Why mmr and varicella together

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Meningococcal ACWY. Meningococcal B. Travel Vaccines. Disease Issues. Pregnancy and Postpartum Considerations. For Healthcare Personnel. What is the current situation with measles, mumps, and rubella in the United States?

A clinical case of measles is defined as an illness characterized by. Back to top. What are the current recommendations for the use of MMR vaccine? Acceptable presumptive evidence of immunity against measles includes at least one of the following:.

Although birth before is considered acceptable evidence of measles immunity, healthcare facilities should consider vaccinating unvaccinated personnel born before who do not have other evidence of immunity with 2 doses of MMR vaccine minimum interval 28 days. During an outbreak of measles, healthcare facilities should recommend 2 doses of MMR vaccine at the appropriate interval for unvaccinated healthcare personnel regardless of birth year if they lack laboratory evidence of measles immunity.

For which adults are 0, 1, or 2 doses of MMR vaccine recommended to prevent measles? Zero, one, or two doses of MMR vaccine are needed for the adults described below. Given the risk of outbreaks of measles in the U.

Although birth before is considered acceptable evidence of measles immunity for routine vaccination, healthcare facilities should consider vaccinating unvaccinated healthcare personnel HCP born before who do not have laboratory evidence of measles immunity, laboratory confirmation of disease, or vaccination with 2 appropriately spaced doses of MMR vaccine.

However, during a local outbreak of measles, all healthcare personnel, including those born before , are recommended to have 2 doses of MMR vaccine at the appropriate interval if they lack laboratory evidence of measles. Healthcare facilities should check with their state or local health department's immunization program for guidance. Access contact information here: www. If there is an outbreak in my area, can we vaccinate children younger than 12 months? MMR can be given to children as young as 6 months of age who are at high risk of exposure such as during international travel or a community outbreak.

How does being born before confer immunity to measles? People born before lived through several years of epidemic measles before the first measles vaccine was licensed in As a result, these people are very likely to have had measles disease.

Persons born before can be presumed to be immune. However, if serologic testing indicates that the person is not immune, at least 1 dose of MMR should be administered. Why is a second dose of MMR necessary? This occurs for a variety of reasons. The second dose is to provide another chance to develop measles immunity for people who did not respond to the first dose.

Are there any situations where more than 2 doses of MMR are recommended? There are two circumstances when a third dose of MMR is recommended. ACIP recommends that women of childbearing age who have received 2 doses of rubella-containing vaccine and have rubella serum IgG levels that are not clearly positive should receive 1 additional dose of MMR vaccine maximum of 3 doses.

Further testing for serologic evidence of rubella immunity is not recommended. MMR should not be administered to a pregnant woman. More information about this recommendation is available at www. When is it appropriate to use MMR vaccine for measles post-exposure prophylaxis?

MMR vaccine given within 72 hours of initial measles exposure can reduce the risk of getting sick or reduce the severity of symptoms. Another option for exposed, measles-susceptible individuals at high risk of complications who cannot be vaccinated is to give immunoglobulin IG within six days of exposure. Information on post-exposure prophylaxis for measles can be found in the ACIP guidance at www.

Do any adults need "booster" doses of MMR vaccine to prevent measles? Adults with evidence of immunity do not need any further vaccines. No "booster" doses of MMR vaccine are recommended for either adults or children. They are considered to have life-long immunity once they have received the recommended number of MMR vaccine doses or have other evidence of immunity.

Many people who were young children in the s do not have records indicating what type of measles vaccine they received in the mids. What measles vaccine was most frequently given in that time period? That guidance would assist many older people who would prefer not to be revaccinated. Both killed and live attenuated measles vaccines became available in Live attenuated vaccine was used more often than killed vaccine. The killed vaccine was found to be not effective and people who received it should be revaccinated with live vaccine.

Without a written record, it is not possible to know what type of vaccine an individual may have received. So persons born during or after who received killed measles vaccine or measles vaccine of unknown type, or who cannot document having been vaccinated or having laboratory-confirmed measles disease should receive at least 1 dose of MMR.

Some people at increased risk of exposure to measles such as healthcare professionals and international travelers should receive 2 doses of MMR separated by at least 4 weeks. Do people who received MMR in the s need to have their dose repeated? Not necessarily. People who have documentation of receiving live measles vaccine in the s do not need to be revaccinated.

People who were vaccinated prior to with either inactivated killed measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine.

This recommendation is intended to protect people who may have received killed measles vaccine which was available in the United States in through and was not effective. People vaccinated before with either killed mumps vaccine or mumps vaccine of unknown type who are at high risk for mumps infection such as people who work in a healthcare facility should be considered for revaccination with 2 doses of MMR vaccine.

I understand that ACIP changed its definition of evidence of immunity to measles, rubella, and mumps in Please explain. In the revision of its MMR vaccine recommendations ACIP includes laboratory confirmation of disease as evidence of immunity for measles, mumps, and rubella. ACIP removed physician diagnosis of disease as evidence of immunity for measles and mumps. Physician diagnosis of disease had not previously been accepted as evidence of immunity for rubella. With the decrease in measles and mumps cases over the last 30 years, the validity of physician-diagnosed disease has become questionable.

In addition, documenting history from physician records is not a practical option for most adults. Is there anything that can be done for unvaccinated people who have already been exposed to measles, mumps, or rubella? Measles vaccine, given as MMR, may be effective if given within the first 3 days 72 hours after exposure to measles. Immune globulin may be effective for as long as 6 days after exposure.

Postexposure prophylaxis with MMR vaccine does not prevent or alter the clinical severity of mumps or rubella. However, if the exposed person does not have evidence of mumps or rubella immunity they should be vaccinated since not all exposures result in infection.

What are the current ACIP recommendations for use of immune globulin IG for measles, mumps, and rubella post-exposure prophylaxis?

The dose of IGIM is 0. Alternatively, MMR vaccine can be given instead of IGIM to infants age 6 through 11 months, if it can be given within 72 hours of exposure. Other people who do not have evidence of measles immunity can receive an IGIM dose of 0. Give priority to people who were exposed to measles in settings where they have intense, prolonged close contact such as household, child care, classroom, etc. IG is not indicated for persons who have received 1 dose of measles-containing vaccine at age 12 months or older unless they are severely immunocompromised.

IG should not be used to control measles outbreaks. IG has not been shown to prevent mumps or rubella infection after exposure and is not recommended for that purpose. What type of vaccine should these students receive?

Single antigen vaccine is no longer available in the U. If a college student or other person at increased risk of exposure cannot produce written documentation of either immunization or disease, and titers are negative, they should receive two doses of MMR.

I have patients who claim to remember receiving MMR vaccine but have no written record, or whose parents report the patient has been vaccinated. Should I accept this as evidence of vaccination? Self-reported doses and history of vaccination provided by a parent or other caregiver are not considered to be valid.

You should only accept a written, dated record as evidence of vaccination. Under what circumstances should adults be considered for testing for measles-specific antibody prior to getting vaccinated? Adults without evidence of immunity and no contraindications to MMR vaccine can be vaccinated without testing. Only adults without evidence of immunity might be considered for testing for measles-specific IgG antibody, but testing is not needed prior to vaccination.

CDC does not recommend measles antibody testing after MMR vaccination to verify the patient's immune response to vaccination. Two documented doses of MMR vaccine given on or after the first birthday and separated by at least 28 days is considered proof of measles immunity, according to ACIP.

Documentation of appropriate vaccination supersedes the results of serologic testing for measles, mumps, rubella, and varicella. A patient born in has a history of measles disease and is also immunosuppressed due to multiple myeloma. The patient wants to travel to Africa, but is concerned about the measles exposure risk. Should the patient receive the MMR vaccine?

A history of having had measles is not sufficient evidence of measles immunity. A positive serologic test for measles-specific IgG will confirm that the person is immune and is not at risk of infection regardless of the multiple myeloma. Multiple myeloma is a hematologic cancer and is considered immunosuppressive so MMR vaccine is contraindicated in this person.

We have adult patients in our practice at high risk for measles, including patients going back to college or preparing for international travel, who don't remember ever receiving MMR vaccine or having had measles disease. How should we manage these patients? You have two options. You can test for immunity or you can just give 2 doses of MMR at least 4 weeks apart. There is no harm in giving MMR vaccine to a person who may already be immune to one or more of the vaccine viruses.

If you or the patient opt for testing, and the tests indicate the patient is not immune to one or more of the vaccine components, give your patient 2 doses of MMR at least 4 weeks apart. If any test results are indeterminate or equivocal, consider your patient nonimmune.

ACIP does not recommend serologic testing after vaccination because commercial tests may not be sensitive enough to reliably detect vaccine-induced immunity.

I have a year-old patient who is traveling to Haiti for a mission trip. She doesn't recall ever getting an MMR booster she didn't go to college and never worked in health care. She was rubella immune when pregnant 20 years ago. Her measles titer is negative. Would you recommend an MMR booster? ACIP recommends 2 doses of MMR given at least 4 weeks apart for any adult born in or later who plans to travel internationally.

A patient who was born before and is not a healthcare worker wants to get the MMR vaccine before international travel. Does he need a dose of MMR? No, it is not considered necessary, but he may be vaccinated. Immunisation is the best protection against measles, mumps, rubella and chickenpox.

It is important to know that it is safe for children with egg allergies to receive the MMRV vaccine. Protection against measles, mumps, rubella and chickenpox is available under the National Immunisation Program Schedule.

From 14 years of age people require the MMR vaccine and a separate chickenpox vaccine. A person with an impaired immune system should not be vaccinated. If you have an impaired immune system, speak with your doctor about what options might be available. You should not be given the MMR vaccine if you are already pregnant.

Pregnancy should also be avoided for 28 days after the vaccination. Before immunisation, it is important that you tell your immunisation provider if you or your child :. Common side effects following immunisation are usually mild and temporary occurring in the first few days after vaccination. Specific treatment is not usually required. Vaccines may cause soreness, redness, itching, swelling or burning at the injection site for one to two days.

Paracetamol might be required to ease the discomfort. Sometimes a small, hard lump at the injection site may persist for some weeks or months. This should not be of concern and requires no treatment. If a side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your child's condition after a vaccination, see your doctor or immunisation nurse as soon as possible, or go directly to a hospital.

It is important to seek medical advice if you or your child are unwell, as this may be due to other illness rather than because of the vaccination. You can discuss how to report problems in other states or territories with your immunisation provider.

Serious allergic reaction is a very rare side effect, occurring in less than one out of a million vaccinations. Serious allergic reaction anaphylaxis to any vaccine rarely occurs. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following vaccination, in case further treatment is required. Another rare side effect is thrombocytopenia, which is bleeding caused by insufficient blood platelets.

If any other reactions are severe and persistent, or if you are worried, contact your doctor for further information. The immunisations you may need are decided by your health, age, lifestyle and occupation.

Together, these factors are referred to as HALO. Talk to your doctor or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary.

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Section Navigation. Facebook Twitter LinkedIn Syndicate. Minus Related Pages. On This Page. Why get vaccinated? It can lead to seizures often associated with fever , ear infections, diarrhea, and pneumonia.

Rarely, measles can cause brain damage or death. MUMPS M causes fever, headache, muscle aches, tiredness, loss of appetite, and swollen and tender salivary glands under the ears. It can cause arthritis in up to half of teenage and adult women. If a person gets rubella while they are pregnant, they could have a miscarriage or the baby could be born with serious birth defects. MMRV vaccine. MMRV vaccine may be given to children 12 months through 12 years of age , usually: First dose at age 12 through 15 months Second dose at age 4 through 6 years MMRV vaccine may be given at the same time as other vaccines.

Talk with your health care provider. Tell your vaccination provider if the person getting the vaccine: Has had an allergic reaction after a previous dose of MMRV, MMR, or varicella vaccine , or has any severe, life-threatening allergies Is pregnant or thinks they might be pregnant—pregnant people should not get MMRV vaccine Has a weakened immune system , or has a parent, brother, or sister with a history of hereditary or congenital immune system problems Has ever had a condition that makes him or her bruise or bleed easily Has a history of seizures, or has a parent, brother, or sister with a history of seizures Is taking or plans to take salicylates such as aspirin Has recently had a blood transfusion or received other blood products Has tuberculosis Has gotten any other vaccines in the past 4 weeks In some cases, your health care provider may decide to postpone MMRV vaccination until a future visit or may recommend that the child receive separate MMR and varicella vaccines instead of MMRV.

Risks of a vaccine reaction. Sore arm from the injection, redness where the shot is given, fever, and a mild rash can happen after MMRV vaccination.