MMR Vaccination for International Travel to Measles-Endemic Areas
Assessment of Previous Vaccination Status
- Individuals vaccinated in 1979 or 1990 have likely received one or two doses of MMR vaccine, but protection may wane over time, particularly when traveling to high-risk areas 1, 3
- Persons who received a vaccine of unknown type after 1967 should receive a second dose before undertaking international travel, even if they previously received appropriate vaccination 1, 4
Recommendations for International Travelers
- The Advisory Committee on Immunization Practices (ACIP) specifically recommends that travelers to areas with increased measles risk should be immune to measles before leaving the United States 2
- Consideration should be given to providing a dose of measles vaccine to persons born during or after 1957 who travel abroad and who have not previously received two doses of measles vaccine 2
Rationale for Additional Dose
- Even with previous vaccination, the risk of measles infection increases in areas with high prevalence 1, 5
- An additional dose provides a boost to immunity that may have waned over time since the original vaccinations in 1979 and 1990 4
Safety of Additional MMR Dose
- Side effects tend to occur among vaccine recipients who are nonimmune and are very rare after revaccination 4
- No evidence exists that persons who have previously received mumps vaccine (killed or live) are at increased risk for local or systemic reactions upon receiving MMR or live mumps vaccine 4
- The risk of adverse events after an additional dose is minimal compared to the risk of contracting measles in an endemic area 1, 4
Common Pitfalls and Considerations
- Failing to recognize that international travel to measles-endemic areas represents a significant risk factor that warrants revaccination 1, 2
- Assuming that vaccination from 30+ years ago provides sufficient protection without a booster dose when traveling to high-risk areas 3