, told Healthbeat she was struck by the spikes in titer testing during outbreaks because historically, the standard recommendation has been to just vaccinate people who don鈥檛 have proof of immunity.
鈥淭o me, that suggests outbreaks are influencing healthcare-seeking behavior and reflects growing concern among Americans who want to understand their immunity status and protect themselves and their loved ones amid rising measles activity,鈥 said Masters, a former Centers for Disease Control and Prevention epidemiologist who has deployed to multiple measles outbreaks.
As the U.S. is poised to have for measles, people who are infected are increasingly to the virus in , from schools and churches to restaurants, stores, and airports. The virus spreads through the air and can after the infectious person has left, putting anybody who goes through the area at risk if they lack immunity.
The result is that large numbers of people need to quarantine at home for up to 21 days if they are not vaccinated against measles or cannot provide proof of their immunity through previous vaccination or illness.
鈥淲e think it鈥檚 important for people to know their immunity status,鈥 said Dr. Emma Doran of the North Carolina Department of Health and Human Services, which recommends titer tests as one of the ways people can check their immunity before they are exposed.
Titer tests can be particularly helpful for older adults who were vaccinated against measles long before electronic medical records and state immunization registries, and no longer have their paper vaccination records. The measles vaccine provides . Two doses of the combination measles-mumps-rubella shot is 97% effective against measles, and one dose is 93% effective.
鈥淭here is a good chunk of the population there that, unfortunately, if somebody didn鈥檛 hold on to that paper, they don鈥檛 have it,鈥 said Doran, who is the medical director of the department鈥檚 Vaccine Preventable and Respiratory Diseases Medical Consultation Unit.
Immunity tests spiked in US during Texas, South Carolina outbreaks
The new data on titer testing provides a window into one of the many ways the return of measles in the United States is impacting people鈥檚 lives. The disease was from the country in 2000. In November, an international public health body whether the disease has once again become endemic to the United States.
During 2025 鈥 as a was underway in West Texas 鈥 more than 62,000 older adults across the country went to doctors鈥 offices to get measles titer tests, the Truveta analysis found.
The surge in testing was dramatic, and not just in Texas.
Nationwide, adults 50 and older received measles immunity testing last year at nearly seven times the rate they had in recent years. From 2021 through 2024, a typical month saw about 50 people get tested for measles immunity for every 100,000 adults who had an outpatient doctor鈥檚 visit. But in 2025, that figure reached nearly 341 tests per 100,000 adults.
The rate of titer testing within the state of Texas was particularly high, peaking at 627 tests per 100,000. But even when data from Texas was excluded, the data for the rest of the United States still showed a spike in testing at nearly 309 tests per 100,000.
A similar pattern played out during the first three months of this year, when more than 12,000 U.S. adults over 50 received titer tests as became the nation鈥檚 largest in 35 years. The analysis showed an even larger spike in testing rates in 2019, when measles outbreaks also fueled of cases.
The Truveta analysis involved an examination of electronic health record data from nearly 30 million patients over 50 who had outpatient visits from January 2018 through March 2026. The data is provided to Truveta by the company鈥檚 . The researchers looked at data for older adults to try to focus on those seeking the tests long after childhood vaccination or illness, as well as to reduce the inclusion of routine prenatal testing.
Truveta conducted the analysis after Healthbeat asked the company whether its data could provide any information about whether more people were seeking titer tests amid the recent measles outbreaks.
While the data does not say why the individuals received measles titer tests, Masters and her research team said the spikes in titer testing during outbreaks likely reflect a combination of patient concern, vigilance by healthcare providers, exposure-related evaluations, and adult uncertainty about immunization status. Media coverage might also play a role.
There could be many reasons why an adult might want to check their immunity amid the increased spread of measles, the researchers said. They include grandparents seeking to confirm they are protected before visiting infant grandchildren, as well as adults who are worried about the risk of living in or traveling to an outbreak area.
Protecting her newborn grandbabies was Nancy Churnin鈥檚 motivation in getting a measles titer test last year before they were born. The babies鈥 parents were also seeking to safeguard their infants against infectious diseases.
鈥淎nybody who wanted to see the baby was on notice: Get all your shots or we can鈥檛 let you around the baby unless you鈥檙e fully, fully vaccinated,鈥 recalled Churnin.
When Churnin鈥檚 titer test result came back, she was surprised to learn she was not immune to measles. She was certain she had been vaccinated as a child, but she was born in 1957 and she has no access to her records, and her parents aren鈥檛 around to ask. After the test, she got vaccinated.
鈥淚 was very, very glad I got the test. I鈥檓 very, very glad I got immunized,鈥 Churnin said. 鈥淚 don鈥檛 want to do anything to endanger those babies, anybody鈥檚 babies.鈥
Should you get a titer test? Cost, doctors鈥 views shape decisions.
Most older adults are likely to be protected against measles either because they were vaccinated as children or had the disease before vaccines became available.
Adults born before 1957 are officially presumed to be immune to measles when they were children, according to the Centers for Disease Control and Prevention. Vaccines against measles have been available in the United States since the early 1960s, with an improved version of the vaccine .
Should those who can鈥檛 find their vaccination records ask their doctors for titer tests?
The CDC recommends that adults born during or after 1957 who can鈥檛 find their immunization records get the MMR vaccine. But the also says they can get a measles titer test to determine if they need the vaccine. 鈥淭here is no harm in getting another dose of MMR vaccine if an individual may already be immune,鈥 the CDC says.
There are several factors to consider in deciding whether to do a titer test or just get another MMR shot, experts said.
Dr. Margot Savoy, chief medical officer of the American Academy of Family Physicians, told Healthbeat that it鈥檚 not common for patients to ask for a titer test unless they work in a healthcare field where the test is required.
鈥淭he question that they normally ask is: How do I know if I鈥檓 protected?鈥 she said.
鈥淔or most family physicians, and most physicians in general, their answer would be, I don鈥檛 know that I would draw titers on most people. If we鈥檙e at all worried that you might not be protected, we would just give you another MMR鈥 vaccine, she said.
Savoy said the time and cost of getting a titer test is not worth it for the average patient, because the test may show the person needs to get vaccinated anyway.
Unlike the MMR vaccine, which is routinely covered by insurance plans without patient cost-sharing, there are no requirements for insurance coverage of titer tests, although insurers can choose to cover them. In addition to getting the tests through a doctor鈥檚 office, many direct-to-consumer labs and walk-in clinics also will do the tests without a prescription, but the costs can range from $40 to $150 or more.
Individual patients may weigh the costs and benefits differently when deciding between just getting an MMR shot or getting tested, said Doran.
鈥淚 think there鈥檚 no one-size-fits-all approach for whether to do an MMR vaccine if you don鈥檛 have the records or whether to get a titer first,鈥 she said.
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