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The MMR Vaccine The components of the MMR vaccine are the measles, mumps, and rubella vaccines.  They are all live viral vaccines, and so require careful refrigeration for storage.   The vaccine is given at the age of 15 months or later.  When the measles vaccine has been given at the age of 9 months, this second dose covers those children who did not develop immunity at that time.   If measles vaccine was given later, there should be a gap of 3 months before MMR is given.  If no measles vaccine has been given till the age of 15 months, a single dose of MMR is enough for lifelong immunity.   However, some children do not develop immunity when given one dose of these vaccine, and a second dose, given at school entry, or at 11-12 years, can provide immunity to these children. The mumps vaccine is not effective below the age of 1 year, and so the MMR vaccine cannot be given instead of measles at 9 months.   The rubella vaccine also should not be given below one year of age.  It is a highle effective vaccine, giving immunity to 95% of recipients.   It gives long term and probably lifetime immunity.   The MMR vaccine vaccine is given as a shallow (under the skin) injection, and does not cause significant pain or fever.

Rubella (German Measles)

This is a common, communicable infection, and is often so mild as to go unnoticed or undiagnosed.  The child (or adult) has a low fever, a mild rash (which may not be visible in dark skinned people) and enlargement of the lymph nodes of the head and neck.

The disease starts with fever, respiratory symptoms, and tender swelling of the lymph nodes. The rash appears begins on the face, and progresses down the body.  Usually, the rash lats for three days.  Occasionally it is so transient that it may fade from the face by the time the trunk is affected.  Rubella is known to occur without rash.

Complications of Rubella

Rubella has infrequent complications, unlike measles.  Swelling of the joints or nerves is seen occasionally, and brain swelling (encephalitis) occurs in 1 in 6,000 cases.

The importance of rubella lies in the congenital rubella syndrome.  If women get a rubella infection in the first few weeks of pregnancy, the unborn baby also gets infected.  Almost all organs are affected.  The baby is usually low birth weight, and has cataracts in one or both eyes. Congenital heart disease, deafness, and mental retardation are other components of the Congenital Rubella Syndrome.

Rubella is the only disease for which a vaccine was made with the intention of preventing disease in unborn children.  The rubella vaccine is available individually, but is mostly used as a component of the MMR vaccine.

Last revision: July 15, 2007

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