Guidelines for MMR IgG Titer Testing
General Recommendations
- Routine serologic screening for measles‑mumps‑rubella (MMR) immunity is unnecessary when individuals have documented appropriate vaccination; however, titers should be checked for healthcare workers lacking documentation, persons who received immune‑globulin products and need confirmation of vaccine response, and in specific outbreak or occupational settings where proof of immunity is required. CDC 1
Healthcare Workers
- All healthcare workers must have documented evidence of measles and rubella immunity, irrespective of their patient‑care responsibilities. CDC 2
- Workers born in 1957 or later are considered adequately protected when they have received two doses of a measles‑containing vaccine and at least one dose of a rubella‑containing vaccine. CDC 1
- Pre‑vaccination serologic screening is not required unless a facility deems it cost‑effective; testing is appropriate only when susceptible individuals will be vaccinated promptly afterward. CDC 1
- During measles or rubella outbreaks, serologic screening before vaccination is discouraged because rapid vaccination is essential to stop transmission. CDC 1
- For workers born before 1957 who lack documentation of immunity or a physician‑diagnosed disease, facilities should favor recommending MMR vaccination rather than routine titer checking. CDC 1
Post‑Immune‑Globulin Administration
- Individuals who receive MMR vaccine and then an immune‑globulin preparation within 14 days should undergo serologic testing at least 3 months later to confirm antibody production to each vaccine component. CDC 3
- Women who receive anti‑Rho(D) immune globulin during pregnancy or delivery and are vaccinated postpartum should be tested ≥ 3 months later to verify immunity to rubella and measles. CDC 3
Immunocompromised / Adverse‑Reaction Considerations
- When a person develops thrombocytopenia within 6 weeks of a prior MMR dose, serologic evidence of measles immunity may be obtained in lieu of administering another MMR vaccine dose. CDC 3
Populations Not Requiring Routine Titers
- Individuals with documented receipt of two MMR doses administered on or after the first birthday do not need serologic confirmation of immunity. CDC 4
- Persons born before 1957 are generally regarded as immune; facilities may still opt for vaccination rather than titer testing in this group. CDC 1
International Travelers
- Travelers lacking documentation of MMR vaccination should receive the vaccine rather than undergo serologic testing before departure. CDC 2