MMR Vaccination for Adults
Adults born in 1957 or later should receive at least one dose of MMR vaccine, with a second dose (administered at least 28 days after the first) specifically recommended for healthcare workers, students in postsecondary institutions, and international travelers. 1
Birth Year Determines Baseline Requirements
- Adults born before 1957 are generally considered immune to measles and mumps and do not require vaccination 1
- Adults born in 1957 or later need documentation of at least one MMR dose unless they have laboratory evidence of immunity to all three diseases or laboratory confirmation of disease 1, 2
- Provider-diagnosed disease is NOT acceptable evidence of immunity for any of the three diseases (measles, mumps, or rubella) 1, 3
Who Needs Two Doses
A second dose of MMR (minimum 28 days after the first) is specifically indicated for: 1, 3
- Students in postsecondary educational institutions
- Healthcare facility workers
- International travelers
- Adults in outbreak settings or recently exposed to measles
- Adults who received killed measles vaccine or measles vaccine of unknown type between 1963-1967
- Adults vaccinated with mumps vaccine before 1979 who are at high risk for mumps infection
Special Populations Requiring Attention
Healthcare Personnel Born Before 1957:
- Despite birth year suggesting immunity, unvaccinated healthcare workers born before 1957 who lack laboratory evidence of immunity should be considered for vaccination with 2 doses of MMR for measles/mumps or 1 dose for rubella 1, 3
- This is a critical exception to the general "born before 1957" rule 3
Women of Childbearing Age:
- All women of childbearing age should be considered susceptible to rubella unless they have received at least one MMR dose or have serologic evidence of immunity 2
- Pregnant women who lack immunity should receive MMR immediately upon completion or termination of pregnancy, before hospital discharge 1
- Contraindication: MMR must not be given to pregnant women or those planning pregnancy within 4 weeks 3, 2
Dosing Interval and Administration
- The two doses must be separated by at least 28 days (minimum interval) 1, 4
- This interval is based on the principle that live virus vaccines not given simultaneously should be separated by at least one month 1
- The second dose is not a booster but addresses primary vaccine failure in the small proportion who don't respond to the first dose 1
Evidence of Immunity (Acceptable Documentation)
Adults are considered immune if they have: 4, 2
- Documentation of age-appropriate vaccination with MMR
- Laboratory evidence of immunity to all three diseases
- Laboratory confirmation of disease (NOT provider diagnosis)
- Birth before 1957 (except healthcare personnel)
Safety Profile
- A third dose study in young adults showed mild, transient symptoms: 18% experienced increased symptoms post-vaccination, most commonly headache (13%), joint problems (10%), and diarrhea (8%), with median onset 3-6 days and duration 1-2 days 5
- Second dose administration shows comparable safety whether given as MMRV or MMR, with no increased risk of febrile convulsions compared to MMR alone 6