Which adults need the Measles, Mumps, and Rubella (MMR) vaccine?

MMR Vaccination Recommendations for Adults

Adults born in 1957 or later should receive at least one dose of MMR vaccine unless they have documentation of vaccination or other acceptable evidence of immunity to measles, mumps, and rubella. 1

General Adult Recommendations

• Adults born in 1957 or later who do not have a medical contraindication should receive at least one dose of MMR vaccine unless they have documentation of prior vaccination or other evidence of immunity 1
• Persons born before 1957 are generally considered immune to measles and mumps, except for healthcare personnel 1, 2
• Women of childbearing age should be considered susceptible to rubella unless they have received at least one dose of MMR vaccine or have serologic evidence of immunity 1

Adults Requiring Two Doses of MMR

A second dose of MMR vaccine is recommended for adults who:

• Are students in postsecondary educational institutions 1, 2
• Work in healthcare facilities 1, 2
• Plan to travel internationally 1, 2
• Have been recently exposed to measles or are in an outbreak setting 1, 2
• Were previously vaccinated with killed measles vaccine 1, 2
• Were vaccinated with an unknown type of measles vaccine during 1963-1967 1, 2
• Live in a community experiencing a mumps outbreak and are in an affected age group 1

Special Populations

Healthcare Personnel

• Healthcare personnel born before 1957 who lack laboratory evidence of immunity should receive at least one dose of MMR vaccine 1, 2
• During outbreaks, healthcare facilities should consider administering a second dose to healthcare personnel born before 1957 1

Women of Childbearing Age

• MMR vaccine should be offered to all women of childbearing age who lack evidence of rubella immunity 1
• Vaccination opportunities include:
  • Routine medical and gynecologic visits 1
  • Family planning settings 1
  • Before discharge from hospitals or birthing centers 1
• Women should avoid pregnancy for 4 weeks after vaccination 1

International Travelers

• Adults traveling internationally should ensure they are immune to measles, mumps, and rubella 1
• Two doses of MMR vaccine are recommended for international travelers 1, 2

Evidence of Immunity

Acceptable evidence of immunity to measles, mumps, and rubella includes:

• Documentation of age-appropriate vaccination 1, 2
• Laboratory evidence of immunity or laboratory confirmation of disease 1, 2
• Birth before 1957 (except for healthcare personnel and women who could become pregnant) 1
• For measles: Healthcare provider diagnosis of previous measles infection 1
• For mumps: Healthcare provider diagnosis of previous mumps infection 1

Safety Considerations

• MMR vaccine is generally safe and well-tolerated in adults 3, 4
• Common mild adverse events include:
  • Injection site reactions (reported in 25% of recipients) 5
  • Headache, joint problems, and lymphadenopathy 5
• Serious adverse events are rare, with incidence ≤6 per 100,000 doses 3
• MMR vaccine should not be administered to pregnant women 1

Common Pitfalls to Avoid

• Assuming all adults born before 1957 are immune to rubella, especially women of childbearing age 1
• Failing to vaccinate international travelers, healthcare workers, and college students with a second dose 1, 2
• Accepting self-reported history of disease as evidence of immunity (laboratory confirmation or healthcare provider diagnosis is required) 1, 2
• Not recognizing the need for MMR vaccination in certain immigrant populations who may have grown up in areas without routine rubella vaccination 1