Q&As about Monovalent M-M-R Vaccines

Monovalent vaccines—ATTENUVAX® (measles vaccine), MUMPSVAX® (mumps vaccine) and MERUVAX® (rubella vaccine)

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On October 21, 2009, Merck announced that based on input from the Advisory Committee on Immunization Practices (ACIP), professional societies, scientific leaders, and customers, Merck has decided not to resume production of ATTENUVAX® (Measles Virus Vaccine Live), MUMPSVAX® (Mumps Virus Vaccine Live), and MERUVAX®II (Rubella Virus Vaccine Live).

What do health expert groups say regarding the use of separate and combination vaccines against measles, mumps, and rubella?

In the United States, the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Practioners (AAFP) provide guidelines on vaccination and on the use of combination vaccines. ACIP recommends that “combined measles-mumps-rubella (MMR) vaccine generally should be used whenever any of its component vaccines is indicated.” Receiving MMR vaccine rather than the separate component vaccines results in fewer shots and decreases the chance of delays in protection against all three diseases (measles, mumps and rubella). The AAP also recommends that combined MMR vaccine be used for immunization of U.S. children against measles, mumps, and rubella.

Is MMR vaccine safe?

The combined measles, mumps, and rubella (MMR) vaccine has been available since 1971 to protect against measles, mumps, and rubella. These diseases are serious and can be deadly. Each year in the United States, nearly 10 million doses of MMR are distributed. The most commonly reported adverse events following the MMR vaccine are pain where the vaccine is given, fever, and a mild rash. Apart from pain at the injection site, these adverse events are most common following the first dose of MMR vaccine.  Serious adverse events following MMR vaccine are rare. When fever occurs following MMR vaccine administration, it may result in febrile seizures, as might occur with other causes of fever. Many carefully performed scientific studies have found no link between MMR vaccine and autism (see Beliefs & Concerns and Vaccine Safety).

Why is it necessary to be vaccinated against measles, mumps, and rubella when these diseases are now relatively uncommon in the United States?

Even though outbreaks of measles, mumps, and rubella in the United States are not as common as they were before widespread use of vaccine, these diseases still occur in this country. In 2006 a record number of cases of mumps were reported in the United States. In 2008, the United States had the highest number of reported cases of measles in more than 10 years. Most of these measles cases occurred among school-age children whose parents chose not to have them vaccinated. A number of these case-patients were hospitalized, including infants and young children. Two persons have died from measles in the United States since 2001. People who decide not to vaccinate their children put their children and others at risk for getting these diseases.

What is the recommended schedule for vaccination against measles, mumps, and rubella in the United States?

The first dose of MMR vaccine is recommended at 12 through 15 months of age, and the second dose is recommended at 4 through 6 years of age. The second dose can be given at an earlier age (for example, during an outbreak or before traveling abroad) provided that it is given at least 28 days after the first dose.

What should I do about children less than 12 months of age who are traveling abroad and need measles protection?

Infants aged 6 through 11 months who travel abroad should receive one dose of MMR vaccine before departure. Children administered MMR vaccine before their first birthday should receive two more doses of MMR vaccine—the first when the child is 12 through 15 months of age and the second at least 28 days later. The second dose usually is administered at 4 through 6 years of age.

If someone started receiving the monovalent (single ingredient) vaccines which are now not available, instead of MMR vaccine, how should the series be completed?

If a person has received a single dose of one or more of the monovalent vaccines—that is, the single measles, mumps, or rubella vaccine—and a second dose of vaccine is needed, they should receive their second dose in the form of MMR vaccine.

My child has already received one dose of the measles monovalent (single ingredient) vaccine but no vaccine for mumps or rubella. If we switch to MMR vaccine, my child will have to receive two additional doses for protection against all three diseases. This means she/he will receive three doses of measles-containing vaccine. Is there a problem with this?

No. Administering MMR vaccine to people who already are immune to measles, mumps, or rubella (as a result of previous vaccination or natural disease) does not increase the risk for adverse reactions.