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Measles, mumps and rubella (MMR) vaccine

Published by Bupa's health information team, January 2010.

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. Children will usually receive a first dose at around the age of 13 months and another at 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
Single vaccines
Questions and answers
Related topics
Further information
Sources

What is the MMR vaccine?

The MMR vaccine is an injection that prevents you from catching measles, mumps and rubella. Although people usually recover from these illnesses, each one can be unpleasant and have serious consequences.

Measles can cause ear infections, pneumonia, eye infections, fits and encephalitis (inflammation of your brain). Sometimes it can be fatal.
Mumps can cause meningitis and result in deafness. It may also cause inflammation of your pancreas. In boys, it can damage the testicles and cause infertility. In girls, it can cause swelling of the ovaries.
Rubella is also known as German measles and it's usually a minor illness. However, it's harmful to pregnant women. If you become infected during the first three months of pregnancy, it's very likely to affect your unborn baby. It can cause blindness, deafness, brain damage and heart damage in your baby. Rubella can also lead to miscarriage. If you become infected with rubella after the first three months of pregnancy, your baby may still be harmed but the risk is smaller. After 20 weeks, there is no increased risk.

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

The MMR vaccine has been around for over 30 years and is used in over 100 countries.

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 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 your 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.

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

If a child needs to be protected against measles quickly (e.g. during a measles outbreak), they can have the second dose of the MMR vaccine one month after the first dose. However, if they have the second dose before they reach the age of 18 months, they should still receive the routine dose when they reach three to five years old, before they start school.

The MMR vaccine may 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 and you're a woman of childbearing age, a healthcare worker who may come into contact with pregnant women or if you have just had a baby, you will be offered the vaccine. Talk to your GP about the MMR vaccine if you're thinking of becoming pregnant and you have never had rubella or the MMR vaccination.

It's not dangerous to receive the MMR vaccine more than once. If you can't remember whether or not you have had it, ask your GP.

Is the MMR vaccine effective?

The first dose of the MMR vaccine is likely to give 90 percent of those receiving it protection against measles and mumps, and 97 percent of people protection against rubella. This means that out of 100 people given the vaccine, around 90 will then be immune to measles and mumps, and around 97 immune to rubella.

Ninety-nine out of 100 people will be protected against all three illnesses after the second dose.

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 when their mother developed rubella during pregnancy.

Special care

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

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 has had an anaphylactic reaction to gelatin or the antibiotics kanamycin and neomycin
anyone who has had another live vaccine within the previous four weeks
anyone who has a fever
pregnant women

Talk to your GP or nurse if you're not 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 of the vaccine starts to work six to 10 days after immunisation. Your child may have a fever, develop a measles-like rash and/or go off their food. You can give your child a dose of junior paracetamol if he or she develops a fever. However, if the fever persists, contact your child's GP.

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.

It's rare, but your child may get mild, mumps-like symptoms (fever and swollen glands) about three weeks after immunisation, when the mumps part of the vaccine 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. It can be caused by the measles or rubella parts of the vaccine. Take your child to his or her GP if you see spots like this.

Fewer than one child in a million develops encephalitis (inflammation of the brain) after the MMR vaccine. 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. If you're concerned about any of your child's symptoms, see your GP.

Egg allergy and the MMR vaccine

The MMR vaccine is made using a protein related to egg. However, evidence shows that 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, let your GP or nurse know. He or she can make special arrangements to give your child 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. The doctors 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.

If your child has autism, you will usually start to notice the signs when he or she is 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.

Single vaccines

Where the MMR vaccine is available, no country recommends single rather than combined vaccines. However, Japan stopped using the combined MMR vaccine in 1993 because the mumps component of the MMR vaccine used in Japan caused side-effects. This is a different mumps vaccine to the one used in the UK. Japan now offers immunisation against measles and rubella, but not mumps.

There are a number of reasons why the vaccines in the combined MMR aren't routinely given separately in the UK.

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 aren't licensed in the UK, and have not passed the UK's safety and effectiveness testing.