When is mmr booster given

There are two types of PEP for measles:. For more information on measles outbreak control and post-exposure prophylaxis, healthcare providers should consult their health department and refer to the measles chapter of the Manual for the Surveillance of Vaccine-Preventable Diseases. Some special considerations for mumps vaccination are described below. Persons 4 years of age or older who are unvaccinated or have received only one dose of MMR or MMRV should receive MMR 2 doses for unvaccinated, and 1 dose for people who previously received the first dose, administered 28 days apart.

During mumps outbreaks, public health authorities might also recommend that people who belong to groups at increased risk for getting mumps receive an additional dose of MMR second dose for persons previously vaccinated with one dose or a third dose for persons previously vaccinated with 2 doses.

Public health authorities will communicate to providers which groups are at increased risk and should receive a dose. Unlike with measles, MMR vaccine is not effective at helping protect people who have recently been infected with mumps post-exposure prophylaxis, or PEP.

However, vaccination after exposure is not harmful and may possibly prevent later disease if re-exposed. For more information on mumps outbreak control and post-exposure prophylaxis, healthcare providers should consult their health department and refer to the mumps chapter of the Manual for the Surveillance of Vaccine-Preventable Diseases.

Some special considerations for rubella vaccination are described below. All women of childbearing age, especially those who grew up outside the United States in areas where routine rubella vaccination might not occur, should be vaccinated with one dose of MMR vaccine or have other acceptable presumptive evidence of rubella immunity.

Only a positive serologic test for rubella antibody or documentation of appropriate vaccination should be accepted as presumptive evidence of immunity for women who may become pregnant.

Women known to be pregnant or attempting to become pregnant should not receive a live virus vaccine, including MMR vaccine. Although there is no evidence that rubella vaccine virus is harmful to the fetus during pregnancy, as a precaution, women should not get pregnant for 4 weeks 28 days after MMR vaccination. Unlike with measles, MMR vaccine is not effective at helping protect people who have recently been infected with rubella post-exposure prophylaxis, or PEP.

For more information on rubella outbreak control and post-exposure prophylaxis, healthcare providers should consult their health department and refer to the rubella chapter of the Manual for the Surveillance of Vaccine-Preventable Diseases.

Skip directly to site content Skip directly to page options Skip directly to A-Z link. How can I best protect the young children in my practice? First of all, make sure all your patients are fully vaccinated according to the U.

In certain circumstances, MMR is recommended for infants age 6 through 11 months. Give infants this age a dose of MMR before international travel.

In addition, consider measles vaccination for infants as young as age 6 months as a control measure during a U. Consult your state health department to find out if this is recommended in your situation. Do not count any dose of MMR vaccine as part of the 2-dose series if it is administered before a child's first birthday.

Instead, repeat the dose when the child is age 12 months. In the case of a local outbreak, you also might consider vaccinating children age 12 months and older at the minimum age 12 months, instead of 12 through 15 months and giving the second dose 4 weeks later at the minimum interval instead of waiting until age 4 through 6 years.

Finally, remember that infants too young for routine vaccination and people with medical conditions that contraindicate measles immunization depend on high MMR vaccination coverage among those around them. Be sure to encourage all your patients and their family members to get vaccinated if they are not immune.

In recent years, mumps outbreaks have occurred primarily in populations in institutional settings with close contact such as residential colleges or in close-knit social groups.

The current routine recommendation for 2 doses of MMR vaccine appears to be sufficient for mumps control in the general population, but insufficient for preventing mumps outbreaks in prolonged, close-contact settings, even where coverage with 2 doses of MMR vaccine is high. In a measles outbreak, do children who have not had MMR vaccine pose a threat to vaccinated people?

It is my understanding that vaccinated people can still contract measles. Am I correct? You are correct that vaccinated people can still be infected with viruses or bacteria against which they are vaccinated. More information is available for each vaccine and disease at www. Should these doses be repeated? All live injected vaccines MMR, varicella, and yellow fever are recommended to be given subcutaneously. However, intramuscular administration of any of these vaccines is not likely to decrease immunogenicity, and doses given IM do not need to be repeated.

We often need to give MMR vaccine to large adults. Can this be considered a valid dose? Although this is off-label use, CDC recommends that when a dose of MMRV is inadvertently given to a patient age 13 years and older, it may be counted towards completion of the MMR and varicella vaccine series and does not need to be repeated. How soon can we give the second dose of MMR vaccine to a child vaccinated at 12 months old?

The minimum interval is 28 days for dose 2. Does the 4-day "grace period" apply to the minimum age for administration of the first dose of MMR? What about the day minimum interval between doses of MMR?

A dose of MMR vaccine administered up to 4 days before the first birthday may be counted as valid. However, school entry requirements in some states may mandate administration on or after the first birthday. The 4-day "grace period" should not be applied to the day minimum interval between two doses of a live parenteral vaccine. Can MMR be given on the same day as other live virus vaccines? If you can give the second dose of MMR as early as 28 days after the first dose, why do we routinely wait until kindergarten entry to give the second dose?

The second dose of MMR may be given as early as 4 weeks after the first dose, and be counted as a valid dose if both doses were given after the first birthday.

The second dose is not a booster, but rather it is intended to produce immunity in the small number of people who fail to respond to the first dose. The risk of measles is higher in school-age children than those of preschool age, so it is important to receive the second dose by school entry.

It is also convenient to give the second dose at this age, since the child will have an immunization visit for other school entry vaccines. What is the earliest age at which I can give MMR to an infant who will be traveling internationally? Also, which countries pose a high risk to children for contracting measles? ACIP recommends that children who travel or live abroad should be vaccinated at an earlier age than that recommended for children who reside in the United States.

Before their departure from the United States, children age 6 through 11 months should receive 1 dose of MMR. The risk for measles exposure can be high in high-, middle- and low-income countries. Consequently, CDC encourages all international travelers to be up to date on their immunizations regardless of their travel destination and to keep a copy of their immunization records with them as they travel.

For additional information on the worldwide measles situation, and on CDC's measles vaccination information for travelers, go to wwwnc. If we give a child a dose of MMR vaccine at 6 months of age because they are in a community with cases of measles, when should we give the next dose? The next dose should be given at 12 months of age. The child will also need another dose at least 28 days later. For the child to be fully vaccinated, they need to have 2 doses of MMR vaccine given when the child is 12 months of age and older.

A dose given at less than 12 months of age does not count as part of the MMR vaccine two-dose series. I have an 8-month-old patient who is traveling internationally. The infant needs to be protected from hepatitis A as well as measles, mumps, and rubella. The family is leaving in 11 days. IG may contain antibodies to measles, mumps, and rubella that could reduce the effectiveness of MMR vaccine. For this reason, in February ACIP voted to recommend that hepatitis A vaccine should be administered to infants age 6 through 11 months traveling outside the United States when protection against hepatitis A is recommended.

MMR and hepatitis A vaccine may be safely co-administered to children in this age group. Neither vaccine is counted as part of the child's routine vaccination series.

Can I give the second dose of MMR earlier than age 4 through 6 years the kindergarten entry dose to young children traveling to areas of the world where there are measles cases? The second dose of MMR can be given a minimum of 28 days after the first dose if necessary. If I give MMR to an infant traveler younger than age 1 year, will that dose be considered valid for the U. A measles-containing vaccine administered more than 4 days before the first birthday should not be counted as part of the series.

MMR should be repeated when the child is age 12 through 15 months 12 months if the child remains in an area where disease risk is high.

The second dose should be administered at least 28 days after the first dose. Live measles vaccine given prior to the application of a TST can reduce the reactivity of the skin test because of mild suppression of the immune system. An year-old college student says he had both measles and mumps diseases as a preschooler, but never had MMR vaccine.

Is rubella vaccine recommended in such a situation? This student should receive two doses of MMR, separated by at least 28 days. A personal history of measles and mumps is not acceptable as proof of immunity. Acceptable evidence of measles and mumps immunity includes a positive serologic test for antibody, birth before , or written documentation of vaccination.

For rubella, only serologic evidence or documented vaccination should be accepted as proof of immunity. Additionally, people born prior to may be considered immune to rubella unless they are women who have the potential to become pregnant. When not given on the same day, is the interval between yellow fever and MMR vaccines 4 weeks 28 days or 30 days? I have seen the yellow fever and live virus vaccine recommendations published both ways. The CDC travel health website recommends that yellow fever vaccine and other parenteral or nasal live vaccines should be separated by at least 30 days if possible.

Either interval is acceptable. What is the recommendation for MMR vaccine for healthcare personnel? ACIP recommends that all HCP born during or after have adequate presumptive evidence of immunity to measles, mumps, and rubella, defined as documentation of two doses of measles and mumps vaccine and at least one dose of rubella vaccine, laboratory evidence of immunity, or laboratory confirmation of disease.

During an outbreak of measles or mumps, healthcare facilities should recommend 2 doses of MMR separated by at least 4 weeks for unvaccinated healthcare personnel regardless of birth year who lack laboratory evidence of measles or mumps immunity or laboratory confirmation of disease.

During outbreaks of rubella, healthcare facilities should recommend 1 dose of MMR for unvaccinated personnel regardless of birth year who lack laboratory evidence of rubella immunity or laboratory confirmation of infection or disease. Would you consider healthcare personnel with 2 documented doses of MMR vaccine to be immune even if their serology for 1 or more of the antigens comes back negative? Healthcare personnel HCP with 2 documented doses of MMR vaccine are considered to be immune regardless of the results of a subsequent serologic test for measles, mumps, or rubella.

Documented age-appropriate vaccination supersedes the results of subsequent serologic testing. In contrast, HCP who do not have documentation of MMR vaccination and whose serologic test is interpreted as "indeterminate" or "equivocal" should be considered not immune and should receive 2 doses of MMR vaccine minimum interval 28 days.

ACIP does not recommend serologic testing after vaccination. However, the person is not infectious, and no special precautions such as exclusion from work need to be taken. A year-old female is going to pharmacy school and the school wants her to have a second dose of MMR vaccine. She had the first dose as a child and developed measles within 24 hours of receiving the vaccine.

Recent serologic testing showed she is immune to mumps and measles but not immune to rubella. Can I give her a second dose of the MMR with her having measles after the first dose? Yes, as a healthcare professional, this person should get a second dose of MMR to ensure she is immune to rubella.

There is no harm in providing MMR to a person who is already immune to one or more of the components. If she developed measles only one day after getting her first MMR, she must have been exposed to the disease prior to vaccination. What are the contraindications and precautions for MMR vaccine? See www. We have many patients who are immunocompromised and cannot get the MMR vaccine. How should we advise our patients?

People with medical conditions that contraindicate measles immunization depend on high MMR vaccination coverage among those around them. To help prevent the spread of measles virus, make sure all your staff and patients who can be vaccinated are fully vaccinated according to the U.

Also, encourage patients to remind their family members and other close contacts to get vaccinated if they are not immune. If patients who cannot get MMR vaccine are exposed to measles, CDC has guidelines for immune globulin for post-exposure prophylaxis which can be found at www. We have a patient who has selective IgA deficiency. We also have patients with selective IgM deficiency. Can MMR or varicella vaccine be administered to these patients?

It is possible that the immune response may be weaker, but the vaccines are likely effective. I have a patient who is traveling internationally and needs MMR vaccine. He recently received an injectable steroid. How long should he wait before receiving MMR vaccine? There is no need to wait a specific interval before giving MMR. Injectable steroids are not considered immunosuppressive for the purpose of vaccination decisions, and so there is no concern about safety or efficacy of MMR.

Can I give MMR to a child whose sibling is receiving chemotherapy for leukemia? MMR and varicella vaccines should be given to the healthy household contacts of immunosuppressed children.

We have a 40 lb six-year-old patient who has been taking 15 mg of methotrexate weekly for arthritis for 12 months. Can we give the child MMR and varicella vaccine based on this methotrexate dosage? Administration of both varicella and MMR vaccines are contraindicated until such time as the methotrexate dosage can be reduced. The IDSA definition of low-level immunosuppression for methotrexate is a dosage of less than 0.

Is it true that egg allergy is not considered a contraindication to MMR vaccine? Several studies have documented the safety of measles and mumps vaccine which are grown in chick embryo tissue culture in children with severe egg allergy. ACIP recommends routine vaccination of egg-allergic children without the use of special protocols or desensitization procedures. Can I give MMR to a breastfeeding mother or to a breastfed infant?

Breastfeeding does not interfere with the response to MMR vaccine. Vaccination of a woman who is breastfeeding poses no risk to the infant being breastfed. Although it is believed that rubella vaccine virus, in rare instances, may be transmitted via breast milk, the infection in the infant is asymptomatic. The U. An outbreak is when a disease happens in greater numbers than expected in a particular area. During an outbreak, doctors may recommend a third vaccine dose for some people. If you have questions about vaccinating your family during an outbreak, call your doctor or your state or local health department.

Measles, mumps, and rubella are infections that can lead to serious illness. Serious problems such as allergic reactions are rare. If your vaccination records are not available, or do not exist, it will not harm you to have the MMR vaccine again. You should also avoid becoming pregnant for 1 month after having the MMR vaccine. Evidence suggests there will be no harm to your baby, but it's better to let them know.

The MMR vaccine is not recommended for people with a severely weakened immune system. For example, people receiving chemotherapy. If you have a medical condition, or are taking medicine that may affect your immune system, check with your healthcare provider if it's safe for you to have the MMR vaccine. It's best to have vaccines on time, but you can still catch up on most vaccines if you miss them.

The MMR vaccine is given as 2 doses of a single injection into the muscle of the thigh or upper arm. Single vaccines for measles, mumps and rubella are not available on the NHS and are not recommended. Combined vaccines like the MMR vaccine are safe and help to reduce the number of injections your child needs.

Some private clinics in the UK offer single vaccines against measles, mumps and rubella, but these vaccines are unlicensed. This means there are no checks on their safety and effectiveness. The NHS does not keep a list of private clinics. UK has more about why the NHS uses a combined vaccine.

People who are vaccinated against mumps, but still catch it, are less likely to have serious complications or be admitted to hospital. Protection against measles, mumps and rubella starts to develop around 2 weeks after having the MMR vaccine. The MMR vaccine is very safe. Most side effects are mild and do not last long, such as:.

Some children might also cry and be upset immediately after the injection. This is normal and they should feel better after a cuddle. It's important to remember that the possible complications of infectious conditions, such as measles, mumps and rubella, are much more serious.

As there are 3 separate vaccines within a single injection, different side effects can happen at different times. Around 7 to 11 days after the injection, some children get a very mild form of measles.

This includes:.