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Measles mumps and rubella (MMR) vaccine

The MMR vaccine is a combined immunisation shot against the measles, mumps and rubella viruses. Although most people recover from each of these illnesses, they can be unpleasant and have serious consequences. The introduction of the MMR vaccine has meant that measles, mumps and rubella are all less common these days.

What is the MMR vaccine? 

The MMR vaccine is an injection that protects against catching measles, mumps and rubella. It works by introducing a small dose of live, but weakened, measles, mumps and rubella viruses into your body. This triggers your immune system to make antibodies so it can fight these viruses if you come into contact with them later on.

The MMR vaccine is used worldwide in more than 90 countries and research suggests that almost everyone who's had a complete MMR immunisation is successfully protected against these diseases.

When is the MMR vaccine given? 

The MMR vaccine and children

In Australia, children are immunised against measles, mumps and rubella as part of the Immunise Australia program. The MMR vaccine is given as a course of two injections. The first injection of vaccine is usually given at around 12 months of age. A second booster dose is usually given at the age of four.

Sometimes, children need to be protected quickly against a measles outbreak before they've received their booster dose of vaccine. In these cases, a second dose of vaccine can be given before the age of four. Children who receive this second dose before the age of 18 months should still also receive the routine dose at four years of age.

Babies between six and 12 months can also have the vaccine early if they've been exposed to someone with measles. This should be done within three days of contact and can prevent your baby from becoming seriously ill with the measles. It also helps to control the spread of outbreaks. Talk to your GP if you think your baby has come into contact with someone who has measles.

Babies can't have the vaccine early to prevent mumps or rubella if they've been exposed to someone with these infections. This is because the vaccine works too slowly to be effective in these situations.

The MMR vaccine and adults

The combined MMR vaccine has not always been available in Australia. If you can't find any documentation to say you've been immunised, or if a blood test shows you're not immune, your GP can give you an MMR vaccination.

MMR vaccine and pregnancy

If you're thinking about pregnancy, check with your GP to see if you're immune to measles, mumps and rubella. It's especially important to check your status for rubella. Catching rubella in the early stages of pregnancy can cause serious harm to your unborn baby. To check your immunity to these diseases, your doctor can give you a simple blood test. If you're already pregnant or think you might become pregnant within one month, you shouldn't have the vaccine.

Who shouldn't have the MMR vaccine? 

Although most people can have the MMR vaccine, there are some who shouldn't. These include:

  • pregnant women
  • anyone who's sick with a fever on the day the vaccination is scheduled - wait until you're better before having the MMR vaccination
  • anyone who's had another live vaccine within the previous four weeks, for example, vaccines for chicken pox, yellow fever, tuberculosis (BCG), rotavirus, typhoid
  • people who take medicines that lower their immune system's response or who have a weakened immune system because of an illness such as HIV/AIDS or cancer
  • anyone who's had an anaphylactic reaction to gelatine or to the antibiotics kanamycin and neomycin.

Talk to your GP if you're not sure whether you or your family should have the vaccine.

Is the MMR vaccine effective? 

The first dose of the MMR vaccine is likely to give 90 percent of those receiving it immunity against measles and mumps, and 97 percent of people immunity against rubella. After the second dose, 99 percent of recipients will be protected against all three illnesses.

Since the MMR vaccine was introduced in Australia, the number of children catching measles, mumps and rubella has fallen to very low levels, although some adults who were not immunised as children remain at risk of catching these illnesses. The introduction of the vaccine has also led to a drop in the number of babies born with serious disabilities caused when their mother developed rubella during pregnancy.

Side-effects of MMR: what to expect 

It's not possible to say whether any vaccine, including MMR, is absolutely safe. Some children do get side-effects, but these are usually mild. Side-effects are rare after the first dose and even less likely after the second. It's important to weigh up the benefits of vaccination and consider that the risks and complications of catching measles, mumps and rubella if you or your family aren't vaccinated can be more severe.

The table below compares the effects of measles, mumps and rubella with the side-effects of the vaccines.

Disease Effect of disease Side-effect of vaccine

Measles:

Causes fever, cough and rash
  • Pneumonia - developed by one in 15 people with measles
  • Encephalitis (brain inflammation) - developed by one in 1000 people with measles. Of people with measles-related encephalitis, one in 10 will die and four in 10 will develop permanent brain damage
  • subacute sclerosing panencephalitis (SSPE - a degenerative condition of the brain)) - developed by one in 100,000 people with measles' and is always fatal.
  • Discomfort, local inflammation or fever - developed by one in 10 vaccinated against measles
  • Non-infectious rash - developed by one in 20 vaccinated against measles
  • Encephalitis (brain inflammation) - developed by fewer than one in one million people vaccinated against measles

Mumps:

Causes swollen neck and salivary glands and fever
  • Encephalitis (brain inflammation) - developed by one in 200 people with mumps
  • Inflammation of testes - developed by one in five males who have reached or passed puberty
  • Infertility and deafness may sometimes occur
  • Swelling of the salivary glands - developed by one in 100 people vaccinated against mumps
  • Mild encephalitis (brain inflammation) - developed by one in three million people vaccinated against mumps

Rubella:

Also known as german measles. Causes fever, rash and swollen glands
  • Rash and painful swollen glands developed by five in 10 people with rubella
  • Painful joints - developed by five in 10 adolescents and adults with rubella
  • Bruising or bleeding - developed by one in 3000 people with rubella
  • Brain inflammation - developed by one in 6000 people with rubella
  • Major congenital abnormality (including deafness, blindness or heart defects) - developed by nine in 10 babies infected during the first 10 weeks after conception
  • Discomfort, local inflammation, or fever - developed by one in 10 people vaccinated against rubella
  • Swollen glands, stiff neck, or joint pains - developed by one in 20 people vaccinated against rubella
  • Non-infectious rash - developed by one in 20 vaccinated against rubella
  • Bruising or bleeding - developed by about one in 30,000 people after first dose of vaccine

*adapted from The Australian Immunisation Handbook, 9th edition

Generally, an appropriate dose of a liquid paracetamol preparation for children can be used to treat pain or the symptoms of fever that can occur after vaccination. There are many different liquid paracetamol preparations and they aren't all the same strength, so it's important to always read the dosing instructions and give as directed on the bottle. If you have any questions or concerns about the medicines or your child's symptoms, talk to your pharmacist or GP.

Egg allergy and the MMR vaccine

The MMR vaccine is made using a protein related to egg. But research shows it's safe to give the vaccine to nearly all children, even those who have a very severe reaction to eggs.

If your child has a severe egg allergy, tell your GP or early childhood nurse. They can make special arrangements to give your child the MMR vaccine safely, in hospital if necessary.

Autism

You may have heard of a suggested link between the MMR vaccine and autism. However, there's a great deal of scientific evidence available that shows no connection between them, based on the records of millions of MMR vaccinations.

A link between MMR vaccination and autism was suggested in 1998 when a group of doctors put forward a theory that MMR could lead to problems with brain development. The researchers stated in their paper that they hadn't proved a link between autism and the MMR vaccine; however, the resulting media attention gave the impression that there was one. This had led some parents to decide not to give their children the vaccine.

If your child has autism, you will usually start to notice the signs when they're around one to two years old. As the MMR injection is given at around this age, it's easy to understand why some parents thought they might be linked.

The number of people with autism seems to have been increasing over the last 20 years. However, this is thought to be because doctors are now more aware of the condition so can recognise and diagnose it more often.

Further information 

Immunise Australia Program

www.immunise.health.gov.au

Sources 

Department of Health and Ageing (DOHA). The Australian Immunisation Handbook. 9th ed. [online] Canberra, ACT: Commonwealth of Australia. 2008 [Last updated Sept 2010, accessed 12 Jul 2011] Sourced from: http://www.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-home

Martin N Foxwell R. Measles status in Australia, and outbreaks in the first quarter of 2009. Communicable Diseases Intelligence. Jun 2009; 33(2). [online] Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-cdi3302k.htm

National Centre for Immunisation Research and Surveillance (NCIRS). MMR Decision Aid - FAQ 1 - Questions about MMR vaccine. [online] Westmead, NSW: NCIRS. 2009 [Last updated Sept 2009, accessed 12 Jul 2011] Available from: http://www.ncirs.edu.au/

National Centre for Immunisation Research and Surveillance. MMR vaccine, inflammatory bowel disease and autism. [online] Westmead, NSW: NCIRS. Dec 2009 [Accessed 12 Jul 2011] Available from: http://www.ncirs.edu.au/immunisation/fact-sheets/mmr-vaccine-ibd-autism-fact-sheet.pdf (PDF 78Kb)

NSW Therapeutic Advisory Group (TAG). Paracetamol use: A Position Statement of the NSW Therapeutic Advisory Group Inc. December 2008. [online] Darlinghurst, NSW: NSW TAG. Dec 2008 [Accessed 12 Jul 2011] Available from: http://www.ciap.health.nsw.gov.au/

Last published: 30 July 2011

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This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

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