From the Guidelines
Yes, the MMR (measles, mumps, rubella) vaccine is indicated for elderly adults who did not receive measles vaccination in childhood. Adults born before 1957 are generally considered immune to measles due to likely natural infection, but those born after 1957 without documentation of immunity should receive at least one dose of MMR vaccine, as recommended by the Advisory Committee on Immunization Practices (ACIP) 1.
Key Considerations
- For higher-risk situations like healthcare settings, international travel, or during outbreaks, two doses separated by at least 28 days may be recommended 1.
- The standard adult dose is 0.5 mL administered subcutaneously.
- This recommendation is important because measles is highly contagious and can cause severe complications in adults, including pneumonia and encephalitis, with higher mortality rates compared to children.
- The vaccine is generally safe for older adults, though those with severe immunocompromising conditions, pregnancy, or severe allergic reactions to vaccine components should avoid it.
- Side effects are typically mild and may include soreness at the injection site, low-grade fever, or mild rash.
Protection and Community Immunity
Getting vaccinated not only protects the individual but also contributes to community immunity, helping prevent outbreaks.
Special Populations
For women of childbearing age, regardless of birth year, rubella immunity should be determined, and if there is no evidence of immunity, women who are not pregnant should be vaccinated, as stated in the guidelines 1.
Healthcare Personnel
Healthcare personnel born before 1957 who lack laboratory evidence of measles, mumps, and/or rubella immunity or laboratory confirmation of disease should be considered for vaccination with 2 doses of MMR vaccine at the appropriate interval for measles and mumps or 1 dose of MMR vaccine for rubella, according to the recommendations 1.
From the Research
MMR Vaccination for Elderly Adults
- The Centers for Disease Control and Prevention (CDC) 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 2.
- For adults, 2 doses of MMR vaccine are recommended for those at high risk for exposure and transmission, and 1 dose for other adults aged ≥18 years 2.
- There is no specific recommendation for elderly adults who did not receive measles vaccination in childhood, but the CDC recommends that adults born in 1957 or later who have not been vaccinated or have not had measles, mumps, or rubella should receive 1 or 2 doses of MMR vaccine, depending on their risk factors 2.
Safety and Efficacy of MMR Vaccine in Adults
- A prospective cohort study found that the MMR vaccine was safe in adults, with low rates of systemic adverse events and no serious adverse events 3.
- Another study found that a third dose of MMR vaccine was effective in boosting rubella-specific humoral immunity in women of childbearing age 4.
- A randomized controlled trial protocol is currently underway to compare the immunogenicity and safety of MMR vaccine delivered by different routes (intradermal, aerosol, and intramuscular) in previously vaccinated young adults 5.
Immune Response to MMR Vaccine
- A study found that measles, mumps, and rubella neutralizing antibody levels declined annually in both 2- and 3-dose vaccinees, but protection against disease was largely retained 6.
- Another study found that rubella-specific humoral immunity was boosted after a third dose of MMR vaccine in women of childbearing age, with significant increases in antibody titers and frequencies of antigen-specific memory B cells 4.