Vaccines by disease: Learning more about the measles, mumps & rubella vaccine

This vaccine protects against three serious illnesses: measles, mumps and rubella (German measles). Measles has been eliminated in the United States, but in 2008 more cases occurred than in the prior decade because measles was introduced into an unvaccinated community by an American traveler. Measles cases now are imported from countries where measles outbreaks occur (eg., British Isles, Switzerland, Japan, developing countries, etc), and unvaccinated people bring measles here where it is spread to unvaccinated  and incompletely vaccinated children and adults.  Rubella, or German measles, also has been eliminated in the United States. Mumps is uncommon since MMR vaccine was introduced, but outbreaks still occur and these infections are common in some parts of the world.

Measles is a severe illness that can lead to ear infections, brain damage, pneumonia and seizures. One to three of every 1,000 children who contract measles in the United States develops complications such as ear infections, pneumonia and, less often, brain inflammation and  death. In rare cases, children who recover from measles develop a severe and fatal neurological illness called subacute sclerosing panencephalitits (SSPE) many years after getting measles. SSPE never occurs after MMR vaccination. Pregnant women who develop measles can miscarry, have a premature birth or develop severe pneumonia requiring hospitalization.

People who develop mumps have swelling of the parotid glands inside the cheek and can suffer several complications including deafness; meningitis; and inflammation of the testicles, ovaries or pancreas. Pregnant women who develop mumps early in pregnancy can miscarry.

Rubella may cause fever, rash, swollen glands, joint pain, a decrease in a patient’s platelet count, encephalitis and temporary arthritis. Pregnant women who contract rubella may miscarry, or the fetus could develop congenital rubella syndrome, a syndrome that includes defects of the eyes, ears, heart, brain and nervous system.

Prevention is the key to not contracting measles, mumps and rubella and the most effective preventive method is the MMR vaccine.

Who should receive the MMR vaccine? In order for the MMR vaccine to be fully effective, two doses should be given to children when they are the following ages: 12 to 15 months 4 to 6 years Though this is the recommended MMR dosage schedule, the second dose of this vaccine is necessary and can be given at any age as long as 28 days have passed since the first dose. It is recommended that the second dose is given before the age of 4 to 6 years if the risk of exposure is high (for example, during an outbreak or if traveling to an area where measles is common). If a child or adolescent skipped the second dose of MMR, this should be given at the next health care visit. If the first dose is given after age 2, the second dose of MMR can be given 3 or more months later. During outbreaks of measles, the first dose of MMR can be given to children as young as 6 months of age, but to be fully protected children who receive their first dose of MMR before 1 year of age need two further doses starting at 12 to 15 months of age. Adults who are 18 years of age and born after 1956 should consider getting at least one dose of the MMR vaccine unless they can show they have had the diseases or the earlier vaccines. Pregnant women after delivery before hospital discharge if they are susceptible to rubella or have not had MMR vaccine or just one dose of MMR vaccine. Women who receive the MMR vaccine should wait one month after receiving MMR before trying to become pregnant. Some people should not receive the MMR vaccine including: Anyone who is severely allergic to gelatin, the antibiotic neomycin or has had a serious reaction to a previous dose of the MMR vaccine People with HIV/AIDS, weakened immune systems, cancer or low platelet counts; those being treated for another condition with steroids or those who have recently received a blood transfusion should speak with their primary health care providers about this vaccine. Review the vaccination schedule for those who start late on a vaccine or are more than one month behind.

When did the MMR vaccine become available?
A vaccine for measles was first licensed in the United States in 1963, followed by approval of mumps vaccine in 1967 and a rubella vaccine in 1969. Today, vaccines for measles, mumps and rubella are given in a combination vaccination called MMR. This vaccine is licensed for use in children, adolescents and adults.

In 2006, another vaccine called MMRV which combines MMR with the varicella vaccine was licensed in the United States for use in children ages 1 to 12 years. As of 2008, MMRV has not been available because of a shortage of the varicella component. It should become available again, however, in 2011.

How does someone become infected with measles, mumps and rubella?
These infections are caused by viruses that are spread through contact with another person or sometimes by airborne route (sneeze or cough).

How effective is the MMR vaccine?
When both doses of the MMR vaccine are given, the immunized person is 99.7 percent protected from measles and rubella, and about 85 percent from mumps.

Since the measles vaccine was licensed, there has been a 100 percent reduction in measles cases in the United States. All cases now are imported from other countries by unimmunized or under-immunized people. As of September of 2008 there were outbreaks of measles in 17 states (137 cases in children too young to have been vaccinated and children and adults not vaccinated).

With the introduction of the mumps vaccine, the number of mumps cases has fallen from approximately 200,000 cases per year to 600 cases annually. However, in 2006 outbreaks of mumps in adolescents and young adults were reported from several states.

Before a vaccine was developed for rubella, there was a rubella outbreak in the United States from 1963 to 1964 and 12 million people contracted the disease. 11,000 fetuses died and 20,000 babies were born with birth defects. Today, congenital rubella syndrome has been eliminated in the United States, and fewer than 25 rubella cases are reported in the United States each year.

However, outbreaks of measles, mumps and rubella still occur,, so it is important to keep vaccination rates high in the community.

Are there any serious side effects of the MMR vaccine?
Mild side effects may include:

• mild fever
• mild rash
• swelling of cheek or neck glands

• seizures brought on by a high fever
• temporary joint pain or stiffness
• temporary lowering of the patient’s platelet count

Rare side effects are a serious allergic reaction to a component in the vaccine

Millions of doses of MMR vaccine have been safely administered to children worldwide. Learn more about vaccines and autism.

How do I learn more about this vaccine?
The best person to ask about this or any vaccine is your child’s doctor. Your provider can answer your questions and give you more information on the measles, mumps and rubella vaccine.

Immunization is the best thing you can do for your child or yourself to protect against measles, mumps and rubella.