Trevor James
The MMR vaccine is recommended for both children and adults who do not have evidence of immunity against measles, mumps, and rubella. While most people receive the MMR vaccine as children, in two shots, adults may also require one or two doses depending on their risk factors and immunity status. The MMR vaccine is administered to children from as early as 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, while adults may receive their doses 28 days apart. The MMR vaccine is critical in preventing measles, mumps, and rubella, which can have severe health consequences, especially in children.
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What You'll Learn
MMR vaccine dosage for children
The MMR vaccine is recommended routinely for children at the age of 12 through 15 months, with a second dose at age 4 through 6 years. The second dose of MMR can be given as early as 4 weeks (28 days) after the first dose and be counted as a valid dose if both doses are given after the child's first birthday. The second dose is not a booster but is intended to produce immunity in the small number of people who fail to respond to the first dose.
The MMR vaccine is also recommended for those who do not have evidence of immunity, such as older children, adolescents, and adults born after 1957. This includes those with well-controlled HIV/AIDS. The CDC recommends that separate MMR and varicella vaccines be given for the first dose in children aged 12-47 months; however, MMRV may be used if parents or caregivers express a preference.
During measles outbreaks, health departments may recommend a second dose for adults or an earlier second dose for children 1 to 4 years of age who are residing in or visiting the affected areas, with the second dose given at least 28 days after the first dose. If there is an ongoing community-wide transmission affecting young infants, health departments may recommend an early dose for infants 6 to 11 months of age.
It is important to note that no "booster" doses of MMR vaccine are recommended for either adults or children, and they are considered to have lifelong immunity once they have received the recommended number of MMR vaccine doses.
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MMR vaccine dosage for adults
The MMR vaccine is a vaccine against measles, mumps, and rubella (German measles). It is recommended for both children and adults who do not have evidence of immunity.
The Centers for Disease Control and Prevention (CDC) recommends that adults receive either one or two doses of the MMR vaccine, depending on their risk factors and immunity status. Here are the detailed guidelines for MMR vaccine dosage for adults:
- One dose of MMR vaccine: Most adults need only one dose of the MMR vaccine if they don't have evidence of immunity. Evidence of immunity can include written documentation of receiving at least one dose of a live measles-containing vaccine after their first birthday or laboratory evidence of immunity.
- Two doses of MMR vaccine: Certain groups of adults are recommended to receive two doses of the MMR vaccine, separated by at least 28 days. These include:
- Adults at high risk of exposure to measles, mumps, or rubella, including students at post-secondary educational institutions, healthcare personnel, and international travelers.
- Adults with well-controlled HIV infection who don't have evidence of measles immunity or severe immunosuppression.
- Adults born after 1957 who have never had measles or received a measles vaccination and don't have proof of immunity.
- Adults who previously received the inactivated (killed) measles vaccine between 1963 and 1967. This vaccine was less effective, and those individuals should be revaccinated with the live MMR vaccine.
It is important to note that adults should consult with their healthcare providers before receiving the MMR vaccine, especially if they have specific medical conditions or concerns. Additionally, women who are pregnant or planning to become pregnant should defer vaccination and avoid pregnancy for at least one month after receiving the MMR vaccine.
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MMR vaccination for children with HIV
The MMR vaccine is generally safe for children with HIV, provided they have a CD4 count of at least 200 cells/mm3 and show no evidence of severe immunosuppression. Severe immunosuppression is defined as CD4 percentages less than 15% for 6 months or longer for children five years of age or younger.
For children with HIV who meet these criteria, two doses of the MMR vaccine are recommended, separated by at least 28 days. This is in line with the general recommendation that children receive two doses of the MMR vaccine, with the second dose coming at least four weeks after the first.
It is important to note that the MMR vaccine is contraindicated for children with HIV who have a CD4 count of less than 200 cells/mm3. This is because the MMR vaccine is a live attenuated vaccine, which has been linked to fatal cases of measles-associated pneumonitis in individuals with HIV and low CD4 counts.
In the event of measles exposure, non-immune individuals with HIV and a CD4 count of 200 cells/mm3 or higher should receive the MMR vaccine within 72 hours of exposure or immunoglobulin (IG) within 6 days of exposure. If the individual is pregnant, IG should be administered within 6 days of exposure.
Additionally, individuals with HIV who have received two doses of the MMR vaccine and still show no evidence of immunity may need to repeat the two-dose series, especially if they were not virologically suppressed during the initial vaccination.
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MMR vaccination for adults with HIV
The MMR vaccine is recommended for all adults and children who do not have evidence of immunity against measles, mumps, and rubella. The Advisory Committee on Immunization Practices (ACIP) recommends that those without evidence of immunity get vaccinated with the MMR or MMRV vaccine.
For adults with HIV, the MMR vaccine is contraindicated for those with CD4 counts of less than 200 cells/mm3. This is because the MMR vaccine is a live attenuated formulation, which has been linked to fatal cases of measles-associated pneumonitis in people with HIV and low CD4 counts. However, for those with CD4 counts of 200 cells/mm3 or higher, the MMR vaccine has been deemed safe, although the antibody response may be lower than for patients without HIV.
People with HIV and a CD4 count of 200 cells/mm3 or higher who do not have evidence of measles immunity or severe immunosuppression should receive two doses of the MMR vaccine, separated by at least 28 days. Severe immunosuppression is defined as CD4 percentages of less than 15% for 6 months or longer for children under five years old, and less than 15% with a CD4 count of less than 200 cells/mm3 for 6 months or longer for those over five years old.
Acceptable evidence of immunity for people with HIV includes being born before 1957, documented evidence of two doses of the MMR vaccine, or the presence of positive antibody titers. Several studies from the 1990s found that 90-95% of adults with HIV were immune to measles, and serostatus did not vary by CD4 count. However, a more recent study found a measles seroprevalence rate of 70.3%. It is also believed that people with HIV retain immunity to mumps and rubella even after acquiring HIV.
Overall, while the MMR vaccine is contraindicated for people with HIV and low CD4 counts, it is recommended and considered safe for those with CD4 counts of 200 cells/mm3 or higher who do not have evidence of immunity.
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MMR vaccination for pregnant people
The MMR vaccine is not recommended during pregnancy due to a small chance of illness from the weakened viruses in the vaccine. There has been one documented case of a pregnant woman who received the MMR vaccine during the first trimester, and her baby was subsequently diagnosed with congenital rubella syndrome (CRS). Miscarriage is common and can be caused by various factors, and it is not known if the MMR vaccine increases the risk. However, contracting measles, mumps, or rubella during pregnancy may increase the risk of miscarriage and birth defects.
Pregnant women who have not received the MMR vaccine are advised to wait until after giving birth to get vaccinated. The MMR vaccine can be safely administered while breastfeeding. It is recommended that women wait at least one month after receiving the MMR vaccine before getting pregnant, and they should confirm their immunity with a blood test.
The MMR vaccine is crucial for protecting against measles, mumps, and rubella, which are highly contagious viral diseases. Vaccination helps safeguard both the mother and the baby from potentially severe illnesses. During a measles outbreak, non-pregnant individuals without evidence of immunity should receive the MMR vaccine immediately, followed by a second dose at least 28 days later.
In summary, while the MMR vaccine is not advised during pregnancy, it is essential for pregnant individuals to receive it either before or after their pregnancy to protect themselves and their babies.
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Frequently asked questions
The MMR vaccine protects against measles, mumps, and rubella. The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age.
The MMR vaccine is recommended for children and adults who do not have evidence of immunity against measles, mumps, and rubella.
Adults should receive 1 or 2 doses of the MMR vaccine, depending on their risk factors. Adults at high risk include students at post-secondary institutions, healthcare providers, and international travellers.
