Measles, Mumps and Rubella (MMR)

The MMR vaccine is a combined vaccine which prevents against Measles Mumps and Rubella diseases.

Since its introduction in 1988 it has successfully reduced the number of cases of these diseases.

Some parents ask about having the vaccines given singly, and these are available at some private clinics. Having single vaccines usually involves scheduling them several weeks or months apart. The recommendation from the NHS is that the combined vaccine is the safest and most effective way to vaccinate against these diseases and it avoids the risk of children being left at risk of these serious illnesses while waiting to complete a course of single injections.

Currently, there are no licensed single vaccines in the UK for either measles or mumps. The official licensing process is a form of quality testing to ensure that the products are safe and effective.

For more detailed information please see the Great Ormond Street Hospital and Institute of Child health immunisation pages or the national NHS immunisation pages (see external links section below).

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Why vaccinate?

Measles, mumps and rubella are diseases with serious complications:

• Measles – causes a range of symptoms from ear infection and bronchitis to convulsions (fits) or brain damage, and can be fatal.
• Mumps – used to be the main cause of viral meningitis in children. Also causes temporary deafness, miscarriage, inflammation of the pancreas, and pain and swelling in the testicles in older males.
• Rubella –can lead to painful joints, blood disorders and/or swelling of the brain (encephalitis). It damages unborn babies, and may cause miscarriage if the mother catches the disease while pregnant. Babies born with congenital rubella syndrome may have some degree of deafness, blindness, and damaged heart or brain functioning.

There has been some controversy about the MMR vaccine in recent years, owing to a study published in The Lancet in 1998 by Dr Andrew Wakefield. His initial study appeared to show a link between the MMR vaccine and autism and/or bowel disease, but subsequent work and other studies have been unable to prove any association with these conditions.

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When to vaccinate

The first MMR vaccination is given to children at around 13 months of age, with a booster dose given before they start school (usually at around between 3 and 5 years old). Between 5 and 10% of children are not fully immune after the first dose, so the booster gives increased protection resulting in less than 1% remaining at risk.

Women who may be considering pregnancy should ask their GP to screen them (using a simple blood test) to check whether they are fully immune to rubella. Women who were born before 1988 were only given one vaccination against rubella, compared to those born later who received the recommended two doses of MMR.

Women who find that their protection from rubella is low or uncertain are routinely offered MMR vaccination to provide the immunity they need.

Rubella in pregnancy can cause serious problems in the developing baby. Doctors advise women to avoid pregnancy for one month after a rubella vaccination. Pregnant women who have not been screened prior to conceiving and find out (through routine antenatal blood tests) that their immunity is low will be offered a rubella vaccination after delivery of the baby, normally at their six-week postnatal check.

In the event of a measles outbreak, MMR can be used to protect people who may have come into contact with the disease within the previous 72 hours (3 days). This is because the development of measles antibodies following vaccination is faster than as a result of natural infection. Current advice states that there are no ill effects from vaccinating people who are already immune (e.g. if there is any doubt whether they have already been vaccinated).

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