Are there new Measles (Rubeola) vaccine recommendations?

From the Guidelines

Yes, there are new measles vaccine recommendations, specifically the approval of a second MMR vaccine, PRIORIX, which is recommended as an option to prevent measles, mumps, and rubella according to the existing recommended schedules and for off-label uses. The CDC recommends that infants aged 6-11 months who will travel or live abroad or during measles outbreaks should receive one dose of MMR vaccine before departure, which does not count toward the routine childhood vaccination series [ 1 ]. The routine childhood vaccination series still consists of two doses given at 12-15 months and 4-6 years of age. Additionally, for adults born after 1957 with no evidence of immunity, two doses of MMR vaccine are recommended, especially before international travel [ 1 ]. Healthcare personnel should have documented evidence of two MMR doses or laboratory evidence of immunity.

Key Points

• The new MMR vaccine, PRIORIX, is safe, immunogenic, and noninferior to M-M-R II [ 1 ]
• PRIORIX is fully interchangeable with M-M-R II for all indications for which MMR vaccination is recommended [ 1 ]
• The CDC recommends PRIORIX as an option for off-label uses, including infants aged 6-11 months who will travel or live abroad or during measles outbreaks, and for measles postexposure prophylaxis [ 1 ]

Recommendations

• PRIORIX is recommended as an option to prevent measles, mumps, and rubella according to the existing recommended schedules and for off-label uses [ 1 ]
• Infants aged 6-11 months who will travel or live abroad or during measles outbreaks should receive one dose of MMR vaccine before departure [ 1 ]
• Adults born after 1957 with no evidence of immunity should receive two doses of MMR vaccine, especially before international travel [ 1 ]

From the Research

Measles Vaccine Recommendations

The current recommendations for measles vaccination are as follows:

• Two doses of MMR vaccine are recommended for children, with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years before school entry 2
• Two doses are recommended for adults at high risk for exposure and transmission, and 1 dose for other adults aged ≥18 years 2
• For prevention of rubella, 1 dose of MMR vaccine is recommended for persons aged ≥12 months 2

Updates to Measles Vaccine Recommendations

Recent updates to measles vaccine recommendations include:

• Removing documentation of physician diagnosed disease as an acceptable criterion for evidence of immunity for measles and mumps 2
• Including laboratory confirmation of disease as a criterion for acceptable evidence of immunity for measles, rubella, and mumps 2
• Expanding recommendations for vaccination to all persons aged ≥12 months with HIV infection who do not have evidence of current severe immunosuppression 2
• Recommending revaccination of persons with perinatal HIV infection who were vaccinated before establishment of effective antiretroviral therapy (ART) with 2 appropriately spaced doses of MMR vaccine once effective ART has been established 2

World Health Organization (WHO) Recommendations

The WHO recommends the following:

• Removal of introduction criteria for the routine second dose of measles-containing vaccine (MCV2) 3
• Guidance on when to vaccinate infants from 6 months of age 3
• Guidance on re-vaccination of HIV-infected children receiving highly active anti-retroviral therapy (HAART) 3

Immunogenicity and Safety of Measles Vaccines

Studies have shown that:

• A second dose of measles vaccine administered to healthy participants 7 years of age or older induces robust immune responses and is well tolerated 4
• The effectiveness of measles vaccine in preventing measles is 95% after one dose and 96% after two doses 5
• The effectiveness of Jeryl Lynn containing MMR vaccine in preventing mumps is 72% after one dose and 86% after two doses 5
• There is evidence supporting an association between aseptic meningitis and MMR vaccines containing Urabe and Leningrad-Zagreb mumps strains, but no evidence supporting this association for MMR vaccines containing Jeryl Lynn mumps strains 5