From the Guidelines
Adults who have not been vaccinated against measles, mumps, and rubella (MMR) should receive two doses of MMR vaccine, administered a minimum of 28 days apart, especially if they are students in postsecondary educational institutions, work in a health care facility, or plan to travel internationally. According to the recommended adult immunization schedule: United States, 2013 1, a routine second dose of MMR vaccine is recommended for adults who are at high risk for mumps infection. Key groups that should be considered for MMR vaccination include:
- Students in postsecondary educational institutions
- Health care facility workers
- International travelers
- Women of childbearing age who lack evidence of rubella immunity
- Health care personnel born before 1957 who lack laboratory evidence of measles, mumps, and/or rubella immunity or laboratory confirmation of disease. For women of childbearing age, rubella immunity should be determined, and if there is no evidence of immunity, they should be vaccinated if not pregnant 1. It is essential to note that the MMR vaccine is highly effective in preventing measles, mumps, and rubella, and vaccination is crucial for both individual and community protection, especially in high-risk settings.
From the Research
MMR Vaccination Guidelines for Adults
The guidelines for measles, mumps, and rubella (MMR) vaccination in adults are as follows:
- Two doses of MMR vaccine are recommended 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.
- One dose of MMR vaccine is recommended for other adults aged ≥18 years 2.
- For prevention of rubella, 1 dose of MMR vaccine is recommended for persons aged ≥12 months 2.
- The Standing Committee on Immunization (STIKO) recommends a first vaccination against measles as a measles-mumps-rubella combined vaccination (MMR) in adults born after 1970, if they have not yet been vaccinated against measles or have only been vaccinated once against measles or if their vaccination status is unclear 3.
Special Considerations
- For persons with human immunodeficiency virus (HIV) infection, the Advisory Committee on Immunization Practices (ACIP) recommends vaccination to all persons aged ≥12 months with HIV infection who do not have evidence of current severe immunosuppression 2.
- For measles postexposure prophylaxis, ACIP recommends the use of immune globulin administered intramuscularly (IGIM) to include infants aged birth to 6 months exposed to measles, and the use of immune globulin administered intravenously (IGIV) for severely immunocompromised persons and pregnant women without evidence of measles immunity who are exposed to measles 2.
Safety and Efficacy
- A prospective cohort study found that the MMR vaccine is safe in adults, with low rates of systemic adverse events and no serious adverse events 4.
- A longitudinal study found that neutralizing antibody levels against measles and rubella remain high in adults up to 11 years after receipt of a third MMR dose, but some adults may become susceptible to measles infection over time despite receipt of 3 vaccine doses 5.
- The Centers for Disease Control (CDC) recommend 2 documented doses of the MMR vaccine for adequate measles, mumps, and rubella immunity for all children and most adults, but sometimes individuals may not achieve seroconversion after 2 doses, raising questions about adequate immunity 6.