MMR Vaccine Timing

Administer the first dose of MMR vaccine at 12-15 months of age and the second dose at 4-6 years of age (before school entry). 1, 2

Standard Childhood Schedule

The minimum age for MMR vaccination is 12 months 1
Routine administration should occur between 12-15 months of age 3, 1, 2
In high-risk areas (counties with large inner city populations, recent outbreaks among unvaccinated preschoolers, or >5 cases among preschoolers in each of the last 5 years), give the first dose as soon as the child reaches 12 months 3
For children aged 12-47 months receiving their first dose, use separate MMR and varicella vaccines rather than MMRV due to increased febrile seizure risk (approximately one additional febrile seizure per 2,300-2,600 doses) 1

Routinely administer the second dose at 4-6 years of age, ideally before kindergarten or first grade entry 3, 1
The minimum interval between first and second doses is 4 weeks 3, 1, 2
The second dose may be given earlier than 4-6 years if needed, provided at least 4 weeks have elapsed since the first dose 3, 1
For the second dose at any age, MMRV is generally preferred over separate injections 1, 2

If not previously vaccinated according to schedule, administer 2 doses at least 4 weeks apart 3, 4, 2
Children who missed the second dose by school entry should complete the schedule by age 11-12 years 1
Review vaccination records at the 11-12 year health maintenance visit to ensure two doses have been received 3

Adults born in 1957 or later without documentation of vaccination or immunity should receive at least one dose 4, 2
High-risk adults (students in postsecondary institutions, healthcare personnel, international travelers, household contacts of immunocompromised persons) require a complete 2-dose series with at least 4 weeks between doses 4
Adults born before 1957 are generally presumed immune, though vaccination should be considered during outbreaks if they may be exposed 3

Infants aged 6-11 months traveling internationally or during measles outbreaks should receive a single dose of MMR for protection 4
This early dose does not count toward the routine two-dose schedule; these children still need two additional doses starting at 12 months 4

A personal or family history (sibling or parent) of seizures is a precaution for MMRV vaccination 1, 4
In these cases, use separate MMR and varicella vaccines instead of the combination product 1, 2

HIV-infected children without severe immunosuppression should receive MMR vaccine at 12 months 3
Children with perinatal HIV infection vaccinated before effective antiretroviral therapy should be revaccinated with 2 appropriately spaced doses once effective therapy is established 5

Severe immunocompromise is an absolute contraindication 1, 4, 2
Pregnancy is a contraindication, though women can be vaccinated immediately postpartum if non-immune 4
Severely immunocompromised persons and pregnant women without evidence of immunity who are exposed to measles should receive immune globulin rather than vaccine 5

MMR can be administered simultaneously with other vaccines at different anatomic sites 4, 2
If not given simultaneously with other live vaccines, separate by at least 28 days 3, 4
The two MMR vaccines available in the US (M-M-R II and PRIORIX) are fully interchangeable 4, 2
Administer subcutaneously as a 0.5 mL dose of reconstituted vaccine 4