Measles, mumps and rubella (MMR) vaccine Q&As
Published by Bupa's health information team, May 2009.
Answers to questions about measles, mumps and rubella (MMR) vaccine
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- Do I need to have an MMR vaccination to travel abroad?
- Why doesn't the NHS offer single vaccines of measles, mumps and rubella?
- Why are two doses of MMR needed?
Do I need to have an MMR vaccination to travel abroad?
Measles, mumps and rubella are infectious diseases that occur throughout the world. In many countries children aren't usually immunised with MMR and outbreaks of these diseases are more common than in the UK. Therefore, if you haven't been immunised with the MMR vaccine, you should have it before you travel. This will protect you from these infections and also prevent you bringing them back to the UK and spreading them further.
Explanation
Almost 200 countries offer immunisation against measles and many, but not all, also offer immunisation against mumps and rubella. All three diseases, in particular measles, need a large number of people to be immunised for the whole population to be protected. This is known as herd immunity. However, in many countries this doesn't happen and outbreaks of the diseases are common. This means that although you may be unlikely to catch measles, mumps or rubella in the UK, you may be at risk if you travel abroad and don't have immunity to these diseases.
More than 20 million people across the world catch measles every year and hundreds of thousands of people, mostly children, die from it. Africa and South-East Asia are the most badly affected areas - few people are immunised against the disease in these areas.
Just over half of all countries immunise children against mumps. Mumps is also common in Africa and South-East Asia where people aren't usually immunised and where there are epidemics every two to five years.
Epidemics of rubella happen every five to nine years in some areas of the world and as many as 700,000 unborn children die every year when their mothers catch the disease. However, epidemics and outbreaks of measles, mumps and rubella don't just happen in the developing world. For example, there was a large outbreak of measles in Austria and Switzerland during the 2008 European Football Championship.
Every year, people from the UK who haven't been immunised catch measles, mumps or rubella while they are abroad. These diseases may then be brought back to the UK where they may spread further. The Health Protection Agency (HPA) recommends that before you travel you should find out whether you have had the MMR immunisation. If you haven't, you can make an appointment with your GP or nurse to have it. This is particularly important if you're travelling to areas of the world where few people are immunised and there are outbreaks of these diseases. If you're pregnant or there is a chance that you may become pregnant while you're travelling, it's very important to make sure you're immune to rubella, or have the immunisation before you go away.
Further information
- Health Protection Agency
www.hpa.org.uk - NHS Immunisation Information
www.immunisation.nhs.uk
Sources
- Diseases of close association. Health Protection Agency. www.hpa.org.uk, accessed 23 October 2008
- Measles. National Travel Health Network and Centre. www.nathnac.org, accessed 19 October 2008
- Prevention of specific infectious diseases. Centre for Disease Control and Prevention. www.cdc.gov, accessed 23 October 2008
- Rubella. National Travel health Network and Centre. www.nathnac.org, accessed 23 October 2008
- MMR The Facts. NHS Immunisation Information. www.immunisation.nhs.uk/Vaccines/MMR, accessed 28 October 2008
Why doesn't the NHS offer single vaccines of measles, mumps and rubella?
The NHS doesn't offer single vaccines because they haven't been properly researched or tested to see how safe they are and how well they work, whereas the MMR vaccine has. Single vaccines aren't recommended because they put babies and children at an increased risk from measles, mumps and rubella.
Explanation
Recent stories in the media have raised concerns about a possible link between the MMR vaccine, autism and bowel disease. Although there has been a great deal of research evidence from around the world that shows no connection between these conditions and the MMR vaccine, many parents are still concerned and have looked for alternatives. One of these is to give single vaccines of measles, mumps and rubella.
Although there are 100 countries in the world that offer the MMR immunisation, only one, Japan, offers single vaccines instead. This is because in the 1990s the vaccine used there for the mumps part of the MMR vaccine caused some people to get meningitis and the decision was made to use single vaccines instead. The mumps vaccine that was used in Japan is different to the one used in the MMR vaccine in the UK.
Single vaccines for mumps and measles aren't licensed in the UK. This means that the vaccines don't undergo any testing in the UK to see how safe they are or how well they work. There is no research to show how they should be given or how much of a gap is needed between injections. However, there is a lot of research to prove the safety and effectiveness of the MMR vaccine.
There are also concerns about the quality and side-effects of single vaccines. For example, one mumps vaccine was found to give immunity to only a small number of children and another caused meningitis as a side-effect. Your child may also be more at risk of a severe allergic reaction, called anaphylaxis, after having a single vaccine of measles or rubella, compared with the MMR vaccine.
Single vaccines could put babies and children at greater risk from measles, mumps and rubella. If you decide to give your child single vaccines, he or she will need to have a total of six injections. Not only does this mean more injections, which many children find upsetting, but also a much bigger gap between injections when your child could catch any of the diseases. If your child catches measles, mumps or rubella, he or she could give it to brothers and sisters who are too young to have the immunisations, to pregnant women or to children who have a weakened immune system.
Around one parent in 20 now chooses to give their child single vaccines against measles, mumps and rubella. However, only half of these children have two doses of all three vaccines. This means that your children may not be protected against these diseases as they grow up. You can also catch measles, mumps and rubella as an adult when the effects may be very serious. For example, if you're pregnant and catch rubella, it can affect the development of your unborn baby. If you're a man and catch mumps as an adult, it can reduce your fertility.
Further information
- NHS Immunisation Information
www.immunisation.nhs.uk - Health Protection Agency
www.hpa.org.uk
Sources
- Why is MMR preferable to single vaccines? Health Protection Agency. www.hpa.org.uk, accessed 30 October 2008
- Frequently asked questions. NHS Immunisation Information. www.immunisation.nhs.uk, accessed 30 October 2008
- MMR, single vaccines and choice. NHS Immunisation Information. www.immunisation.nhs.uk, accessed 30 October 2008
- Researchers warning over monitoring of the safety of single measles and rubella vaccines. NHS Immunisation Information. www.immunisation.nhs.uk, accessed 30 October 2008
- Pearce A, Law C, Elliman D et al. Factors associated with uptake of measles, mumps and rubella vaccine (MMR) and the use of single antigen vaccines in a contemporary UK cohort: prospective cohort study. BMJ 2008; 336(7647):754-57
Why are two doses of MMR needed?
After the first dose of MMR vaccine most, but not all, children will develop immunity to measles mumps and rubella. Because there are still some children who don't have immunity after the first dose, a second dose is given. After this almost all of the children who didn't have immunity will develop it.
Explanation
When your child is immunised against measles, mumps and rubella he or she will have two vaccinations. The first is given to your baby at about 13 months and the second 'booster' is given when your child is between three and five years old, before he or she starts school.
The immunisations are given at these times for a reason. Up until your baby reaches a year old he or she will still have some protection against infection from antibodies passed on in the womb. If the MMR vaccine is given when your baby is just a few months old, there is a chance that immunity from the baby's mother will prevent the vaccine from working properly. The booster is given just before your child starts school or nursery where he or she will be mixing with lots of new children and there is a greater risk of catching these diseases.
There are also some children who miss the first immunisation when they are babies. The second booster gives you a chance to have your child immunised before he or she starts school and will boost the immunity of a child who has already been immunised.
Further information
- Health Protection Agency
www.hpa.org.uk - NHS Immunisation Information
www.immunisation.nhs.uk
Sources
- The MMR vaccine. NHS Immunisation Information. www.immunisation.nhs.uk, accessed 30 October 2008
- Measles, mumps and rubella vaccine factsheet 1. NHS Immunisation Information. www.immunisation.nhs.uk, accessed 30 October 2008
- Study confirms measles component of MMR vaccine is highly effective. Health Protection Agency. www.hpa.org.uk, accessed 30 October 2008
- Why are two doses of MMR vaccine needed? NHS Immunisation Information. www.hpa.org.uk, accessed 30 October 2008
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: May 2009
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