The MMR vaccine (abbreviated as MMR) is a combination vaccine against measles, mumps, and rubella (German measles).[2] It contains the combined measles vaccine, mumps vaccine, and rubella vaccine into a single injection.[2][6][7][8] After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella.[6] The vaccine is also recommended for those who do not have evidence of immunity,[6] those with well-controlled HIV/AIDS,[9][10] and within 72 hours of exposure to measles among those who are incompletely immunized.[7] It is given by injection.[11]
The MMR vaccine is widely used around the world. As of 2012, 575 million doses had been administered since the vaccine's introduction worldwide.[12] Measles resulted in 2.6 million deaths per year before immunization became common.[12] This has decreased to 122,000 deaths per year as of 2012, mostly in low-income countries.[12] Through vaccination, as of 2018, rates of measles in North and South America are very low.[12] Rates of disease have been seen to increase in populations that go unvaccinated.[12] Between 2000 and 2018, vaccination decreased measles deaths by 73%.[13]
Side effects of immunization are generally mild and resolve without any specific treatment.[14] These may include fever, as well as pain or redness at the injection site.[14] Severe allergic reactions occur in about one in a million people.[14] Because it contains live viruses, the MMR vaccine is not recommended during pregnancy but may be given during breastfeeding.[6] The vaccine is safe to give at the same time as other vaccines.[14] Being recently immunized does not increase the risk of passing measles, mumps, or rubella on to others: That is, even though the vaccine contains live viruses, they are not transmitted.[6] There is no evidence of an association between MMR immunization and autistic spectrum disorders.[15]
The MMR vaccine was developed by Maurice Hilleman.[18] It was licensed for use in the US by Merck in 1971. Stand-alone measles, mumps, and rubella vaccines had been previously licensed in 1963, 1967, and 1969, respectively.[19][20] Recommendations for a second dose were introduced in 1989.[19] The MMRV vaccine, which also covers chickenpox, may be used instead.[6] An MR vaccine, without coverage for mumps, is also occasionally used.[21]
Medical use
Cochrane concluded that the "Existing evidence on the safety and effectiveness of MMR and MMRV vaccine supports current policies of mass immunisation aimed at global measles eradication to reduce morbidity and mortality associated with measles mumps rubella and varicella."[15]
The combined MMR vaccine induces immunity less painfully than three separate injections at the same time, and sooner and more efficiently than three injections given on different dates. Public Health England reports that providing a single combined vaccine as of 1988, rather than giving the option to have them also done separately, increased uptake of the vaccine.[22]
Measles
Before the widespread use of a vaccine against measles, rates of disease were so high that infection was felt to be "as inevitable as death and taxes."[23] Reported cases of measles in the United States fell from hundreds of thousands to tens of thousands per year following introduction of the vaccine in 1963. Increasing uptake of the vaccine following outbreaks in 1971, and 1977, brought this down to thousands of cases per year in the 1980s.
Safety
Adverse reactions, rarely serious, may occur from each component of the MMR vaccine. Ten percent of children develop fever, malaise, and a rash 5–21 days after the first vaccination;[35] and 3% develop joint pain lasting 18 days on average.[36] Older women appear to be more at risk of joint pain, acute arthritis, and even (rarely) chronic arthritis.[37] Anaphylaxis is an extremely rare but serious allergic reaction to the vaccine.[38] One cause can be egg allergy.[39] In 2014, the FDA approved two additional possible adverse events on the vaccination label: acute disseminated encephalomyelitis (ADEM), and transverse myelitis, with permission to also add "difficulty walking" to the package inserts.[40]
History
The component viral strains of MMR vaccine were developed by propagation in animal and human cells.[63]
For example, in the case of mumps and measles viruses, the virus strains were grown in embryonated chicken eggs. This produced strains of virus which were adapted for chicken cells and less well-suited for human cells. These strains are therefore called attenuated strains. They are sometimes referred to as neuroattenuated because these strains are less virulent to human neurons than the wild strains.
The rubella component, Meruvax, was developed in 1967, through propagation using the human embryonic lung cell line WI-38 (named for the Wistar Institute) that was derived six years earlier in 1961.[64][65]
The term "MPR vaccine" is also used to refer to this vaccine, whereas "P" refers to parotitis which is caused by mumps.[5]
MMRV vaccine
The MMRV vaccine, a combined measles, mumps, rubella, and varicella (chickenpox) vaccine is used as a replacement for the MMR vaccine to simplify the administration of the vaccines.[72]
MR vaccine
The MR vaccine (abbreviated "MRV") is a vaccine for measles and rubella, not mumps.[21] In 2014, the World Health Organization reported it as used in a "few (unidentified) countries".[21] A MRV delivered by a microneedle patch was the subject of a study reported in 2024.[73]
Society and culture
Further reading
External links
References
- Measles virus vaccine / mumps virus vaccine / rubella virus vaccine (M-M-R II) Use During Pregnancy Drugs.com, 16 October 2019, retrieved 5 September 2020^
- M-M-R II- measles, mumps, and rubella virus vaccine live injection, powder, lyophilized, for suspension DailyMed, 23 May 2022, retrieved 19 June 2022^
- Priorix- measles, mumps, and rubella vaccine, live kit