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Measles, mumps and rubella (MMR) vaccine

The MMR vaccine is a combined, single vaccination 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 are 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. Not having the vaccination puts you at much greater risk of developing these diseases. Although most people recover from measles, mumps and rubella without any long-term effects, each one can have some serious consequences. These are explained below.

Measles

Measles usually starts with a fever, runny nose, cough and red, inflamed eyes. After two to four days, you develop a rash, which usually starts on your face and descends down your body. Most people feel better around a week after the rash develops but for others, measles can cause some 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.

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

Mumps

Not everyone who gets mumps will show any 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 in boys, and ovaries in girls. It can also cause viral meningitis and deafness.

Mumps is a contagious infection – it was very common in school-age children before the MMR vaccine was introduced, with more than 8 in 10 people catching the disease.

Rubella (German measles)

Rubella is usually a mild infection – you may just get a fever and rash for a few days. However, 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 their GP surgery as part of the routine immunisation schedule. You need two doses of MMR to be sure you have full protection. Children are invited to have the first dose within one month of their first birthday. A second pre-school dose is given between the ages of three years, four months and five years.

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.

If you’re of a woman of child-bearing age, it’s especially important to make sure you get vaccinated before getting pregnant. If you are 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 made from weakened forms of each of the measles, mumps and rubella viruses. The vaccine stimulates your immune system to produce cells which 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 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 in people who have been vaccinated is much less severe.

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

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

  • people who have a severely weakened immune system – for instance, due to taking immunosuppressant medication
  • 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

The vaccine has been shown to be 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 more than 10 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 postpone 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 side-effects as they start to work.

  • Fever and/or rash and generally feeling unwell. If you’re affected, it’ll usually be about a week after the vaccination and only lasts for around two to three days. You can take paracetamol or ibuprofen (or give these to your child), to reduce any symptoms of fever.
  • Swollen glands. If you or your child gets swollen glands, it usually happens two to 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 two weeks 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 do not cause any long-term damage. Infection with the measles virus is more likely to cause febrile convulsions than the MMR vaccine.
  • Bruise-like rash. There’s a very small risk of developing a condition called idiopathic thrombocytopenic purpura (ITP) after MMR vaccination. ITP causes a rash that looks like tiny bruises. You may get it within six weeks of the first dose of the vaccination, but it should settle on its own after six to eight weeks.

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 of your or your child’s symptoms after MMR vaccine, contact your GP surgery.

MMR and autism

There is now overwhelming evidence that the MMR vaccine does not cause autism. In the past, research since shown to be inaccurate was published, suggesting there may be a link. This led to fewer parents getting their children vaccinated with MMR. The result of this was an increase in the number of people getting measles and mumps in the following years. Many scientific researchers have since investigated this alleged link between MMR and autism and it has now been proven wrong. There is a great amount of scientific proof that shows no connection between the MMR vaccine 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. There are a number of reasons for this.

  • 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 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. There’s also no 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.

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

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 those who aren’t immunised (this is known as herd immunity or community immunity). This means that you may be unlikely 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. During 2016 and 2017, there were 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 the ages of 6 months and 1 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 the second dose is given, then the routine pre-school dose should still be given.

FAQ: Why are two doses of MMR needed?

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.

The vaccine is usually given during childhood as part of the routine vaccination schedule. Your child will be invited for their first MMR vaccination within a month of their first birthday. They’ll be offered their second ‘booster’ jab when they are between the ages of three years, four months and five years, before starting school. Having two doses of MMR will ensure that your child is fully protected against measles.

You can have the MMR vaccination 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.

Details

  • Other helpful websites Other helpful websites

    Sources

    • MMR vaccination. Public Health England. www.gov.uk, published 1 August 2016.
    • MMR vaccine (measles, mumps and rubella vaccine). Vaccine Knowledge Project. University of Oxford. vk.ovg.ox.ac.uk, last updated 3 April 2017
    • The UK immunisation schedule. The Green Book. Public Health England. www.gov.uk, last updated 20 September 2016
    • Measles, mumps, rubella (MMR): use of combined vaccine instead of single vaccines. Public Health England. www.gov.uk, published 1 January 2014
    • Infectious disease. Oxford handbook of general practice (online) Oxford Medicine Online. oxfordmedicine.com, published April 2014
    • Measles. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised August 2013
    • Measles. Vaccine Knowledge Project. University of Oxford. vk.ovg.ox.ac.uk, last updated 10 April 2017
    • Mumps. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2013
    • Rubella. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2015
    • Febrile seizure. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2013
    • Asaria P, MacMahon E. Measles in the United Kingdom: can we eradicate it by 2010? BMJ 2006; 333:890. doi:10.1136/bmj.38989.445845.7C
    • Gupta R, MacMahon E. Clinical review: mumps and the UK epidemic 2005. BMJ 2005; 330:1132. doi:10.1136/bmj.330.7500.1132
    • MMR vaccine. Immunisation Scotland. www.immunisationscotland.org.uk, last reviewed 15 July 2016
    • Herd immunity. Vaccine Knowledge Project. University of Oxford. vk.ovg.ox.ac.uk, updated 14 April 2016
    • Measles: worldwide. Travel Health Pro. travelhealthpro.org.uk, published 11 May 2015
    • World Health Organization. Measles continues to spread and take lives in Europe. www.euro.who.int, published 11 July 2017
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    Reviewed by Pippa Coulter, Specialist Health Editor, Bupa Health Content Team, September 2017
    Expert reviewer, Professor Robert Read, Professor of Infectious Diseases
    Next review due: September 2020

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