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Immunization : Measles, Mumps and Rubella MMR Vaccine

Vaccines (or needles or baby shots) are the best way to protect against some very serious infections. The Canadian Paediatric Society and the National Advisory Committee on Immunization strongly recommend routine immunization.

The MMR vaccine is a three-in-one needle that protects against measles, mumps and rubella (German measles). It should be given to children soon after their first birthday. A second dose is given in combination with varicella (chicken pox), as MMRV (a four-in-one needle) at 4-6 years of age. Vaccination against measles, mumps and rubella is required by law for all children attending school in Ontario (unless exempted).

This vaccine should also be given to adults who are not protected against measles, mumps or rubella. Pregnant women who have been told that they are not protected against rubella, should receive MMR vaccine as soon as they are no longer pregnant.

Measles

Measles is a serious infection. It causes high fever, cough, rash, runny nose and watery eyes. Measles lasts for one to two weeks. It can be complicated by ear infections or pneumonia in one out of every 10 children with measles. Measles can also be complicated by encephalitis, an infection of the brain, in about one out of every 1,000 children with measles. This may cause brain damage. Measles causes death in one in about 3,000 cases. In very rare cases, measles is complicated by a disease called SSPE (subacute sclerosing panencephalitis), a very severe and always fatal brain infection. Measles can also make a pregnant woman have a miscarriage or give birth prematurely.

Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing. Also, measles virus can live for up to two hours on a surface or in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected.

Mumps

Mumps can cause fever, headaches and swelling of the cheeks and jaw. The swelling is caused by an infection of the salivary glands. Mumps can cause meningitis, an infection of the fluid and lining covering the brain and spinal cord.About one in every 10 people with mumps gets meningitis. Mumps can cause deafness in some persons.

Mumps can cause very painful, swollen testicles in about one out of four teenage boys or adult men. This may rarely cause sterility. Mumps can cause a painful infection of the ovaries in one out of 20 women. Mumps infection during the first three months of pregnancy may increase the risk of miscarriage. People can get mumps from an infected person coughing or sneezing around them or simply talking to them. It can also be spread through contact with the saliva of an infected person.

Rubella (German Measles)

Rubella is very dangerous in pregnant women. If a woman gets rubella in the early part of a pregnancy, it is very likely that her baby will die or be severely disabled. The most common disabilities are blindness, deafness, mental disability and heart defects.

Rubella is usually a mild illness in children; up to half of the infections with rubella occur without a rash. The disease can be more severe in older children and adults, especially women. Rubella may cause fever, sore throat, swollen glands in the neck and a rash on the face and neck. Temporary aches and pains and swelling of the joints are common in adolescents and adults, especially females. Rubella can be followed by chronic arthritis. It can also cause temporary blood clotting problems and encephalitis (swelling of the brain).

Rubella spreads by contact with an infected person through coughing, sneezing or talking to them. It can also be spread by contact with the saliva of infected people.

How well does MMR vaccine protect against measles, mumps and rubella?

The efficacy of a single dose of measles-containing vaccine given at 12 or 15 months of age is estimated to be 85% to 95%. With a second dose, efficacy in children approaches 100%. Protection from measles, mumps and rubella after getting the vaccine is life-long. The vaccine protects about 95 per cent of people against mumps and about 98 per cent of people against rubella. Vaccination also makes these diseases milder for those who may catch them.

Is the MMR vaccine safe?

The MMR vaccine is very safe and effective. Most individuals will have no reaction. The vaccine can cause a general feeling of being unwell and fever in some children six to 23 days after MMR immunization (with or without rash) lasting up to 3 days. Allergic reactions to the MMR vaccine are very rare.

The mumps part of the vaccine may cause fever and swelling of the glands in the neck. Meningitis (an infection of the fluid and lining covering the spinal cord) may occur very rarely, in one in 800,000 people who get the vaccine. The meningitis caused by mumps vaccine is mild, and permanent brain damage does not occur.

The rubella part of the vaccine may cause a mild fever, rash or swelling of the glands in the neck in one out of seven children. This usually happens 6 to 10 days after getting the shot and lasts for one to 2 days. Less than one in 200 children may develop swelling and pain in some joints after the vaccine. Up to one in four teenage girls and adult women may get painful swelling of some joints within one to three weeks after vaccination. The joint pain and swelling usually lasts only a few days. Very rarely, chronic arthritis may occur.

People who have problems with their immune system should speak with their health care provider to determine when MMR vaccine should be given. As well, women should not be vaccinated if they are pregnant and should not become pregnant within 4 weeks after getting the MMR vaccine.

The vaccine is safe for household members of people with immune system problems and household members of pregnant women. Breastfeeding women can receive the MMR vaccine.

There is no evidence that the MMR vaccine causes autism.

Speak with your health care provider or local public health unit about the benefits and risks of the vaccine, as well as the risks of not getting vaccinated.

Who should not have MMR vaccine?

There are some groups who should generally not be given the vaccine such as, but not limited to:

  • Individuals who are pregnant (Women of childbearing age should be advised to avoid pregnancy for at least 1 month following immunization with MMR vaccine)
  • Individuals who have a history of anaphylaxis after previous administration of the product (or components of the vaccine)
  • Those who have medical conditions that may be contraindicated (for example, individuals with history of convulsions, certain immunosuppressant medications, congenital or hereditary immunodeficiency)

If you think that you or your child is in any of these groups, please talk to your doctor or public health unit.

The MMR vaccine may be given to people who are allergic to eggs even if they have hives, wheezing, difficulty breathing, or swelling of the face or mouth after eating eggs, as long as they are observed after the vaccine for signs of a reaction.

Who should I talk to if I have any questions?

Talk to your doctor or call your local public health unit.

Your record of protection

After you or your child receives any immunization, make sure the doctor updates the personal immunization record, such as the "Yellow Card". You will need to provide this information to your local health unit when your child enters school and as they get additional immunizations. Keep your records in a safe place !

February 2015

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