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Measles, mumps and rubella (MMR) vaccine


Expert reviewer, Professor Robert Read, Professor of Infectious Diseases
Next review due December 2022

The MMR vaccine is a combined vaccination (in a single injection) that protects against three diseases: measles, mumps and rubella (German measles). Measles, mumps and rubella are all serious diseases that can have dangerous complications. They’re easily spread between people who haven’t been vaccinated.

In the UK, the MMR vaccine is offered to all children as part of the NHS childhood immunisation programme. If you didn’t have the MMR vaccine when you were a baby, you can have it when you’re older.

A mother sitting with her children

Why is it important to have the MMR vaccine?

The MMR vaccine is the safest and most effective way to protect against measles, mumps and rubella. Before the MMR vaccine was introduced in 1988, these diseases were extremely common. It’s now rare for children to develop them although outbreaks happen when the number of people having the vaccine drops.

There have been children with measles in recent years so it's important to have the MMR vaccine. If your child doesn’t have the vaccine, it puts them at much greater risk of developing measles, mumps and rubella. Although most people recover from these diseases without any long-term effects, each one can have some serious consequences, and can even be fatal.

Measles

The first symptoms to appear if you get infected with measles are a fever, runny nose, cough and red, sore eyes. After two to four days, you develop a rash, which usually starts on your face and goes down your body ending up in your hands and feet. Most people feel better around a week after the rash develops but for others, measles can cause some potentially serious complications. These can include diarrhoea, ear infections, pneumonia, seizures (fits) and encephalitis (inflammation of the brain). If you catch measles as an adult, it’s likely to be more severe and you’re at greater risk of complications. There isn’t any treatment or cure for measles.

Measles is highly contagious. About 90 in every 100 people who aren’t vaccinated against measles, who come into contact with someone who has it, will catch it. Seven of these people will also develop complications.

Mumps

Not everyone who gets mumps gets symptoms, but many people develop a fever and feel generally unwell. It’s also common to have swollen salivary glands (the glands on either side of your face, just below your ears). Common complications can include swollen testicles (which sometimes affects fertility) in boys, and ovaries in girls. It can also cause viral meningitis, encephalitis and hearing loss. There isn’t any treatment or cure for mumps.

Mumps is a contagious infection. It was very common in school-age children before the MMR vaccine was introduced, with more than eight in 10 people catching the disease.

Rubella (German measles)

Rubella is usually a mild infection – you may just get symptoms similar to a cold and a rash for a few days. But it can be very dangerous for women to catch it in early pregnancy, as it can cause serious birth defects in their babies.

Before the introduction of MMR, around 200 to 300 babies a year were born with birth defects due to rubella.

How can I get the MMR vaccine?

Children should be offered the MMR vaccine at your GP surgery as part of the routine immunisation schedule. Your child will need two doses of MMR to be sure they have full protection. Children are invited to have the first dose on, or soon after, their first birthday. They’ll then have a second pre-school dose when they’re three years and four months old (or soon after).

If you haven’t had the full MMR vaccine or you have an older child who hasn’t, you can contact your GP surgery to get it. Older children may also be offered missing doses of MMR through school. You can have the MMR vaccine at any age. If you have it as an older child or adult, you’ll have a gap of at least a month between doses. The MMR vaccine for adults is the same as that for children.

If you’re a woman planning to have a family, it’s especially important to make sure you get vaccinated before getting pregnant. If you’re pregnant and don’t have any record of being vaccinated, you can get the vaccination soon after your baby is born. You can’t have the MMR vaccine while you’re pregnant.

Young children have the vaccination as a single injection into their thigh; older children and adults have it in their upper arm.

How does the MMR vaccine work?

The MMR vaccine is a live vaccine made from weakened forms of each of the measles, mumps and rubella viruses. The vaccine stimulates your immune system to produce cells that respond to and remember the viruses. This means that if you come into contact with any of the three viruses in the future, your immune system will recognise the virus and act to prevent an infection.

More than 99 out of 100 people who have had the MMR vaccination will be completely protected against measles and rubella. Protection against mumps is slightly lower, but mumps is much less severe if you’ve had the vaccine.

If you’ve received two doses of the MMR vaccine, this is usually expected to protect you for life, and you won’t need a booster dose.

Is there anyone who can’t have the MMR vaccination?

There are some people who shouldn’t have the MMR vaccine. As well as pregnant women, these include anyone who has:

  • a severely weakened immune system – for instance, if you take immunosuppressant medicines
  • had an anaphylactic reaction (a severe allergic reaction) to gelatine (which is used in some vaccines) or an antibiotic called neomycin
  • had an anaphylactic reaction to an MMR vaccine dose before – you’ll need to be assessed by a health professional who specialises in allergies first

The MMR vaccine is grown in the laboratory on chick cells (not egg white or yolk). Studies show the vaccine is safe for children with an egg allergy. In the past, people with an egg allergy were advised not to have the MMR vaccine, but this advice changed years ago. There isn’t enough egg protein in the vaccine to cause an allergic reaction.

You can still have the MMR vaccination if you have a minor illness. But you might want to delay it if you’re very ill with a fever. Call your GP surgery to check if you’re unsure.

Side-effects of MMR

The MMR vaccine contains weakened, live viruses. You or your child may experience some mild effects of the viruses after the vaccination. This is to be expected and is a sign that the vaccination has worked. The three viruses in the vaccine act at different times and may produce different MMR vaccine side-effects as they start to work. These might include the following.

  • Fever and/or rash and generally feeling unwell. If you’re affected, it will usually be about a week after the vaccination and will only last for around two to three days. You can take paracetamol or ibuprofen to reduce any symptoms of fever.
  • Swollen glands. If you or your child gets swollen glands, it usually happens around three weeks after you had the MMR vaccine. Again, this should only last for a short time.
  • Febrile convulsions. About one in every 1,000 children who have the MMR vaccine has a febrile convulsion within six to 11 days of having the vaccination. A febrile convulsion is a seizure or fit that’s linked to a fever caused by an infection. While scary and upsetting to witness, they don’t cause any long-term harm. Infection with the measles virus is far more likely to cause febrile convulsions than having the MMR vaccine.
  • Bruise-like rash. There’s a very small risk of developing a condition called idiopathic thrombocytopenic purpura (ITP) within six weeks of having the MMR vaccination. ITP causes a rash that looks like tiny bruises and will get better on its own.

Side-effects of the vaccine are usually mild and, most importantly, they aren’t as serious as the potential consequences of having measles, mumps or rubella. You’re less likely to get side-effects after the second dose of the vaccine. If you’re concerned about any symptoms after MMR vaccine, contact your GP surgery.

MMR and autism

There’s now overwhelming evidence that the MMR vaccine does not cause autism. In the past, research was published (now shown to be inaccurate), that suggested there may be a link. This led to fewer parents getting their children vaccinated with MMR. As a result, there was an increase in the number of people who got measles and mumps in the following years.

Many scientific researchers have investigated this alleged link between MMR and autism and there’s lots of scientific proof that there’s no connection between them. In the last few years, senior vaccine scientists have shown without doubt that there’s no connection between MMR and autism.

Single vaccines

The MMR vaccine is given as a combined vaccine, rather than a series of single ones. No country in the world recommends giving vaccines against the three infections separately because of the following reasons.

  • 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 result in fewer children having all the necessary vaccinations, which would increase the level of measles, mumps and rubella in the UK.
  • Single vaccines haven’t been researched very well. For example, there isn’t any guidance about how they should be given or how much of a gap is needed between injections. Also, there isn’t any evidence to say how effective or safe they are.

All the evidence shows that the MMR vaccine is the safest and most effective way to protect you or your child against measles, mumps and rubella. The only single vaccines available in the UK are unlicensed products that have been imported into the country. This means they haven’t been independently tested for how safe they are or how well they work. It’s important to be aware of this if you are considering using these products.

Frequently asked questions

  • If you haven’t been immunised with the MMR vaccine, you should have it before you travel.

    As a large number of people in the UK are immunised, this helps to protect the whole population, including (to a point) those who aren’t immunised. This is known as herd immunity or community immunity. This means that you may be less likely to catch measles, mumps or rubella in the UK. But in other areas of the world, immunisation levels aren’t so high and these diseases are still common. There have been measles outbreaks in several European countries due to pockets of low immunisation levels. You may be at risk if you travel abroad and haven’t been immunised against these infections.

    If you have a child between six months and a year travelling with you, they should receive the MMR vaccine early. Your child should then still have the routine two doses of the vaccine as part of the routine vaccine schedule.

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

  • You need two doses of the MMR vaccine to get full protection from measles, mumps and rubella. Most but not all people develop immunity after the first dose. After the second dose, almost all people develop immunity.



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Related information

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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, December 2019
    Expert reviewer, Professor Robert Read, Professor of Infectious Diseases
    Next review due December 2022

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