What are the latest recommendations for Measles, Mumps, and Rubella (MMR) vaccination?

From the Guidelines

The current recommendation for measles vaccination is that all children should receive two doses of the MMR (measles, mumps, and rubella) vaccine, with the first dose at 12-15 months of age and the second dose at 4-6 years of age, as stated in the most recent guidelines 1.

Key Points:

• Adults born after 1957 who don't have evidence of immunity should get at least one dose of MMR vaccine.
• For those at higher risk, such as healthcare workers, international travelers, and college students, two doses are recommended, separated by at least 28 days.
• During measles outbreaks, additional doses may be recommended for certain populations.
• The vaccine is highly effective, with about 97% of people developing immunity after two doses, as supported by recent studies 1.
• Measles is extremely contagious and can cause serious complications including pneumonia, encephalitis, and even death, which is why vaccination is crucial for both individual and community protection through herd immunity.
• The MMR vaccine is safe, with most side effects being mild and temporary, such as fever or rash, as reported in the literature 1.
• People with severely compromised immune systems, pregnant women, and those with severe allergies to vaccine components should not receive the MMR vaccine.

Special Considerations:

• A personal or family history of seizures is a precaution for MMRV vaccination, and children with such a history should be vaccinated with MMR vaccine and varicella vaccine separately, as recommended by the ACIP 1.
• The use of MMRV vaccine is generally preferred over separate injections of its equivalent component vaccines for the second dose and for the first dose at age ≥48 months, considering provider assessment, patient preference, and potential for adverse events 1.

From the FDA Drug Label

M-M-R II is a vaccine indicated for active immunization for the prevention of measles, mumps, and rubella in individuals 12 months of age and older.

The latest recommendations about measles vaccination are that M-M-R II vaccine is indicated for active immunization for the prevention of measles, mumps, and rubella in individuals 12 months of age and older 2.

• The vaccine is immunogenic in triple seronegative children, 11 months to 7 years of age, with a single subcutaneous injection inducing measles HI antibodies in 95% of susceptible individuals 2.
• Infants as young as 6 months may be vaccinated with Measles Virus Vaccine, Live, with 74% of 6-month-old infants developing detectable neutralizing antibody titers 2.
• Revaccination at 15 months with M-M-R II vaccine can develop antibody titers similar to those of toddlers who were vaccinated previously at 15-months of age 2.

From the Research

Latest Recommendations for Measles Vaccination

The latest recommendations for measles vaccination are as follows:

• The Advisory Committee on Immunization Practices (ACIP) recommends 2 doses of MMR vaccine routinely for children, with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years before school entry 3.
• For adults at high risk for exposure and transmission, 2 doses of MMR vaccine are recommended, while 1 dose is recommended for other adults aged ≥18 years 3.
• The ACIP also recommends that persons with human immunodeficiency virus (HIV) infection who do not have evidence of current severe immunosuppression should receive 2 doses of MMR vaccine, with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years 3.

Vaccine Effectiveness and Safety

Studies have shown that:

• The effectiveness of the MMR vaccine in preventing measles is 95% after one dose and 96% after two doses 4.
• The vaccine is also effective in preventing mumps, with an effectiveness of 72% after one dose and 86% after two doses 4.
• The MMR vaccine has been associated with aseptic meningitis, febrile seizures, and idiopathic thrombocytopaenic purpura, but the risk of these adverse events is small 4.
• There is no evidence to support an association between MMR vaccination and encephalitis, encephalopathy, autistic spectrum disorders, or other serious adverse events 4.

Special Populations

For special populations, such as:

• Infants aged birth to 6 months exposed to measles, the ACIP recommends the use of immune globulin administered intramuscularly (IGIM) 3.
• Severely immunocompromised persons and pregnant women without evidence of measles immunity who are exposed to measles, the ACIP recommends the use of immune globulin administered intravenously (IGIV) 3.
• Healthcare personnel, students attending colleges or other post-high school educational institutions, and international travelers, 2 doses of MMR vaccine are recommended 3.