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Measles, mumps and rubella (MMR) vaccine

 The MMR vaccine is a combined injection that protects you against measles, mumps and rubella.

The MMR vaccine is an injection that prevents you from catching measles, mumps and rubella. It’s usually given during childhood as part of the routine vaccination schedule. However, you can have the MMR vaccine at any age.

Although most people usually recover from these three infections, each one can be unpleasant and may have serious consequences. These are explained below.

  • Measles is a very contagious infection and may cause complications such as diarrhoea, ear infections, pneumonia, seizures (fits) and encephalitis (inflammation of the brain).
  • Mumps is also a contagious infection. It may cause complications such as meningitis and deafness. Mumps may also cause inflammation of your pancreas. In boys, it may damage the testicles and in girls, it may cause swelling of the ovaries. 
  • Rubella (German measles) is usually a mild infection; however, it can be harmful to pregnant women. It may cause deafness, brain and heart damage, and eye defects in unborn babies. Rubella can also lead to miscarriage. The earlier you’re infected, the more likely your baby may be affected. After 16 weeks, the risk is very small. 
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Details

  • How it works How does the MMR vaccine work?

    The MMR vaccine is made from weakened forms of each of the measles, mumps and rubella viruses. The vaccine stimulates your immune system to respond and remember the viruses. This means that if you become infected with any of the three viruses, your immune system will recognise the virus and act to prevent infection.

  • When is the MMR vaccine given? When is the MMR vaccine given?

    Your child will usually be invited to have the first MMR vaccine when he or she is between 12 and 13 months old. This is part of the routine vaccination schedule. He or she will then be invited to have the second dose between the ages of three years and four months and five years old.

    If your child needs to be protected against measles quickly, for example, during a measles outbreak, he or she can have the second dose one month after the first dose. If your child has the second dose before the age of 18 months, your child should still receive the routine dose. This will be when he or she reaches three years and four months to five years old, before starting school.

    The MMR vaccine can 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 MMR vaccine if:

    • you’re a woman of childbearing age
    • you’re a healthcare worker who may come into contact with pregnant women
    • you have just had a baby

    Talk to your GP about the MMR vaccine if you’re thinking about becoming pregnant and if you have never had the MMR vaccination.

    You can receive the MMR vaccine at any age. 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.

    The MMR vaccine will usually be given in your upper arm or on the outside of your upper thigh.

  • Benefits Is the MMR vaccine effective?

    Since the MMR vaccine was introduced in the UK in 1988, the number of children catching measles, mumps and rubella has fallen. The vaccine has also led to a drop in the number of pregnant women developing rubella during pregnancy.

    After the first dose of the MMR vaccine, 64 out of 100 people will be protected against mumps, 90 out of 100 people will be protected against measles and 95 out of 100 people will be protected against rubella.

    You will need two doses of the vaccine to provide enough protection against measles, mumps and rubella. It’s not very common, but some people may not respond to the first dose of the vaccine. Therefore, it’s important to have two doses of the vaccine. This is so that the second dose can work on anyone who isn’t immunised following the first dose.

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  • Special care Special care

    There are some people who shouldn’t have the MMR vaccine. These include:

    • people who have a severely weakened immune system because of an illness, such as HIV/AIDS
    • anyone who has had an anaphylactic reaction (a severe allergic reaction) to gelatine or the antibiotic neomycin
    • anyone who has had a confirmed anaphylactic reaction to a previous dose of the MMR vaccine
    • pregnant women

    Your GP may advise to postpone you or your child’s MMR vaccine until a later date, if:

    • you or your child have received a blood donation of immunoglobulins
    • you or your child have a fever

    Talk to your GP if you’re not sure whether you or your child should have the MMR vaccine.

  • Side-effects Side-effects and safety

    Side-effects are the unwanted but mostly mild and temporary effects of the vaccination. The three viruses in the vaccine act at different times and may produce different side-effects as they start to work.

    About a week after the vaccination, you or your child may develop a fever or a rash. It usually lasts two to three days and is less likely to occur after the second dose of the vaccine.

    Paracetamol or ibuprofen may help to reduce the symptoms of fever if you or your child is feeling unwell. At the time of your child’s immunisation, you should be given advice on the use and dose of paracetamol or ibuprofen to treat a fever.

    You or your child may also get swollen glands two to three weeks after the MMR vaccine. This side-effect is temporary, and should only last for a short time.

    It’s very rare; however, about one in every 1,000 immunised children may have a febrile convulsion. A febrile convulsion is a seizure or fit that is linked to a fever caused by an infection. However, the number of febrile convulsions caused by measles is much higher than the number the MMR vaccine may cause.

    It’s not very common, but sometimes idiopathic thrombocytopenic purpura (ITP) can occur in children following immunisation. ITP is a condition which affects your blood and can cause bruising. If your child does develop ITP, it may occur within six weeks of the first dose of the vaccination, but should settle on its own after six to eight weeks.

    If your child develops ITP, he or she may need to have a blood test. This is done to check to see if the vaccine has been effective, before the second dose is given.

    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 or your child’s symptoms, contact your GP.

    Egg allergy and the MMR vaccine

    The MMR vaccine is grown within chick embryos (eggs). 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, however, you or your child has had an anaphylactic reaction to gelatine, the antibiotic neomycin or a previous dose of the vaccine, you must let your GP know.

    Autism and inflammatory bowel disorders

    You may have heard of a suggested link between the MMR vaccine, autism and inflammatory bowel disorders. This link was suggested in 1998 when a group of researchers published a paper about 12 children who had bowel problems and similar symptoms to autism. 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 to some parents deciding not to give their child the vaccine. The decision that some parents made is thought to have increased the number of people getting measles in some parts of the UK.

    It’s important to note that there is a great deal of evidence available that shows no connection between the MMR vaccine, autism and inflammatory bowel disorders.

    For more information about this evidence, see our FAQs.

    If your child has autism, you will usually start to notice signs when he or she is around two to three years old. As the MMR injection is given at around this age, it’s easy to understand why some parents think there might be a link. 

    Single vaccines

    The MMR vaccine is recommended as a combined vaccine, rather than a series of single ones.

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

    • You or your child would need to have six injections in total. This is more unpleasant because of the pain from each injection and six episodes of possible side-effects.
    • There may be more delay before being completely vaccinated, leaving you or your child at risk of measles, mumps and rubella for longer.
    • It could mean that fewer children have all the necessary vaccinations, increasing the level of measles, mumps and rubella in the UK.
    • Single vaccines have not passed UK safety and effectiveness testing.

    For more information about single vaccines, see our FAQs.

  • Pros and cons Pros and cons

    This information is intended to help you understand the possible advantages and disadvantages of the MMR vaccine. Think about how important each particular issue is to you – this will vary from person to person. You and your GP can work together to make the right decision for you. This will be based on your GP’s expert opinion and your personal values and beliefs.

    Pros

    • The MMR vaccine has helped to reduce the number of children catching measles, mumps and rubella.
    • The vaccine contains a weak form of each virus. If you become infected with any of the viruses, your immune system will recognise the virus and act to prevent you getting an infection.
    • The vaccine has reduced the number of women developing rubella during pregnancy.

    Cons

    • A week after the vaccination, you or your child may develop a fever or rash.
    • Two to three weeks after the MMR vaccine, you or your child may get swollen glands.
    • Around one in every 1,000 child who has had the vaccination may have a febrile seizure (fit).
    • Your child may develop idiopathic thrombocytopenic purpura (ITP) following immunisation. ITP is a condition which affects the platelets (clotting cells) in your blood, and can cause bruising.
  • FAQs FAQs

    Does the MMR vaccine cause autism or inflammatory bowel disorders?

    Answer

    The link between the MMR vaccine, autism and inflammatory bowel disorders was suggested in 1998. And the resulting media attention gave the impression that there was one. However, the MMR vaccine doesn’t cause autism or inflammatory bowel disease and there is a lot of evidence available that shows there is no link.

    Explanation

    A group of researchers published a paper about 12 children who had bowel problems and similar symptoms to autism. The researchers didn’t prove their theory and their paper indicated that they had not proved a link between autism and the MMR vaccine.

    There is a lot of evidence available that shows no link between the MMR vaccine, autism or inflammatory bowel disorders. Some of this evidence is highlighted below.

    • The risk of autism does not rise in children who are given the MMR vaccine, compared with children who don’t receive the vaccine.
    • After the withdrawal of the MMR vaccine in Japan, the rate of autism still continued to increase.
    • There was already an increase in autism before the introduction of the MMR vaccine.
    • There has not been an increase in bowel disorders since the vaccine has been introduced in Finland and the UK.
    • There is no connection between the rate of autism and the MMR vaccine the UK or the US.

    Do I need to have an MMR vaccination to travel abroad?

    Answer

    If you haven’t been immunised with the MMR vaccine, you should have it before you travel. This will protect you from measles, mumps and rubella. It will also prevent you bringing these illnesses back to the UK and spreading them further.

    Explanation

    All three illnesses, in particular measles and mumps, need a large number of people to be immunised for the whole population to be protected. This is known as community immunity. This means that you may be unlikely to catch measles, mumps or rubella in the UK. But, you may be at risk if you travel abroad and haven’t been immunised against these infections.

    Measles is still a common illness, particularly in parts of Africa and Asia. More than 20 million people are affected by measles each year. If you’re travelling to an area where measles is common or where there is a current outbreak, you should have the MMR vaccine.

    If your child is less than six months old and is travelling with you, he or she should receive the MMR vaccine early. Your child should still continue to have a further two doses of the vaccine as part of the routine vaccine schedule.

    Older children who are travelling who have received only one dose of MMR at the routine age of 12 to 13 months may have the second dose brought forward to at least one month after the first. If your child is 18 months or younger when the second dose is given, then the routine pre-school dose should still be given.

    Why are two doses of MMR needed?

    Answer

    After the first dose of the MMR vaccine, most, but not all, people develop immunity to measles, mumps and rubella.

    Explanation

    When you’re immunised against measles, mumps and rubella, you will have two vaccinations. You may not have immunity after the first dose, and so you will be offered a second dose. After the second dose, almost all people develop immunity.

    The vaccine is usually given during childhood as part of the routine vaccination schedule. Your child will be offered the first dose between 12 to 13 months. Your child will be invited to have the second ‘booster’ when he or she is between three years and four months to five years old, before starting school. Having two doses of MMR will ensure that your child is fully protected against measles.

    There are also some children who may miss the first immunisation. The second dose allows your child to be immunised before he or she starts school and will boost immunity of children who have already been immunised.

    Why doesn’t the NHS offer single vaccines of measles, mumps and rubella?

    Answer

    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. However the MMR vaccine has been.

    Explanation

    Stories in the media have raised concerns about a possible link between the MMR vaccine, autism and inflammatory bowel disease. There is a great deal of evidence from around the world that shows no connection between these conditions and the MMR vaccine. However, many parents are still concerned and have looked for alternatives. One of these is to give single vaccines of measles, mumps and rubella.

    Single vaccines for measles, mumps and rubella 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.

    Single vaccines could put your child at greater risk of measles, mumps and rubella. Not only does this mean more injections, which your child may find distressing, but also a much bigger gap between injections during which your child could catch any of the diseases.

  • Resources Resources

    Further information

    Sources

    • Measles, mumps and rubella (MMR) vaccine. Joint Formulary Committee. British National Formulary (online) London: BMJ group and Pharmaceutical Press. www.medicinescomplete.com, accessed 16 October 2013 (online version)
    • Feberile seizure. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published October 2013
    • Immunizations - childhood. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published November 2012
    • Measles, Mumps, Rubella. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published November 2009
    • Immunisation against infectious disease: the green book. GOV.UK. www.gov.uk, published 2006
    • National MMR vaccination catch-up programme announced in response to increase in measles cases. GOV.UK. www.gov.uk, published 25 April 2013
    • Febrile convulsions. PatientPlus. www.patient.co.uk/patientplus.asp, published 11 June 2013
    • Rubella and pregnancy. PatientPlus. www.patient.co.uk/patientplus.asp, published 19 March 2012
    • Measles, mumps and rubella (MMR) vaccination, mumps. PatientPlus. www.patient.co.uk/patientplus.asp, published 14 March 2012
    • Anaphylaxis and its treatment. PatientPlus. www.patient.co.uk/patientplus.asp, published 20 February 2012
    • Idiopathic thrombocytopenic purpura. PatientPlus. www.patient.co.uk/patientplus.asp, published 19 October 2011
    • Possible side-effects from vaccines. Centers for Disease Control and Infection. www.cdc.gov, reviewed 1 July 2013
    • Measles vaccination: who needs it? Centers for Disease Control and Prevention. www.cdc.gov, reviewed 6 April 2009
    • Measles, mumps and rubella (MMR) vaccine. Centers for Disease Control and Infection. www.cdc.gov, reviewed 15 May 2010
    • Measles – Q&A about disease and vaccine. Centers for Disease Control and Infection. www.cdc.gov, reviewed August 2008
    • Brook P, Connell J, Pickering T. Oxford handbook of pain management. Oxford: Oxford University press, 2011:242–6
    • Simon C, Everitt H, van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press, 2010:916
    • Measles. Medical Research Council. www.mrc.ac.uk, published July 2007
    • Why is MMR preferable to single vaccines? Public Health England. www.hpa.org.uk, accessed 24 October 2013
    • Community immunity (“herd immunity”). National Institute of Allergy and Infectious Diseases. www.niaid.nih.gov, reviewed 21 October 2010
    • Measles. World Health Organization. www.who.int, published February 2013
    • MMR vaccine. Immunisation Scotland. www.immunisationscotland.org.uk, reviewed 20 November 2013
  • Related information Related information

  • Author information Author information

    Reviewed by Kuljeet Battoo, Bupa Health Information Team, January 2013.

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