What are the guidelines for measles, mumps, and rubella (MMR) vaccine booster shots?

From the Guidelines

Adults born after 1957 who don't have evidence of immunity should receive at least one dose of MMR vaccine, and certain high-risk groups, including healthcare workers, international travelers, and students at post-secondary educational institutions, should receive two doses separated by at least 28 days. This recommendation is based on the guidelines outlined in the study published in 2013 1, which provides the most recent and highest quality evidence. The study recommends a routine second dose of MMR vaccine for adults who are students in postsecondary educational institutions, work in a health care facility, or plan to travel internationally.

Key Points

• Adults born before 1957 are generally considered immune to measles and mumps, but may still require vaccination against rubella if they do not have evidence of immunity 1.
• Healthcare personnel born before 1957 who lack laboratory evidence of measles, mumps, and/or rubella immunity or laboratory confirmation of disease should be considered for vaccination with 2 doses of MMR vaccine 1.
• Women of childbearing age should have their rubella immunity determined, and if they do not have evidence of immunity, they should be vaccinated with MMR vaccine if they are not pregnant 1.
• The MMR vaccine is highly effective, with about 97% of people developing immunity after two doses, and side effects are generally mild and temporary, including fever, mild rash, and soreness at the injection site.

High-Risk Groups

• Healthcare workers: should receive two doses of MMR vaccine separated by at least 28 days 1.
• International travelers: should receive two doses of MMR vaccine separated by at least 28 days 1.
• Students at post-secondary educational institutions: should receive two doses of MMR vaccine separated by at least 28 days 1.
• Women of childbearing age: should have their rubella immunity determined, and if they do not have evidence of immunity, they should be vaccinated with MMR vaccine if they are not pregnant 1.

From the Research

MMR Vaccine Booster Shots Guidelines

• The Advisory Committee on Immunization Practices (ACIP) recommends 2 doses of MMR vaccine routinely 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.
• For adults at high risk for exposure and transmission, such as students attending colleges or other post-high school educational institutions, healthcare personnel, and international travelers, 2 doses of MMR vaccine are recommended 2.
• A third dose of MMR vaccine (MMR3) may be recommended for individuals who have become susceptible to mumps virus infection during outbreaks, as it has been shown to provide additional protection 3.
• The MMR3 dose has been found to be safe and tolerable among young adults, with mild and transient systemic and local events reported 4.
• Studies have shown that a second dose of MMR vaccine is necessary to eliminate measles, as a large proportion of pre-school children had measles and mumps IgG antibody below the putative level of protection after receiving a first dose of MMR vaccine 5.
• The ACIP has revised its recommendations over the years, including a change from a one-dose to a two-dose schedule using combined MMR vaccine, and new recommendations for vaccination of preschool children at high risk of contracting measles, students in colleges and other institutions of higher education, healthcare personnel, and international travelers 2, 6.

Special Populations

• For persons with human immunodeficiency virus (HIV) infection, the ACIP recommends vaccination with 2 doses of MMR vaccine, with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years 2.
• For healthcare personnel, 2 doses of MMR vaccine are recommended, as they are at high risk for exposure and transmission 2.
• For international travelers, 2 doses of MMR vaccine are recommended, as they may be at high risk for exposure to measles, mumps, and rubella 2.

Booster Shot Effectiveness

• Studies have shown that the MMR3 dose can provide additional protection against mumps, with elevated antibody levels against mumps, measles, and rubella at 3 years after vaccination 3.
• The effectiveness of the MMR3 dose in preventing outbreaks of measles, mumps, and rubella is supported by studies that have shown a significant increase in antibody levels against these diseases after vaccination 3, 5.