Measles, Mumps, and Rubella (MMR) Vaccination: What Everyone Should Know

CDC recommends that people get MMR vaccine to protect against measles, mumps, and rubella. Children should get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults should also be up to date on their MMR vaccination. Two MMR vaccines are available for use in the United States, M-M-R II and PRIORIX. M-M-R II and PRIORIX are fully interchangeable for all indications for which MMR vaccination is recommended. Children may also get MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Who Should Get MMR Vaccine?

Children

CDC recommends all children get two doses of MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

Learn about MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Students at post-high school educational institutions

Students at post-high school educational institutions who do not have presumptive evidence of immunity need two doses of MMR vaccine, separated by at least 28 days.

Adults

Adults who do not have presumptive evidence of immunity should get at least one dose of MMR vaccine.

Certain adults may need 2 doses. Adults who are going to be in a setting that poses a high risk for measles or mumps transmission should make sure they have had two doses separated by at least 28 days. These adults include

  • students at post-high school education institutions
  • healthcare personnel
  • international travelers

International travelers

People 6 months of age and older who will be traveling internationally should be protected against measles. Before any international travel—

  • Infants 6 through 11 months of age should receive one dose of MMR vaccine. Infants who get one dose of MMR vaccine before their first birthday should get two more doses (one dose at 12 through 15 months of age and another dose separated by at least 28 days).
  • Children 12 months of age and older should receive two doses of MMR vaccine, separated by at least 28 days.
  • Teenagers and adults who do not have presumptive evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.

Healthcare personnel

Healthcare personnel should have documented presumptive evidence of immunity, according to the recommendations of the Advisory Committee on Immunization Practices [48 pages] . Healthcare personnel without evidence of immunity should get two doses of MMR vaccine, separated by at least 28 days.

For Healthcare Providers

illustration of a passport

Planning a trip outside the U.S.?

Women of Childbearing Age

Women of childbearing age should check with their doctor to make sure they are vaccinated before they get pregnant. Women of childbearing age who are not pregnant and do not have presumptive evidence of immunity should get at least one dose of MMR vaccine.

It is safe for breastfeeding women to receive MMR vaccination. Breastfeeding does not interfere with the response to MMR vaccine, and the baby will not be affected by the vaccine through breast milk.

Groups at increased risk for mumps because of a mumps outbreak

During a mumps outbreak, public health authorities might recommend an additional dose of MMR vaccine for people who belong to groups at increased risk for getting mumps. These groups are usually those who are likely to have close contact, such as sharing sport equipment or drinks, kissing, or living in close quarters, with a person who has mumps. Your local public health authorities or institution will communicate to the groups at increased risk that they should receive this dose. If you already have two doses of MMR, it is not necessary to seek out vaccination unless you are part of this group.

Who Should Not Get MMR Vaccine?

Measles, Mumps, and Rubella (MMR) vaccine

Some people should not get MMR vaccine or should wait.

Tell your vaccine provider if the person getting the vaccine:

  • Has any severe, life-threatening allergies. A person who has ever had a life-threatening allergic reaction after a dose of MMR vaccine, or has a severe allergy to any part of this vaccine, may be advised not to be vaccinated. Ask your health care provider if you want information about vaccine components.
  • Is pregnant or thinks she might be pregnant. Pregnant women should wait to get MMR vaccine until after they are no longer pregnant. Women should avoid getting pregnant for at least 1 month after getting MMR vaccine.
  • Has a weakened immune system due to disease (such as cancer or HIV/AIDS) or medical treatments (such as radiation, immunotherapy, steroids, or chemotherapy).
  • Has a parent, brother, or sister with a history of immune system problems.
  • Has ever had a condition that makes them bruise or bleed easily.
  • Has recently had a blood transfusion or received other blood products. You might be advised to postpone MMR vaccination for 3 months or more.
  • Has tuberculosis.
  • Has gotten any other vaccines in the past 4 weeks. Live vaccines given too close together might not work as well.
  • Is not feeling well. A mild illness, such as a cold, is usually not a reason to postpone a vaccination. Someone who is moderately or severely ill should probably wait. Your doctor can advise you.
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This information was taken directly from the MMR (Measles, Mumps & Rubella) Vaccine information Statement (VIS) dated 2/12/2018.

Learn who should not get MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Who Does Not Need MMR Vaccine?

You do not need measles, mumps, and rubella (MMR) vaccine if you meet any of these criteria for presumptive evidence of immunity*:

  • You have written documentation of adequate vaccination:
    • at least one dose of a measles, mumps, and rubella virus-containing vaccine administered on or after the first birthday for preschool-age children and adults not at high risk for exposure and transmission
    • two doses of measles and mumps virus-containing vaccine for school-age children and adults at high risk for exposure and transmission, including college students, healthcare personnel, international travelers, and groups at increased risk during outbreaks

    If you do not have presumptive evidence of immunity against measles, mumps, and rubella, talk with your doctor about getting vaccinated. If you’re unsure whether you’ve been vaccinated, you should first try to find your vaccination records. If you do not have written documentation of MMR vaccine, you should get vaccinated. The MMR vaccine is safe, and there is no harm in getting another dose if you may already be immune to measles, mumps, or rubella.

    If you received a measles vaccine in the 1960s, you may not need to be revaccinated. People who have documentation of receiving LIVE measles vaccine in the 1960s do not need to be revaccinated. People who were vaccinated prior to 1968 with either inactivated (killed) measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine. This recommendation is intended to protect those who may have received killed measles vaccine, which was available in 1963-1967 and was not effective.

    *Except during a mumps outbreak. During a mumps outbreak public health authorities might recommend an additional dose of MMR vaccine for people who belong to groups at increased risk for getting mumps, regardless if they meet the criteria listed above.

    **Birth before 1957 provides only presumptive evidence for measles, mumps, and rubella. Before vaccines were available, nearly everyone was infected with measles, mumps, and rubella viruses during childhood. The majority of people born before 1957 are likely to have been infected naturally and therefore are presumed to be protected against measles, mumps, and rubella. Healthcare personnel born before 1957 without laboratory evidence of immunity or disease should consider getting two doses of MMR vaccine.

    How Well Does the MMR Vaccine Work?

    MMR vaccine is very effective at protecting people against measles, mumps, and rubella, and preventing the complications caused by these diseases. People who receive MMR vaccination according to the U.S. vaccination schedule are usually considered protected for life against measles and rubella. While MMR provides effective protection against mumps for most people, immunity against mumps may decrease over time and some people may no longer be protected against mumps later in life. An additional dose may be needed if you are at risk because of a mumps outbreak.

    One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella.

    Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps.

    MMR is an attenuated (weakened) live virus vaccine. This means that after injection, the viruses cause a harmless infection in the vaccinated person with very few, if any, symptoms before they are eliminated from the body. The person’s immune system fights the infection caused by these weakened viruses, and immunity (the body’s protection from the virus) develops.

    Some people who get two doses of MMR vaccine may still get measles, mumps, or rubella if they are exposed to the viruses that cause these diseases. Experts aren’t sure why; it could be that their immune systems didn’t respond as well as they should have to the vaccine or their immune system’s ability to fight the infection decreased over time. However, disease symptoms are generally milder in vaccinated people.

    • About 3 out of 100 people who get two doses of MMR vaccine will get measles if exposed to the virus. However, they are more likely to have a milder illness, and are also less likely to spread the disease to other people.
    • Two doses of MMR vaccine are 88% (range 32% to 95%) effective at preventing mumps. Mumps outbreaks can still occur in highly vaccinated U.S. communities, particularly in settings where people have close, prolonged contact, such as universities and close-knit communities. During an outbreak, public health authorities may recommend an additional dose of MMR for people who belong to groups at increased risk for mumps. An additional dose can help improve protection against mumps disease and related complications.
    • While there are not many studies available, most people who do not respond to the rubella component of the first MMR dose would be expected to respond to the second dose.

    What is MMRV Vaccine?

    MMRV vaccine protects against four diseases: measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children 12 months through 12 years of age.

    CDC recommends that children get one dose of MMRV vaccine at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose of MMRV vaccine earlier than 4 through 6 years. This second dose of MMRV vaccine can be given 3 months after the first dose. A doctor can help parents decide whether to use this vaccine or MMR vaccine.

    MMRV is given by shot and may be given at the same time as other vaccines.

    Please see the MMRV Vaccine Information Statement (VIS) for more information about who should not get MMRV vaccine or should wait.

    For more information, see

    Should You Get Vaccinated After Being Exposed to Measles, Mumps, or Rubella?

    If you do not have immunity against measles, mumps, and rubella and are exposed to someone with one of these diseases, talk with your doctor about getting MMR vaccine. It is not harmful to get MMR vaccine after being exposed to measles, mumps, or rubella, and doing so may possibly prevent later disease.

    If you get MMR vaccine within 72 hours of initially being exposed to measles, you may get some protection against the disease, or have milder illness. In other cases, you may be given a medicine called immunoglobulin (IG) within six days of being exposed to measles, to provide some protection against the disease, or have milder illness.

    Unlike with measles, MMR has not been shown to be effective at preventing mumps or rubella in people already infected with the virus (i.e., post-exposure vaccination is not recommended).

    During outbreaks of measles or mumps, everyone without presumptive evidence of immunity should be brought up to date on their MMR vaccination. And some people who are already up to date on their MMR vaccination may be recommended to get an additional dose of MMR for added protection against disease.

    What are the Childcare and School Requirements for MMR Vaccine?

    All 50 states and the District of Columbia (DC) have state laws that require children entering childcare or public schools to have certain vaccinations. There is no federal law that requires this.

    The Advisory Committee on Immunization Practices recommends that all states require children entering childcare, and students starting school, college, and other postsecondary educational institutions to be up to date on MMR vaccination:

    • 1 dose is recommended for preschool-aged children 12 months or older
    • 2 doses are recommended for school-aged children in kindergarten through grade 12 as well as students attending colleges or other post-high school educational institutions

    How Can Parents Pay For MMR Vaccine?

    Most health insurance plans cover the cost of vaccines. But you may want to check with your health insurance provider before going to the doctor. Learn how to pay for vaccines.

    If you don’t have insurance or if your insurance does not cover vaccines for your child, the Vaccines for Children (VFC) Program may be able to help. This program helps families of eligible children who might not otherwise have access to vaccines. To find out if your child is eligible, visit the VFC website or ask your child’s doctor. You can also contact your state VFC coordinator.

    Plan for Travel

    Measles cases in the U.S. originate from international travel. Make sure you and your loved ones are protected against measles before international travel.

    It is critical for all international travelers to be protected against measles, regardless of their destination.

    illustration of a passport

    Planning a trip outside the U.S.?

    Which travelers are at risk?

    You are at risk of measles infection if you have not been fully vaccinated or have not had measles in the past and you travel internationally to areas where measles is spreading. The best way to protect yourself and your loved ones from measles is by getting vaccinated.

    Before international travel: Make sure you’re protected against measles

    The best way to protect yourself and your loved ones from measles is by getting vaccinated. You should plan to be fully vaccinated at least 2 weeks before you depart. If your trip is less than 2 weeks away and you’re not protected against measles, you should still get a dose of MMR vaccine. The measles-mumps-rubella (MMR) vaccine protects against all 3 diseases. Two doses of MMR vaccine provide 97% protection against measles; one dose provides 93% protection.

    Call your health care provider, your local health department, or locate a pharmacy or clinic near you to schedule an appointment for a MMR vaccine. CDC does not recommend measles vaccine for infants younger than 6 months of age.

    • Get an early dose at 6-11 months
    • Follow the recommended schedule and get another dose at 12-15 months and a final dose at 4-6 years
    • Get first dose immediately
    • Get second dose 28 days after first dose
    • Get first dose immediately
    • Get second dose 28 days after first dose

    * Acceptable presumptive evidence of immunity against measles includes at least one of the following: written documentation of adequate vaccination, laboratory evidence of immunity, laboratory confirmation of measles, or birth in the United States before 1957.

    If you and your children are not traveling internationally, follow CDC’s routinely recommended vaccine schedule.

    Since measles is still common in many countries, unvaccinated travelers bring measles to the U.S., and it can spread. Protect yourself, your family, and your community with the measles-mumps-rubella (MMR) vaccine, especially before traveling internationally.

    What countries are having measles outbreaks?

    Measles remains a common disease in many parts of the world, including Europe, the Middle East, Asia, and Africa. Each year, an estimated 142,000 people die from measles. Many countries have experienced measles outbreaks in recent years; this includes many popular travel destinations like Israel, Thailand, Vietnam, Japan, Ukraine, the Philippines, and more.

    Before your next trip, check your destination and CDC’s global travel notices.

    How do measles outbreaks start in the US?

    In the United States, measles cases originate from international travel. The disease is brought into the United States by unvaccinated people who get infected in other countries. Typically 2 out of 3 of these unvaccinated travelers are Americans. They can spread measles to other people who are not protected against measles, which sometimes leads to outbreaks.

    Since measles is still common in many countries, unvaccinated travelers bring measles to the U.S., and it can spread. Protect yourself, your family, and your community with the measles-mumps-rubella (MMR) vaccine, especially before traveling internationally.

    Do not travel if you are sick. Call your healthcare provider immediately if you think you or your child have been exposed to measles.

    Call your healthcare provider immediately if you think you or your child have been exposed to measles.

    After international travel: watch for measles

    Measles is highly contagious and can spread to others through coughing and sneezing. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected. An infected person can spread measles to others 4 days before the rash even develops.

    Watch your health for 3 weeks after you return. Measles symptoms typically include:

    • high fever (may spike to more than 104° F)
    • cough
    • runny nose (coryza)
    • red, watery eyes (conjunctivitis)
    • rash (3-5 days after symptoms begin)

    If you or your child gets sick with a rash and fever, call your healthcare provider. Be sure to tell your healthcare provider that you traveled abroad, and whether you have received MMR vaccine.

    What can healthcare providers do?

    Before Travel: Check that patients 6 months of age or older traveling internationally have presumptive evidence of immunity against measles before departure. A self-report of a vaccination or disease history is not adequate evidence of protection. Vaccinate any traveler who does not have written documentation of vaccination or other presumptive evidence of measles immunity.

    After Travel: Consider measles in the differential diagnosis of patients presenting with fever and rash, especially those who have recently traveled internationally or who have close contacts who have recently traveled.

    Should i get measles booster before traveling to europe

    woman with mask getting vaccine from doctor

    International travel increases your chances of getting and spreading diseases that are rare or not found in United States. Find out which travel vaccines you may need to help you stay healthy on your trip.

    Before Travel

    Make sure you are up-to-date on all of your routine vaccines. Routine vaccinations protect you from infectious diseases such as measles that can spread quickly in groups of unvaccinated people. Many diseases prevented by routine vaccination are not common in the United States but are still common in other countries.

    Check CDC’s destination pages for travel health information. Check CDC’s webpage for your destination to see what vaccines or medicines you may need and what diseases or health risks are a concern at your destination.

    Make an appointment with your healthcare provider or a travel health specialist at least one month before you leave. They can help you get destination-specific vaccines, medicines, and information. Discussing health concerns as well as your itinerary and planned activities with your provider allows them to give more specific advice and recommendations.

    Because some vaccines require multiple doses, it’s best to see your health care provider as soon as possible.

    Medicines to prevent malaria are pills that you start to take before travel. Take recommended medicines as directed. If your health care provider prescribes medicine for you, take the medicine as directed before, during, and after travel.

    Where can I get travel vaccines?

    You may be able to get some travel vaccines from your primary healthcare provider. If you or your healthcare provider need help finding a location that provides certain vaccines or medicines, visit CDC’s Find a Clinic page.

    If yellow fever vaccine is recommended or required for your destination, you’ll need to go to a vaccine center authorized to give yellow fever vaccinations. Many yellow fever vaccine centers also provide other pre-travel health care services. Find an authorized US yellow fever vaccine center.

    Examples of Vaccines

    Here is a list of possible vaccines that you may need to get for the first time or boosters before you travel.

    Source https://www.cdc.gov/vaccines/vpd/mmr/public/index.html

    Source https://www.cdc.gov/measles/plan-for-travel.html

    Source https://wwwnc.cdc.gov/travel/page/travel-vaccines

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