MMR Vaccination for a 62-Year-Old Not Immune to Mumps and Rubella
A 62-year-old individual who lacks immunity to mumps and rubella should receive one dose of MMR vaccine to establish immunity, unless contraindicated.
Assessment of Immunity Status
For adults born before 1957:
- Generally considered immune to measles and mumps due to natural infection 1
- However, this presumption is not absolute, especially for rubella 1
- Laboratory evidence showing lack of immunity overrides the age-based presumption 1
Vaccination Recommendations
Primary Recommendation
- For a 62-year-old (born before 1957) without immunity to mumps and rubella:
Special Considerations for High-Risk Individuals
If the individual falls into any of these categories, consider a more aggressive approach:
- Healthcare personnel: Consider 2 doses of MMR for measles/mumps immunity and at least 1 dose for rubella immunity 1
- International travelers: 2 doses recommended 1
- During outbreaks: Additional dose may be warranted 1
Contraindications
Do not administer MMR vaccine if the patient has:
- Severe allergic reaction to previous dose or vaccine component 2
- Immunosuppression 2
- Moderate or severe acute illness 2
- Active untreated tuberculosis 2
- Pregnancy (should be avoided for 1 month following vaccination) 2
Expected Outcomes
After vaccination:
- High immunogenicity with seroconversion rates of 95-100% 3
- Long-lasting immunity that may be lifelong 3
- Protection from disease complications, which can be more severe in adults 4
Potential Adverse Effects
- Minor reactions may occur approximately one week after immunization 3
- Common side effects include injection site redness (12.2%), pain (11.8%), and fever (3.0%) 5
- Rarely, mumps vaccine-induced meningitis may occur (milder than wild-type infection) 3
Follow-up
- No routine post-vaccination antibody testing is recommended 1
- Documentation of vaccination should be maintained as evidence of immunity 1
- No booster doses are required after establishing immunity in most cases 1
Important Caveats
- The FDA-approved MMR vaccine is administered as a subcutaneous or intramuscular injection 2
- Vaccination may not offer 100% protection from measles, mumps, and rubella infection 2
- If the individual is planning international travel, vaccination should be completed at least 2 weeks before departure 4
- For women of childbearing age, rubella immunity is particularly important to prevent congenital rubella syndrome 1