MMR vaccine Combination of Measles vaccine Mumps vaccine Rubella vaccine
Pregnancy category AU: B2
The MMR vaccine is a vaccine against measles, mumps, and rubella (German measles), abbreviated as MMR.
The MMR vaccine is a mixture of live weakened viruses of the three diseases.
The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, with at least four weeks between the doses.
After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella.
The vaccine is also recommended for those who do not have evidence of immunity, those with well-controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized.
It is given by injection.
Measles resulted in 2.6 million deaths per year before immunization became common.
This has decreased to 122,000 deaths per year as of 2012, mostly in low-income countries.
Rates of disease have been seen to increase in populations that go unvaccinated.
Side effects of immunization are generally mild and resolve without any specific treatment.
These may include fever, as well as pain or redness at the injection site.
Severe allergic reactions occur in about one in a million people.
MMR vaccine contains live viruses, and is therefore not recommended during pregnancy but may be given during breastfeeding.
The vaccine is safe to give at the same time as other vaccines.
Being recently immunized does not increase the risk of passing measles, mumps, or rubella on to others.
No evidence of an association between MMR immunization and autistic spectrum disorders is present.
The MMRV vaccine, which also covers chickenpox, may be used instead.
The effectiveness of MMR and MMRV vaccine supports current policies of mass immunization aimed at global measles eradication to reduce morbidity and mortality associated with measles mumps rubella and varicella.
Measles cases reported in the United States fell drastically after the introduction of the measles vaccine.
The benefit of measles vaccination in preventing illness, disability, and death has been well documented. In 2017, an outbreak of measles occurred among the Somali-American community in Minnesota, where MMR vaccination rates had declined due to the misconception that the vaccine could cause autism. The US Centers for Disease Control and Prevention recorded 65 affected children in the outbreak by April 2017.[31]
The MMR vaccine is administered by a subcutaneous injection, the first dose typically at twelve months of age.
The second dose may be given as early as one month after the first dose.
The second dose is a dose to produce immunity in the small number of persons (2–5%) who fail to develop measles immunity after the first dose.
In the US it is done before entry to kindergarten because that is a convenient time.
Adverse reactions, rarely serious, may occur from each component of the MMR vaccine.
Ten percent of children develop fever, malaise, and a rash 5–21 days after the first vaccination.
Three percent develop joint pain lasting 18 days on average.
Older women appear to be more at risk of joint pain, acute arthritis, and even (rarely) chronic arthritis.
Anaphylaxis is an extremely rare allergic reaction to the vaccine.
Additional possible adverse events on the vaccination label: acute disseminated encephalomyelitis (ADEM), and transverse myelitis, with difficulty walking.
The measles component of the MMR vaccine can cause measles inclusion body encephalitis in immunocompromised individuals.
A Cochrane review found that, compared with placebo, MMR vaccine was associated with fewer upper respiratory tract infections, more irritability, and a similar number of other adverse effects.
Naturally acquired measles often occurs with immune thrombocytopenic purpura (ITP, a purpuric rash and an increased tendency to bleed that resolves within two months in children), occurring in 1 to 20,000 cases.
Approximately 1 in 40,000 children are thought to acquire ITP in the six weeks following an MMR vaccination.
Multiple peer-reviewed studies have failed to show any association between the vaccine and autism.
The MMRV vaccine, a combined measles, mumps, rubella, and varicella (chickenpox) vaccine, has been proposed as a replacement for the MMR vaccine to simplify the administration of the vaccines.
Data indicate a rate of febrile seizures of 9 per 10,000 vaccinations with MMRV, as opposed to 4 per 10,000 for separate MMR and varicella shots.
US health officials therefore, do not express a preference for use of MMRV vaccine over separate injections.
Some brands of the vaccine use gelatin, derived from pigs, as a stabilizer.
Alternative vaccines without pig derivatives are approved and available.