The MMR vaccine is a "3-in-1" vaccine that protects against measles, mumps, and rubella -- all of which are potentially serious diseases of childhood.

WHO SHOULD GET THIS VACCINE

The MMR is one of the recommended childhood immunizations. Generally, proof of MMR vaccination is required for school entry.

• The first shot is recommended when the child is 12 to 15 months old. The timing of vaccination is important to make sure the child is properly protected. It must not be given too early.
• A second MMR is recommended before entering school at 4 - 6 years, but may be given at any time thereafter. Some states require a second MMR at kindergarten entry.

Adults 18 years or older who were born after 1956 should also receive MMR if they are uncertain of their immunization status or if they have only had one MMR prior to school entry.

Adults born during or prior to 1956 are presumed to be immune. Many people within that age group had the actual diseases during childhood.

BENEFITS

One MMR will protect most individuals from contracting measles, mumps, or rubella throughout their lives. The second MMR is recommended to cover those individuals who may not have received adequate protection from the first MMR.

Measles is a virus which causes a rash, cough, runny nose, eye irritation, and fever in most people, but can also lead to pneumonia, seizures, brain damage, and death in some cases.

Mumps virus causes fever, headache, and swollen glands, but can also lead to deafness, meningitis, swollen testicles or ovaries, and death in some cases.

Rubella, also known as the German measles, is generally a mild disease, but can cause serious birth defects in the child of a woman who becomes infected while pregnant.

RISKS AND SIDE EFFECTS

Watch for and be familiar with how to care for a fever, joint pain and stiffness, minor gland swelling and tenderness, or minor redness and soreness at the injection site. If a rash develops without other symptoms, no treatment is necessary, and it should go away within several days.

Most people who receive the MMR will have no associated problems. Others may have minor problems, such as soreness and redness at the injection site or fevers. Serious problems associated with receiving the MMR are rare.

Potential mild to moderate adverse effects include:

• Fever (1 in 6 children)
• Rash (1 in 20)
• Swollen glands (rare)
• Seizure (1 in 3,000)
• Joint pain/stiffness (1 in 4, usually young women)
• Low platelet count/bleeding (1 in 30,000)

Severe adverse effects may include:

• Allergic reaction (less than 1 per million)
• Long-term seizure, brain damage, or deafness (so rare that the association with the vaccine is questionable)

Despite considerable publicity, there is no evidence linking MMR vaccination with the development of autism. The Centers for Disease Control and Prevention (CDC) website (www.cdc.gov/vaccines) provides further information.

The potential benefits from receiving the MMR vaccine far outweigh the potential risks. Measles, mumps, and rubella are all very serious illnesses, and each can have complications that lead to lifetime disabilities or even death.

CONSIDERATIONS

If the child is ill with something more serious than just a cold, immunization may be delayed. Tell your health care providers if your child had any problems with the first MMR vaccine before scheduling the second one.

The MMR vaccine should not be given to people who have:

• An allergy to gelatin or the antibiotic neomycin serious enough to require medical treatment
• A weakened immune system due to certain cancers, HIV, steroid drugs, chemotherapy, radiation therapy, or other immunosuppressant drugs

You should not receive this vaccine if you are pregnant or planning to become pregnant within the next 28 days.

People who have received transfusions or other blood products (including gamma globulin) or who have had low platelet counts should discuss the proper timing of MMR vaccine with their health care provider.

CALL YOUR DOCTOR IF:

• You aren't sure if the MMR vaccine should be given, withheld, or delayed for a specific person
• You have moderate or serious symptoms after receiving the vaccine
• Other symptoms, not commonly associated with possible side effects of the MMR vaccine, develop
• You have any other questions or concerns related to the vaccine

American Academy of Pediatrics Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents--United States, 2008. Pediatrics. 2008;121(1):219-220.

Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0–18 years--United States, 2008. MMWR. 2007;56:Q1-Q4.

Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, October 2007-September 2008. Ann Intern Med. 2007;147(10):725-729.