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

MMR Vaccine Schedule Recommendations

The MMR vaccine is routinely recommended as a 2-dose series, with the first dose administered at age 12-15 months and the second dose at age 4-6 years. 1, 2

First Dose Recommendations

• The minimum age for MMR vaccination is 12 months 1
• The first dose should be administered between 12-15 months of age as part of routine childhood immunization 1
• For children who missed the routine schedule, the first dose can be administered up to 12 years of age 1
• For children aged 12-47 months, either MMR vaccine plus separate varicella vaccine or the combination MMRV vaccine may be used for the first dose 1
• When considering MMRV for the first dose in children 12-47 months, providers should discuss the benefits and risks with parents/caregivers, noting that MMRV is associated with a higher risk of fever and febrile seizures compared to separate MMR and varicella vaccines 1
• Unless parents specifically request MMRV, the CDC recommends using separate MMR and varicella vaccines for the first dose in children 12-47 months 1

Second Dose Recommendations

• The second dose is routinely recommended at age 4-6 years (before school entry) 1
• The second dose may be administered earlier than 4 years of age, provided at least 4 weeks have elapsed since the first dose 1
• For the second dose at any age (15 months-12 years), MMRV vaccine is generally preferred over separate injections of MMR and varicella vaccines 1
• For the first dose in children ≥48 months, MMRV vaccine is generally preferred over separate injections 1

Special Considerations

• A personal or family history (sibling or parent) of seizures of any etiology is a precaution for MMRV vaccination; in these cases, separate MMR and varicella vaccines are recommended 1
• If not previously vaccinated according to schedule, older children and adolescents should receive 2 doses of MMR vaccine at least 4 weeks apart 1
• For adults without evidence of immunity, 2 doses of MMR vaccine separated by at least 4 weeks are recommended for high-risk groups (college students, healthcare personnel, international travelers) 2, 3
• For other adults without evidence of immunity, 1 dose of MMR vaccine is recommended 2

Minimum Intervals

• The minimum interval between the first and second doses of MMR vaccine is 4 weeks 1
• If MMR vaccine is administered prior to age 4-6 years for the second dose, at least 4 weeks should have elapsed since the first dose 1

Contraindications and Precautions

• MMR should not be administered to severely immunocompromised children 1
• MMR may be administered simultaneously with other vaccines or at any time before or after an inactivated vaccine 1
• If not administered simultaneously with other live vaccines, MMR should be given at least 28 days before or after another live vaccine (except varicella vaccine, for which a minimum interval of 3 months is recommended) 1

Following this schedule provides optimal protection against measles, mumps, and rubella while minimizing the risk of adverse events.