pediatrics
Measles
Prevention of Measles
A Measles, Mumps, and Rubella (MMR) Vaccine is routinely given to children in most nations that have a robust health care system (see also Two doses are recommended: The first dose at age 12 to 15 months but can be given as young as age 6 months during a measles outbreak or before international travel The second dose at age 4 to 6 years Infants immunized at<1 year of age still require 2 additional doses given after their first birthday. MMR vaccination generally provides lasting immunity and has decreased measles incidence in the United States by 99% ( Prevention references ). A large meta-analysis of cohort studies found the effectiveness of the MMR vaccine in preventing measles in children from age 9 months to 15 years was 95% after one dose and 96% after two doses ( C occurs 5 to 12 days after inoculation in 5 to 15% of vaccinees and can be followed by a rash. Central nervous system reactions are exceedingly rare. The Measles-Mumps-Rubella (MMR) Vaccine . MMR is a live vaccine and is contraindicated during pregnancy. See Measles, Mumps, and Rubella (MMR) Vaccine for more information, including Prevention in susceptible contacts is possible by giving the vaccine within 3 days of exposure. If vaccination cannot occur in that timeframe, immune globulin 0.50 mL/kg IM (maximum dose, 15 mL) is given immediately (within 6 days), with vaccination given 5 to 6 months later if medically appropriate. Exposed patients with severe immunodeficiency, regardless of vaccination status, and pregnant women who are not immune to measles are given immune globulin 400 mg/kg IV. In an institutional outbreak (eg, schools), susceptible contacts who refuse or cannot receive vaccination and who also have not received immune globulin should be excluded from the affected institution until 21 days after onset of rash in the last case. Exposed, susceptible health care workers should be excluded from duty from 5 days after their first exposure to 21 days after their last exposure, even if they receive postexposure prophylaxis. 1.McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS; Centers for Disease Control and Prevention: Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: Summary recommendations of the Advisory Committee on Immunization Practices (ACIP).MMWR Recomm Rep62(RR-04):1–34, 2013. 2.Di Pietrantonj C, Rivetti A, Marchione P, et al: Vaccines for measles, mumps, rubella, and varicella in children.Cochrane Database Syst Rev4(4):CD004407, 2020. doi: 10.1002/14651858.CD004407.pub4 