MMR Vaccination for Persons Born in the 1950s
Persons born in the 1950s (1950-1956) generally do not require MMR vaccination, as they are presumed immune to measles, mumps, and rubella due to natural infection during childhood, with the important exception of healthcare workers and women of childbearing age who should be offered vaccination. 1
General Population Born Before 1957
Most adults born before 1957 are considered immune to measles, mumps, and rubella without need for vaccination, as they likely acquired natural immunity during the prevaccine era when these diseases were endemic. 1
Birth before 1957 provides presumptive evidence of immunity and is acceptable documentation for routine purposes. 1
However, measles has occurred in some unvaccinated persons born before 1957, indicating that this presumption is not absolute (approximately 3.7% of measles cases from 1985-1990 occurred in persons born before 1957). 1
Critical Exceptions Requiring Vaccination
Healthcare Workers
Healthcare facilities should strongly consider recommending at least one dose of MMR vaccine for unvaccinated workers born before 1957 who lack laboratory evidence of immunity or documented history of disease. 1
Among healthcare workers with measles during 1985-1989,29% were born before 1957, demonstrating significant susceptibility in this high-risk group. 1
Healthcare workers are at particularly high risk for both acquiring and transmitting measles to vulnerable patients. 1
All healthcare workers should be immune to measles and rubella regardless of birth year, as they have a professional responsibility to prevent disease transmission. 1
Women of Childbearing Age
Women born in the 1950s who could become pregnant should have laboratory evidence of rubella immunity or receive rubella-containing vaccine (preferably MMR). 1
Birth before 1957 is not acceptable evidence of rubella immunity for women who could become pregnant, as congenital rubella syndrome remains a serious risk. 1
Rubella vaccination is particularly important for this population because presumptive immunity does not guarantee protection against infection during pregnancy. 1
MMR should not be administered to women known to be pregnant; women should avoid pregnancy for 3 months after vaccination. 1
International Travelers
Persons born before 1957 traveling to measles-endemic areas should be offered MMR vaccination if they lack laboratory evidence of immunity or documented disease history. 2
International travel to high-risk areas represents a significant exposure risk that warrants vaccination regardless of birth year. 2
The risk of measles infection increases substantially in areas with high disease prevalence. 2
Vaccination Approach When Indicated
MMR trivalent vaccine is the vaccine of choice for persons requiring vaccination, as it provides protection against all three diseases simultaneously. 1
A single dose is typically sufficient for persons born before 1957 when vaccination is recommended. 1
Serologic screening before vaccination is not necessary and may be omitted unless the healthcare facility considers it cost-effective. 1
No evidence suggests increased risk from MMR vaccination in persons who are already immune from previous natural infection or vaccination. 1
Special Vaccination History Considerations
Killed Vaccine Recipients
Persons who received killed measles vaccine (available 1963-1967) or vaccine of unknown type during 1963-1967 should receive two doses of MMR vaccine separated by at least 28 days. 1
These individuals are at risk for severe atypical measles syndrome if exposed to natural measles virus. 1
This recommendation applies regardless of birth year for those with documented receipt of killed vaccine. 1
Killed Mumps Vaccine
Persons vaccinated before 1979 with killed mumps vaccine who are at high risk (e.g., healthcare workers during outbreaks) should be considered for MMR revaccination. 1
- Killed mumps vaccine (licensed 1950-1978) induced only transient immunity. 1
Contraindications
Pregnancy (theoretical risk to fetus from live virus vaccine). 1
Immunocompromised states including immune deficiency diseases, leukemia, lymphoma, or immunosuppressive therapy. 1
History of anaphylactic reaction to eggs or neomycin (requires extreme caution with protocols for vaccination). 1
Common Pitfalls
Failing to recognize that healthcare workers born before 1957 remain at risk and should be offered vaccination despite presumptive immunity. 1
Assuming birth before 1957 provides adequate rubella immunity for women of childbearing age. 1
Not considering vaccination for international travelers born before 1957 when traveling to endemic areas. 2
Overlooking persons who received killed measles vaccine in the 1960s who require revaccination. 1