Measles Vaccination Guidelines

Current MMR Vaccine Options

The Centers for Disease Control and Prevention recommends the use of two MMR vaccines, M-M-R II and PRIORIX, which are fully interchangeable for all indications for which MMR vaccination is recommended 1, 2, 3
Both vaccines contain live attenuated viruses for measles, mumps, and rubella in a single formulation, and have been approved for use in the United States 1, 4

The American Academy of Pediatrics recommends a 2-dose vaccination schedule, with the first dose administered at age 12-15 months and the second dose at age 4-6 years 5, 6
The minimum interval between doses is 28 days (4 weeks) 7, 8
Both vaccines are administered as a subcutaneous injection with a single dose of approximately 0.5 mL after reconstitution 2, 5

For infants aged 6-11 months who will travel or live abroad or during measles outbreaks, a single dose of MMR is recommended as an off-label use 1, 4
For measles post-exposure prophylaxis in unvaccinated persons, 1 dose of MMR should be administered within 72 hours of exposure 4, 6
During mumps outbreaks, a third dose of MMR is recommended for persons identified as being at increased risk 4, 6

The combination MMR vaccine has been the standard approach since the late 1970s in the United States, providing fewer injections for patients, a more favorable benefit/cost ratio, and protection against all three diseases with a single administration 1, 7, 8
The high effectiveness of the MMR vaccine has led to the elimination of endemic measles in the United States in 2000 and rubella in 2004 1

A third dose of MMR vaccine is indicated for persons identified by public health authorities as being at increased risk for acquiring mumps during outbreaks, according to the Centers for Disease Control and Prevention (CDC) 9, 10, 11, 12, 13

For routine vaccination outside of outbreak settings, only 2 doses of MMR are recommended, providing long-lasting immunity in at least 95% of recipients, as stated by the Advisory Committee on Immunization Practices (ACIP) 10, 12, 14

The third dose recommendation is specific to mumps outbreak control and does not apply to measles or rubella outbreak settings, where standard 2-dose vaccination remains the recommendation, as indicated by the CDC 9, 10, 11
For measles postexposure prophylaxis, only 1 dose of MMR within 72 hours is recommended for unvaccinated persons, followed by completion of the 2-dose series, according to the CDC 9, 10, 12, 13
Both M-M-R II and PRIORIX vaccines are fully interchangeable for all indications, including the third dose during mumps outbreaks, as stated by the CDC 9, 10, 11, 12

The World Health Organization recommends a two-dose schedule for measles vaccination, with the first dose at 9 months and the second dose at 15-18 months in countries with high measles transmission rates, and the first dose can be delayed to 12 months of age in countries that have achieved high measles control 15, 16
The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend a universal 2-dose schedule with the first dose at 12-15 months and the second dose at 4-6 years of age, which has been standard in the United States since 1989 17, 18

Primary vaccine failure occurs in approximately 5% of vaccinees, necessitating a second opportunity for immunization, which provides protection to individuals who do not respond to their initial vaccination 18

During outbreaks, all persons at risk should have documentation of two doses of measles vaccine given at least 1 month apart after the first birthday 17, 18
Adults born before 1957 are generally considered immune due to natural disease exposure and require only one dose if vaccination is indicated 17