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Measles, mumps and rubella (MMR) vaccine

Published by Bupa's health information team, January 2008.

This factsheet is for people who would like information about the measles, mumps and rubella (MMR) vaccine.

The MMR vaccine is a combined vaccine against measles, mumps and rubella. Your child will usually receive a first dose at around the age of 13 months and another at age three to five years, before they start school.

What is the MMR vaccine?
When is the MMR vaccine given?
Is the MMR vaccine effective?
Special care
Side-effects and safety
Questions and answers
Related topics
Further information
Sources

What is the MMR vaccine?

The MMR vaccine is an injection that prevents you from catching the following three diseases.

Measles - this can cause ear infections, pneumonia, fits and encephalitis (inflammation of the brain). Sometimes it can be fatal.
Mumps - this can cause meningitis, which can result in deafness. It may cause inflammation of the pancreas, leading to pain, nausea and vomiting. In boys it can damage the testicles and cause infertility.
Rubella - this is also known as German measles and is usually a minor illness. However, it's harmful to pregnant women. If you become infected during the first 10 weeks of pregnancy, it's very likely to cause problems in your unborn baby. These include heart damage, blindness, deafness and brain damage. It can also lead to miscarriage. If you become infected with rubella between 10 and 16 weeks, your baby may still be harmed but the risk is smaller.

Evidence suggests that almost everyone who has had a successful immunisation is protected against these diseases for life.

The vaccine has been around for 30 years and is used in over 100 countries. More than 500 million doses have been given.

Although children usually recover from measles, mumps or rubella, each illness can be unpleasant and have serious consequences.

When is the MMR vaccine given?

The MMR vaccine is usually given to children, who have the first injection when they are about 13 months old. A second dose is given between the ages of three and five years old to cover any children who haven't responded to the first one.

Babies from the age of six months can have the vaccine early if they have been exposed to someone with measles. This can prevent the baby from becoming ill and helps to control a measles outbreak. In this case, the vaccine needs to be given within three days of contact with the infected person. Talk to your GP if you think your baby has come into contact with measles.

The MMR vaccine may also be offered to young people when they leave school or before they enter further education if they haven't already had both doses.

If you aren't already immune to rubella, you will be offered the vaccine if you are a woman of childbearing age, a healthcare worker who may come into contact with pregnant women or if you have just had a baby. Talk to your GP about the MMR vaccine if you are thinking of becoming pregnant and you have never had rubella or the vaccination.

It's not dangerous to receive the vaccine more than once. Therefore, if you can't remember whether or not you have had it, you should see your GP.

Is the MMR vaccine effective?

The first dose of the MMR vaccine is likely to give 90 to 95% of the population protection against measles and mumps, and 97 to 99% of people protection against rubella. This means that out of 100 people given the vaccine, up to 95 will then be immune to measles and mumps, and up to 99 immune to rubella.

Of the small proportion of people who didn't respond the first time, nine out of 10 of them will be protected against all three illnesses after the second dose. Children who had a low level response the first time will have better immunity.

Since the MMR vaccine was introduced in the UK in 1988, the number of children catching measles, mumps and rubella has fallen. The introduction of the vaccine has also led to a drop in the number of babies born with serious disabilities caused because their mother developed rubella during pregnancy.

Special care

Most people can have the MMR vaccine, but there are some who shouldn't.

People who take medicines which lower their immune system's response or who have decreased immunity because of an illness such as cancer or HIV infection shouldn't have the vaccine.
Anyone who has had an anaphylactic reaction to gelatin or the antibiotic neomycin shouldn't have the vaccine.
It's important to wait before having the vaccine if you have had another live vaccine within the past four weeks.
Anyone who has a fever should wait until it's gone before having the vaccine. It wouldn't make the illness worse, but could make it difficult to identify possible side-effects.
You shouldn't have the vaccine if you are pregnant.

Talk to your GP or nurse if you aren't sure whether you or your child should have the vaccine.

Side-effects and safety

It's not possible to say whether any vaccine, including MMR, is absolutely safe. Some children do get side-effects. However, these are very rare after the first dose and even less likely after the second.

The three viruses in the vaccine act at different times and may produce side-effects as they start to work.

The measles part starts to work six to 10 days after immunisation. Your child may have a fever, develop a measles-like rash and go off their food.

About one in every 1,000 immunised children may have a fit caused by the fever. This is called a febrile convulsion. However, the rate of febrile convulsions caused by measles is much higher - one in every 200 children who gets the disease.

It's rare, but your child may get mild, mumps-like symptoms (fever and swollen glands) about three weeks after immunisation as the mumps part starts to work.

Children may get a rash of small bruise-like spots in the first six weeks after the vaccination, but this is also very rare. This can be caused by the measles or rubella parts of the vaccine. Take your child to your GP to be checked if you see spots like this.

Fewer than one child in a million develops encephalitis (inflammation of the brain) after the MMR vaccine. However, if a child who hasn't been vaccinated catches measles, the chance is higher - between one in 200 and one in 5,000.

Side-effects of the vaccine are usually mild and, most importantly, they are milder than the potentially serious consequences of having measles, mumps or rubella. However, if you are concerned about any of your child's symptoms, you should see your GP.

Egg allergy and the MMR vaccine

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

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

Autism and bowel disease

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

A link between MMR vaccination and autism was suggested in 1998 when a group of doctors published a paper about 12 autistic children who also had bowel problems. They put forward a theory that bowel inflammation, caused by the MMR vaccine, could lead to problems with brain development. The researchers didn't prove their theory and they actually stated in their paper that they had not proved a link between autism and the MMR vaccine. However, the resulting media attention gave the impression that there was one. This led some parents whose children were born after 1999 to decide not to give them the vaccine. These children may be at risk if they travel abroad or if there is an epidemic in the UK. Check with your GP if you aren't sure about your child's vaccination status.

If your child has autism, you will usually start to notice the signs when he or she is 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 and can recognise and diagnose it more often.

Single vaccines

No country recommends single rather than combined vaccines. There are a number of reasons why the vaccines aren't given separately.

Children would need three times as many injections (six in total), which is more unpleasant because of the pain from each jab and six episodes of possible side-effects.
It could mean that fewer children have all the necessary vaccinations, increasing the levels of measles, mumps and rubella in the UK.
There may be more delay before being completely vaccinated, leaving children at risk of infection from the diseases for longer.
Single vaccines are not licensed in the UK, and have not passed the UK's safety and effectiveness testing.