Measles, Mumps, and Rubella Vaccine Recommendations and Safety

The MMR vaccine is administered to children in a 2-dose series at ages 12 through 15 months and 4 through 6 years. The second dose may be administered before age 4 years, provided at least 4 weeks have elapsed since the first dose.

Vaccination of Adults

Adults born before 1957 are generally considered immune to measles and mumps. All adults born in 1957 or later should have documentation of 1 or more doses of MMR vaccine unless they have a medical contraindication to the vaccine or laboratory evidence of immunity to each of the three diseases. Documentation of provider-diagnosed disease is not considered acceptable evidence of immunity for measles, mumps, or rubella.

Measles component:
A routine second dose of MMR vaccine, administered a minimum of 28 days after the first dose, is recommended for adults who:

  • are students in postsecondary educational institutions;
  • work in a health care facility; or
  • plan to travel internationally.

Persons who received inactivated (killed) measles vaccine or measles vaccine of unknown type during 1963–1967 should be revaccinated with 2 doses of MMR vaccine.

Mumps component:
A routine second dose of MMR vaccine, administered a minimum of 28 days after the first dose, is recommended for adults who:

  • are students in a postsecondary educational institution;
  • work in a health care facility; or
  • plan to travel internationally.

Persons vaccinated before 1979 with either killed mumps vaccine or mumps vaccine of unknown type who are at high risk for mumps infection (e.g., persons who are working in a health care facility) should be considered for revaccination with 2 doses of MMR vaccine.

Rubella component:
For women of childbearing age, regardless of birth year, rubella immunity should be determined. If there is no evidence of immunity, women who are not pregnant should be vaccinated. Pregnant women who do not have evidence of immunity should receive MMR vaccine upon completion or termination of pregnancy and before discharge from the health care facility.

Health care personnel born before 1957:

For unvaccinated health care personnel born before 1957 who lack laboratory evidence of measles, mumps, and/or rubella immunity or laboratory confirmation of disease, health care facilities should consider vaccinating personnel with 2 doses of MMR vaccine at the appropriate interval for measles and mumps or 1 dose of MMR vaccine for rubella.

Measles, Mumps, and Rubella (MMR) Vaccine Safety

There is one MMR vaccine licensed in the United States.

The safety record of the MMR vaccine is very good.  Most children who get the vaccine do not have any problems.  As with all medicine, some problems – usually very minor – can happen. The MMR vaccine sometimes causes pain where the shot is given, fever, a mild rash, or swelling of the neck or cheek.  On very rare occasions, the vaccine’s ingredients cause severe (anaphylactic) allergic reactions.  In addition, the MMR vaccine has been linked with a very small risk of febrile seizures (seizures or jerking caused by fever).  This happens most often in children between 12-23 months old.

Febrile seizures can happen any time a child gets sick and has a fever.  Most happen in children 14-18 months old.  Because the risk of febrile seizures increases as infants get older, it is recommended that children get vaccinated as soon as recommended (12-15 months old for the MMR vaccine).

Other rare risks linked with MMR vaccine include joint pain, temporary arthritis, and immune thrombocytopenic purpura (ITP), a disorder that decreases the blood platelet count. 

Two recent studies indicate that for every 10,000 children who get their first MMR and varicella vaccines as separate shots when they are 12-23 months old, about 4 will have a febrile seizure during the 5-12 days following vaccination. Children of the same age who get the combined measles, mumps, rubella and varicella (MMRV) vaccine as their first vaccine against these diseases  are twice as likely to have a febrile seizure during the same time period.

Studies have shown that for children younger than 7 years old, there is a small increased risk of febrile seizures approximately 8 to14 days after the MMR shot; this happens in about 1 in 3,000-4,000 children.

Immune thrombocytopenic purpura (ITP) is a disorder that decreases the body’s ability to stop bleeding.  It can happen after both natural measles infection as well as after receipt of MMR vaccine. It is usually not life threating, however; treatment can include blood transfusion. The risk of ITP has been shown to be increased in the six weeks following an MMR vaccine, with one study estimating 1 case per 40,000 vaccinated children.

Joint pain is linked with the rubella portion of MMR vaccine. Joint pain and temporary arthritis happen more often after MMR vaccination in adults than in children.  Females after puberty also experience this issue more often than males. Joint pain or stiffness occurs in up to 25% of females past puberty; their symptoms generally begin 1 to 3 weeks after vaccination, are usually mild and last about two days.  These symptoms rarely come back.

Measles inclusion body encephalitis, or severe brain swelling caused by the measles virus, is a complication of getting infected with the wild measles virus.  While rare, this almost always happens in patients with low immune systems.  The illness usually develops within one year after initial measles infection and has a high death rate. There have been 3 published reports of this complication happening to vaccinated people. In these cases, encephalitis developed between 4 and 9 months after the MMR shot. In one case, the measles vaccine strain was identified as the cause.

 

For more information regarding MMR vaccine safety, visit CDC's webpage Measles, Mumps, and Rubella (MMR) Vaccine Safety

Source: http://www.cdc.gov/vaccinesafety/Vaccines/MMR/

 

Updated 10/16/15

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