What is the recommended Measles, Mumps, and Rubella (MMR) vaccine schedule for children?

MMR Vaccination Schedule for Children

The recommended MMR vaccination schedule for children consists of two doses: the first dose at 12-15 months of age and the second dose at 4-6 years of age. 1, 2, 3

First Dose (12-15 months)

• The first dose of MMR vaccine should be administered at 12-15 months of age 1, 2
• Minimum age for the first dose is 12 months 1
• For the first dose at age 12-47 months, either:
  • MMR vaccine and varicella vaccine separately, OR
  • MMRV (combined measles, mumps, rubella, and varicella) vaccine 1
• CDC recommends using separate MMR and varicella vaccines for the first dose in children 12-47 months unless parents specifically prefer MMRV 1

Second Dose (4-6 years)

• The second dose is routinely recommended at age 4-6 years 1, 2, 3
• The second dose may be administered earlier than 4 years, provided at least 4 weeks have elapsed since the first dose 1
• For the second dose, MMRV vaccine is generally preferred over separate MMR and varicella vaccines 1
• Children who have not received the second dose by age 11-12 years should complete the schedule at that time 1

Special Considerations

Minimum Intervals

• Minimum interval between doses: 4 weeks 1
• If not previously vaccinated, 2 doses of MMR can be administered during any visit with at least 4 weeks between doses 1

Catch-up Vaccination

• Children who received their first dose before their first birthday should receive two additional doses at the recommended ages (12-15 months and 4-6 years) 3
• There is no need to restart a vaccine series regardless of the time elapsed between doses 1

Precautions

• A personal or family history (sibling or parent) of seizures is a precaution for MMRV vaccine use 1, 2
• Children with seizure history should generally receive separate MMR and varicella vaccines instead of MMRV 1, 2

Early Vaccination Considerations

• Early vaccination (before 12 months) is not part of the routine schedule but may be considered in special circumstances such as during outbreaks 4
• Research shows that vaccination before 8.5 months of age may lead to blunted antibody responses to subsequent MMR vaccinations 4
• Early vaccination should only be considered during measles outbreaks or situations with increased risk of measles virus infection 4

Administration

• MMR vaccine can be administered either intramuscularly or subcutaneously 3
• The standard dose is approximately 0.5 mL 3
• For post-exposure prophylaxis for measles, administer MMR vaccine within 72 hours after exposure 3

The two-dose MMR vaccination schedule has proven highly effective in preventing measles, mumps, and rubella, with seroconversion rates approaching 100% after the second dose 5, 6. Following this schedule is critical for both individual protection and maintaining community immunity against these highly contagious diseases.