infectious diseases
Measles, Mumps, and Rubella (MMR) Vaccine
Indications for MMR Vaccine
The MMR vaccine is a routine childhood vaccination (seeCDC: Child and Adolescent Immunization Schedule by Age). All adults who were born in 1957 or later should be given 1 dose of the vaccine unless they have one of the following (seeCDC: Adult Immunization Schedule by Age): Documentation of vaccination with one or more doses of MMR Laboratory evidence that indicates immunity to the 3 diseases A contraindication to the vaccine Documented diagnosis of disease by a physician is not considered acceptable evidence of immunity for measles, mumps, or rubella. Documented diagnosis of disease is not considered acceptable evidence of immunity for measles, mumps, or rubella. A second dose of MMR vaccine (or, if they have not been vaccinated, 2 doses given ≥ 28 days apart) is recommended for adults who are likely to be exposed: Students in colleges or other post–high school educational institutions Health care workers born in 1957 or later with no evidence of immunity International travelers Patients with HIV infection, CD4 ≥ 15% and CD4 cell count ≥ 200/mcL for ≥ 6 months, and no evidence of immunity to measles, mumps, or rubella People born before 1957 are generally considered immune. However, such people who work within health care facilities (whether or not they have patient care duties) should be considered for vaccination if they have no evidence of immunity. Two doses of MMR are given (one dose if only rubella coverage is needed). If people aged ≥ 12 months were previously given ≤ 2 doses of mumps-containing vaccine and are identified by public health authorities to be at increased risk of mumps during a mumps outbreak, they should be given 1 dose of MMR vaccine. Because rubella during pregnancy can have dire consequences for the fetus (eg, miscarriage, multiple birth defects), all women of childbearing age, regardless of birth year, should be screened for rubella immunity. If there is no evidence of immunity, women who are not pregnant should be vaccinated. Pregnant women who do not have evidence of immunity should be vaccinated when pregnancy is completed and before they are discharged from the health care facility. People who were vaccinated with inactivated (killed) measles vaccine or measles vaccine of unknown type during 1963 to 1967 should be revaccinated with 2 doses of MMR vaccine. People who were vaccinated before 1979 with killed mumps vaccine or mumps vaccine of unknown type and who are at high risk of mumps exposure should be offered revaccination with 2 doses of MMR vaccine. 