Measles, Mumps, Rubella

Available vaccines: MMR II® (measles, mumps, rubella), ProQuad® (measles, mumps, rubella, and varicella)

Measles

Measles is a highly contagious disease caused by a virus spread through respiratory droplets. Initial prodromal symptoms include high fever, cough, runny nose, and red or watery eyes. Two weeks after exposure, a maculopapular rash develops, starting at the head and extending to the trunk and lower extremities. In severe cases, measles can cause inflammation of the brain and death. Those most at risk for severe cases include infants and individuals with weakened immune symptoms. Individuals are contagious from 4 days before to 4 days after the rash appears.

Currently, there is no antiviral therapy for measles and medical care is used to relieve symptoms and reduce the risk of complications and bacterial infections.

Mumps

Mumps was a contagious virus that causes the typical symptoms of a swollen jaw and puffy cheeks due to swelling of the salivary glands. Other symptoms of mumps include fever, headache, myalgia, fatigue, and loss of appetite. Some individuals who get mumps have very mild or no symptoms and are unaware they have the disease.

Mumps is transmitted through respiratory droplets and is contagious prior to salivary gland swelling and up to 5 days afterward.

Complications of mumps include inflammation of the testicles in males who have reached puberty (in rare cases, this can lead to infertility), encephalitis, meningitis, oophoritis, mastitis, and deafness.

Rubella

Rubella, also known as German measles, is also caused by a highly contagious virus that is different than the measles. Initially, rubella presents with a low-grade fever, headache, mild conjunctivitis, swollen lymph nodes, cough, and runny nose. After 1 to 5 days, a rash develops on the face and spreads to the rest of the body lasting about 3 days. Complications from rubella can cause encephalitis and bleeding problems. Rubella can have serious negative effects on a developing fetus, including heart problems, loss of hearing and eyesight, liver or spleen damage, and intellectual disability after birth; other complications include miscarriage or death of the infant.

A person with rubella is contagious up to 7 days prior to rash development and 7 days afterward.

Currently, there is no specific medication to treat rubella; otherwise, symptoms can be managed with rest and supportive care.

MMR Vaccine

Measles was declared eliminated in the United States, but due to measles activity in Europe, Asia, Africa, and the Pacific, and as a result of individuals not receiving the vaccine, there was an increase in cases reported in 2014.

Mumps was a common childhood disease until 1967, when the mumps vaccination program was intiated. Since then, mumps cases have decreased more than 99%.

Prior to vaccine availability in 1969, rubella infected 12.5 million people, 11,000 pregnant women lost their babies, and 2,100 newborns died. Currently, fewer than 10 people are reported to have rubella each year.

After two doses of MMR, the vaccine is 97% effective against measles and 88% effective against mumps. After one dose of MMR, the vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella.

Who Should Get the Vaccine?

ACIP recommends that any healthy person  who does not have evidence of immunity to measles, mumps, and rubella should get vaccinated.

ACIP and CDC recommend initiating the vaccine course in children aged 12 to 15 months.

MMR vaccinations are important for students attending college, international travelers, healthcare professionals, women of child bearing age who are not pregnant, people who care for or are around immunocompromised people, and people with HIV without severe immunosuppression.

Who Should NOT Get the Vaccine?

The vaccine should not be given to anyone who has had a severe allergic reaction to the MMR vaccine in the past, has a known severe immunodeficiency, is currently pregnant, or has a history of anaphylactic reactions to neomycin.

Side Effects

The most common adverse effect from receiving the MMR or MMRV vaccines is injection-site reactions. Occasionally, a mild rash, fever, swollen glands, and myalgia are reported.

Insurance Coverage

Medicare Part D plans should cover the MMR and MMRV vaccines—contact the specific insurance provider for more information.

Medicaid covers vaccines per the ACIP vaccination recommendations—contact the specific insurance provider for more information.

Most private health insurances cover the vaccines—check with your provider for information.

The Vaccines for Children Program may be able to help if you do not have health insurance coverage for your child or if your insurances do not cover vaccines.