Measles, mumps and rubella vaccine

Also known as MMR vaccine

Easy-to-read medicine information about the measles, mumps and rubella (MMR) vaccine – what it is, when it is given and possible side effects.

MMR is a vaccine that protects you against 3 viral infections – measles, mumps and rubella. There are no single vaccines available for these infections in New Zealand.

Measles outbreak 2019: Ministry of Health update 6th December 2019

If you are experiencing any of the signs or symptoms of measles, we recommend you stay at home and call your doctor or Healthline on 0800 611 116. If you have measles, it’s really important to limit spreading it to others, so avoid waiting rooms and stay at home.

People who aren’t immune and have early symptoms of measles (fever, cough, runny nose, sore eyes and/or a rash) should not travel.

Travelling to the Pacific

Given the outbreaks of measles in Samoa, Tonga, Philippines and Fiji, the Ministry of Health is asking primary care providers to ensure vaccinations are up-to-date for any individual (aged 50 and under) who indicates they will be travelling to one of these areas or any country that has an active outbreak of measles. 

The MOH also recommend infants aged 6 to 11 months travelling to an outbreak area have one dose of MMR. Please remember that any child vaccinated before 12 months of age will still need 2 further doses of MMR.

All people need to be vaccinated at least 2 weeks before travel. 

People who aren’t immune and have early symptoms of measles (fever, cough, runny nose, sore eyes and/or a rash) should not travel.

Travelling to New Zealand

People intending to travel to New Zealand should be fully immunised for measles. If you need additional vaccination, it should be administered at least 2 weeks before arriving in New Zealand.

Remember, people who aren’t immune and have early symptoms of measles (fever, cough, runny nose, sore eyes and/or a rash) shouldn’t travel.

The Ministry will issue a public travel advisory on encouraging vaccination for people travelling to outbreak areas.

Information for parents, whānau and caregivers 

Babies

We know measles is worrying for everyone, especially for parents and whānau of babies and young children. Babies born to mums who are immune will have some of this protection passed on because antibodies are transferred from mother to baby, giving baby some immunity for those early months.

The best protection for very young children is to ensure that whānau, carers, and other people around them are vaccinated. If you have a Plunket or Well Child Tamariki Ora book, it should record if you’ve been immunised against measles. Unimmunised people who might have been in contact with someone who has measles should take a cautious approach when interacting with babies.

Read more about how to protect your baby during an outbreak

Babies and children travelling to Auckland

People with babies aged 6–11 months and who live outside of Auckland, but are planning to travel to the region, should consider vaccinating their infant at least two weeks before travelling. 

If an infant is vaccinated under 12 months, they’ll need two more doses of MMR vaccine when they’re 15 months and 4 years old.

Make sure children aged under 5 are immunised 2 weeks before travelling to places with serious measles outbreaks, including Auckland.

Read the MOHs advice about taking children and babies to Auckland.

Pregnancy and MMR vaccine

Women shouldn’t get immunised against measles while pregnant. If you're pregnant and think you may have measles or have come in contact with someone with measles, you should call your general practice, lead maternity carer or Healthline on 0800 611 116 as soon as possible.

Over 50s

You don’t need an immunisation as measles used to be very common, which means people over the age of 50 are considered immune.

Read the latest measles update from the Ministry of Health.

What is the MMR vaccine?

The MMR vaccine protects you against 3 viral infections – measles, mumps and rubella. The vaccine is a live vaccine, which is made using the mumps, measles and rubella viruses that have been weakened (or attenuated). After vaccination, the weakened vaccine viruses replicate (grow) inside you. This means a very small dose of virus is given to activate your immune system.

Just one dose of MMR gives you a 95% chance of being protected against measles. The reason for a second dose is to make sure the 5% who need this second vaccine get immunity. Read more about the effectiveness of the MMR vaccine.

Live attenuated vaccines do not usually cause problems in people who are healthy. If it does cause symptoms of the disease, it is milder than if you had caught the disease. 

There is no evidence that the MMR vaccine causes autism. Read more

Why is vaccination against measles, mumps and rubella important?

Vaccination with the MMR vaccine is the best way to protect against measles, mumps and rubella. While these infections may be mild in some people, they can cause serious complications in others.

  • Measles:  The infection can be serious, with 1 in 10 needing to go to hospital. Complications include diarrhoea (which can lead to dehydration), ear infections (which can cause hearing loss), pneumonia (which is the most common cause of death) and encephalitis (brain inflammation), which can cause brain damage. Read more about measles.
  • Mumps: The symptoms of mumps are usually mild, such as swollen salivary glands (at the side of your face), headache and fever, but it can cause serious complications such as deafness, swollen testicles or ovaries and meningitis. Read more about mumps.
  • Rubella (also called German measles): This is usually a mild infection that gets better within about 7 to 10 days, but it becomes a serious concern if a pregnant woman catches the infection during the first 20 weeks of her pregnancy. This is because the rubella virus can affect the development of the baby and cause severe health problems such as eye problems, deafness, heart abnormalities and brain damage. Read more about rubella

Measles, mumps and rubella are all easily spread from an infected person, by coughing, sneezing or talking. They can be spread by face-to-face contact within a metre, or by touching an object infected from droplets, such as a used tissue or keyboard. 

Measles can also be caught by breathing in the same air as an infected person, such as when walking past someone who has the disease.

All cases of measles seen in New Zealand are the result of non-immune people bringing the virus into the country from overseas. Very high coverage of the MMR vaccine is necessary to prevent the spread of these diseases, in particular, measles. If enough people are vaccinated, these diseases will not be spread. This is called herd immunity.

Who should get the MMR vaccine?

MMR vaccine is funded for all children from 12 months of age and adults, born on/after 1 January 1969, who have not completed a two-dose course of MMR vaccine.

It is part of the childhood immunisation schedule for children at 15 months and 4 years of age.

In an outbreak of measles

  • The first dose of MMR vaccine can be given at any time from 12 months of age, and the second dose as early as 28 days later. 
  • People worried about a baby aged 6-11 months being at high risk of exposure should speak to their GP. If an infant is vaccinated under 12 months, they’ll need two more doses of MMR vaccine when they’re 15 months and 4 years old.
If you or your child has had only one dose or has missed any vaccinations at the recommended ages, you can catch up on them. Talk to your GP or nurse.  

Women

All women of childbearing age need to know if they are protected from rubella.

In pregnant women, rubella can cause serious complications to the unborn baby, especially during the first 20 weeks of pregnancy. Immunity from the mother can stop the baby becoming infected. If you are planning a pregnancy, check with your midwife or doctor whether you need to be vaccinated against rubella. When you get vaccinated, avoid getting pregnant for at least 1 month afterwards. 

MMR vaccine is a live vaccine and should not be given to pregnant women.

Travel

The Ministry of Health is advising people travelling overseas to make sure they are fully vaccinated against measles before they go. While cases in New Zealand are rare because endemic measles has been eliminated here, the disease is regularly brought into the country through international travel. Read more about measles overseas and in New Zealand

Who should NOT get the MMR vaccine?

Since the MMR vaccine is a live vaccine, it can cause mild measles, mumps or rubella infections. It should not be given if you:

  • are pregnant  
  • have a severe weakness of the immune system
  • have had a severe allergic response (anaphylaxis) to this vaccine or part of this vaccine before
  • have had another live vaccine within the past 4 weeks.

Where can I get vaccinated?

The best place to go for vaccinations is your family medical clinic. They have your medical records and can check to see if you’ve already had a particular vaccination. Either your doctor or a nurse can give the vaccination.

If you don’t have a family doctor, you can go to one of the after-hour medical clinics. Ring them first to make sure they can help you with the vaccination you need.

Because of the current measles outbreak, drop-in vaccination clinics have been also set up in Counties Manukau.

In other areas, you can find a clinic near you on the Healthpoint website. Put in your address and region, and under Select a service, click on GPs/Accident & Urgent Medical Care.

Vaccines on the National Immunisation Schedule are free. Other vaccines are funded only for people at particular risk of disease. You can choose to pay for vaccines that you are not eligible to receive for free.

How effective is the MMR vaccine?

After a single dose of MMR vaccine 90–95 out of 100 people will be protected from measles, 69–81 protected from mumps and 90–97 from rubella. After a second dose of MMR vaccine the number of people protected from these diseases increases, and almost everyone will be protected from measles and rubella, and up to 88% protected from mumps.

If given to babies under 12 months of age, the measles component of MMR vaccine may not be effective and they are unlikely to develop enough protection against measles. It is best given to babies older than 12 months. If there is an outbreak of measles, and it is given earlier, it will still need to be given at 15 months and 4 years.   

MMR vaccine, if given within 72 hours of exposure to the measles virus, may provide protection to the unimmunised and thus limit the spread of measles.

How is the MMR vaccine given?

The MMR vaccine is given as a subcutaneous injection (injected under your skin). It is given as 2 doses, usually at 15 months and 4 years of age. Parents can ask for the first MMR dose anytime after 12 months of age and the second one 4 weeks after the first.

Possible side effects

Like all medicines, vaccines can cause side effects, although not everyone gets them. Most side effects are mild and short-lived. The chance of a severe reaction from MMR is very small, but the risks from not being vaccinated are very serious.

Because the MMR vaccine combines 3 separate vaccines (measles, mumps, rubella) in 1 injection, each vaccine can cause reactions at different times after the injection.

  • About a 6 to 10 days after the MMR injection, some children get a very mild form of measles. This includes a rash, high temperature, loss of appetite and a general feeling of being unwell for about 2 or 3 days.
  • Around 1 to 4 weeks after having the MMR injection, 1 in 50 children develop a mild form of mumps. This includes swelling of the glands in the cheek, neck or under the jaw, and lasts for a day or two.
  • Around 12 to 14 days after the injection, the rubella vaccine may cause a brief rash and possibility a slightly raised temperature. On rare occasions, a rash may also occur up to 6 weeks later. Rarely, at around 1 to 3 weeks, some adults experience painful, stiff or swollen joints, which can last for around 3 days.

There's less chance of side effects after the second dose of MMR than the first.

Side effects What should I do?
  • Mild rash
  • May be from the measles or rubella part of the vaccine. Usually happens between 6 and 14 days after vaccination.
  • It should get better after a few days.
  • No treatment is required. The rash is not infectious.
  • Contact your doctor if you are worried.
  • Mild swelling under the jaw
  • May be from the mumps part of the vaccine.
  • It can happen 1 to 4 weeks after the vaccine was given.
  • It should get better after a few days.
  • Contact your doctor if you are worried.
  • Pain, swelling, or redness around the injection site (hard and sore to touch)
  • Heavy arm
  • This is quite common after having the vaccination.
  • It usually starts a few hours after getting the injection and settles within a few days.
  • Place a cold, wet cloth or ice pack where the injection was given. Leave it on for a short time. 
  • Do not rub the injection site.
  • Tell your doctor if troublesome.
  • Read more After your immunisation
  • Fever
  • Feeling unwell, tired or weak
  • Loss of appetite
  • Muscle ache
  • Headache
  • These are quite common for the first 1 or 2 days after receiving the injection.
  • It usually settles within a few days.
  • Rest and drink plenty of fluids.
  • Because paracetamol or ibuprofen may interfere with your immunisation response to a vaccine, only take them for relief of severe discomfort or high fever. 
  • Tell your doctor if troublesome.
  • Read more After your immunisation

Risk of autism

There is no evidence that the MMR vaccine causes autism.

The confusion came about because in 1998 a British doctor thought there was a link between the vaccine and autism, but no other studies have confirmed this. In fact, in 2004 the study was removed from the scientific literature and the British authorities removed the doctor’s licence to practice medicine. In 2008, it was found the doctor had changed the patient data and the laboratory reports were incorrect. 

In March 2019, a large-scale Danish study found no evidence of any connection between autism and the MMR vaccine, even among at-risk individuals.

Read more:

Learn more

The following links provide further information on MMR vaccine:

References

  1. Immunisation Handbook, New Zealand, 2017
  2. Priorix The Immunisation Advisory Centre, New Zealand
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 04 Oct 2019