Mumps, Rubella, Measles (Live Attenuated) Vaccine
Indications
Mumps, Rubella, Measles (Live Attenuated) Vaccine is used for:
Active immunization against infection by measles, mumps and rubella
Adult Dose
IM or SC
Active immunisation against measles, mumps and rubella
19-49 years old: 0.5 mL SC; second dose may be administered 28 days apart
>50 years old: 0.5 mL SC; administer 1 dose only
2nd dose recommendations
Student in postsecondary eduction
Recent exposure
Occupational risk
Previously vaccinated with killed measles vaccine
Vaccinated with unknown type of measles vaccine during 1963-67
International travelers
Healthcare personnel should consider receiving 2 doses of MMR vaccine at the appropriate interval for measles and mumps or 1 dose of MMR vaccine for rubella
Immunization in Pregnancy
Pregnant women who do not have evidence of immunity should receive MMR vaccine upon completion or termination of pregnancy and before discharge from the health-care facility
Pregnancy should be avoided for 28 days following vaccine administration
Child Dose
IM or SC
Active immunisation against measles, mumps and rubella
Routine vaccination: First dose of 0.5 mL SC between age 12-15 months; administer second dose between 4-6 yr. But may be administered during any visit
provided that at least 4 weeks have elapsed since the first dose and that both doses are administered beginning at or after age 12 months.
Those who have not received the second dose previously should complete the schedule by the visit at age 11–12 years.
Ensure all school-aged children and adolescents received 2 doses (0.5 mL SC each)
Minimum time between 1st and 2nd dose is 4 wk
Renal Dose
Administration
Contra Indications
Current febrile respiratory illness or other febrile infection. Patients receiving immunosuppressive therapy; primary and acquired immunodeficiency states. Blood dyscrasias, cancers affecting the bone marrow or lymphatic systems. Pregnancy. Active untreated tuberculosis.
Precautions
Patients with history of cerebral injury or seizures. Patients with thrombocytopenia and those who develop thrombocytopenia after 1st dose. For patients with active tuberculosis, tuberculosis treatment should be started before using the vaccine. Vaccination may be deferred in patients with moderate or severe acute illness. Pregnancy should be avoided for 28 days after vaccination. Lactation.
Lactation: Uot known if measles and mumps excreted in breast milk; rubella is excreted in milk; use caution
Pregnancy-Lactation
Pregnancy
Contraindicated during pregnancy; avoid pregnancy for 3 months following vaccination
In a 10-year survey involving over 700 pregnant women who received rubella vaccine within 3 months before or after conception (of whom 189 received the Wistar RA 27/3 strain), none of the newborns had abnormalities compatible with congenital rubella syndrome
Mumps infection during the first trimester of pregnancy may increase the rate of spontaneous abortion
Although mumps vaccine virus has been shown to infect the placenta and fetus, there is no evidence that it causes congenital malformations in humans
Reports have indicated that contracting wild-type measles during pregnancy enhances fetal risk; increased rates of spontaneous abortion, stillbirth, congenital defects and prematurity have been observed subsequent to infection with wild-type measles during pregnancy
There are no adequate studies of the attenuated (vaccine) strain of measles virus in pregnancy; however, it would be prudent to assume that the vaccine strain of virus is also capable of inducing adverse fetal effects
Lactation
Unknown if measles or mumps vaccine is secreted in human milk
The prescribing information describes studies that have shown lactating postpartum women immunized with live attenuated rubella vaccine may secrete the virus in breast milk and transmit it to breastfed infants
Interactions
Immune globulins may reduce the efficacy of vaccines. May reduce the diagnostic effect of tuberculin tests.
Potentially Fatal: Concurrent use with immunosuppressants may increase the adverse effects of vaccines; may also reduce the efficacy of vaccines.
Adverse Effects
Side effects of Mumps, Rubella, Measles (Live Attenuated) Vaccine :
Fever, Syncope, Ataxia, Pain at site, Headache, Rash, Lymphadenopathy, Myalgia, Stevens-Johnson syndrome, Thrombocytopenia, Optic neuritis, Encephalitis, Malaise, Irritability, Guillain-Barre synd, Subacute sclerosing panencephalitis (rare), Seizures, Parotitis, Bronchospasm, Leukocytosis, Conjunctivitis, Otitis media, Nerve deafness
Mechanism of Action
Live, attenuated viruses stimulate active immunity to disease caused by measles, rubella, and mumps viruses.