From the Guidelines
If someone shows immunity to measles and mumps but not rubella, they should receive the MMR (measles, mumps, rubella) vaccine, as recommended by the most recent guidelines 1. The standard recommendation is one dose of MMR vaccine, which contains attenuated strains of all three viruses. For adults, no separate rubella-only vaccine is commercially available in most countries.
- The MMR vaccine is safe to administer even if the person already has immunity to measles and mumps components, as stated in the guidelines 1.
- After vaccination, immunity to rubella typically develops within 2-4 weeks. This recommendation is particularly important for women of childbearing age, as rubella infection during pregnancy can cause congenital rubella syndrome in the developing fetus, leading to serious birth defects, highlighting the need for rubella immunity as emphasized in the guidelines 1.
- Healthcare workers, college students, and international travelers should also ensure rubella immunity. The vaccine is contraindicated in pregnant women, severely immunocompromised individuals, and those with severe allergic reactions to vaccine components.
- Side effects are generally mild and may include soreness at the injection site, low-grade fever, and temporary rash, as noted in the guidelines 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Immunity to Measles and Mumps but not Rubella
- If someone shows immunity to measles and mumps but not rubella, it indicates that they have developed immune responses against measles and mumps viruses, but not against the rubella virus.
- According to the study 2, for acceptable evidence of immunity, laboratory confirmation of disease is a criterion for acceptable evidence of immunity for measles, rubella, and mumps.
- The study 3 found that anti-measles and anti-rubella antibody titers declined moderately after vaccination but remained well above the seropositivity threshold after 10 years, while anti-mumps antibody levels remained relatively stable over the 10-year follow-up.
Recommendations for Vaccination
- 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 2.
- 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 2.
- The study 4 found that a third dose of MMR vaccine may be given under certain circumstances, and that persons who received MMR2 or MMR3 had high seroprotection rates against measles, mumps, and rubella.
Booster Doses and Waning Immunity
- The study 3 found that a second dose of MMR vaccine later in life had a minor and transient effect on anti-measles and anti-rubella waning titers, while it had a boosting effect on anti-mumps antibody titers and seropositivity rates.
- The study 4 found that estimated nAb levels declined annually across both cohorts, all viruses, and baseline nAb strata, though patterns and magnitude varied, and that waning of mumps antibodies was greater than for measles and rubella in both 2- and 3-dose vaccinees.