Editing MMR vaccine (section)

{{Short description|Combined vaccine against measles, mumps, and rubella}}
{{pp-pc|small=yes}}
{{Use dmy dates|date=June 2024}}
{{cs1 config|name-list-style=vanc|display-authors=6}}
{{Infobox drug
| Verifiedfields = changed
| Watchedfields = changed
| verifiedrevid = 476995634
| type = combo
| image = MMR vaccine.jpg
| alt =
| caption = MMR vaccine

<!-- Combo data -->
| component1 = Measles vaccine
| class1 = [[Vaccine]]
| component2 = Mumps vaccine
| class2 = Vaccine
| component3 = Rubella vaccine
| class3 = Vaccine

<!-- Clinical data -->
| tradename = M-M-R II, Priorix, Tresivac, others
| Drugs.com = {{drugs.com|monograph|measles-mumps-and-rubella-virus-vaccine}}
| MedlinePlus = a601176
| DailyMedID = Measles
| pregnancy_AU = B2
| pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{cite web | title=Measles virus vaccine / mumps virus vaccine / rubella virus vaccine (M-M-R II) Use During Pregnancy | website=Drugs.com | date=16 October 2019 | url=https://www.drugs.com/pregnancy/measles-virus-vaccine-mumps-virus-vaccine-rubella-virus-vaccine.html | access-date=5 September 2020 | archive-date=12 November 2020 | archive-url=https://web.archive.org/web/20201112003104/https://www.drugs.com/pregnancy/measles-virus-vaccine-mumps-virus-vaccine-rubella-virus-vaccine.html | url-status=live }}</ref>
| ATC_prefix = J07
| ATC_suffix = BD52

| legal_AU = S4
| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK = POM
| legal_US = Rx-only
| legal_US_comment = <ref>{{cite web | title=M-M-R II- measles, mumps, and rubella virus vaccine live injection, powder, lyophilized, for suspension | website=DailyMed | date=23 May 2022 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0a9e384f-e717-436b-b9a0-15e53cef0862 | access-date=19 June 2022 | archive-date=6 April 2020 | archive-url=https://web.archive.org/web/20200406003823/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0a9e384f-e717-436b-b9a0-15e53cef0862 | url-status=live }}</ref><ref>{{cite web | title=Priorix- measles, mumps, and rubella vaccine, live kit | website=DailyMed | date=3 June 2022 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=95c6fdb6-b587-4413-92f9-d592b9f7a23e | access-date=19 June 2022 | archive-date=20 June 2022 | archive-url=https://web.archive.org/web/20220620005258/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=95c6fdb6-b587-4413-92f9-d592b9f7a23e | url-status=live }}</ref>
| legal_EU = Rx-only
| legal_EU_comment = <ref name="M-M-RVaxPro EPAR">{{cite web | title=M-M-RVaxPro EPAR | website=[[European Medicines Agency]] | date=17 September 2018 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/m-m-rvaxpro | access-date=4 December 2020 | archive-date=6 April 2020 | archive-url=https://web.archive.org/web/20200406174101/https://www.ema.europa.eu/en/medicines/human/EPAR/m-m-rvaxpro | url-status=live }}</ref>
| legal_status = Rx-only

<!-- Identifiers -->
| CAS_number = 1704518-68-2
| ChemSpiderID = None
| synonyms = MPR vaccine<ref name="mpr">{{cite book |vauthors=Grignolio A |title=Vaccines: Are they Worth a Shot? |date=2018 |publisher=Springer |isbn=9783319681061 |page=2 |url=https://books.google.com/books?id=hgFkDwAAQBAJ&pg=PA2 |access-date=22 May 2020 |archive-date=17 April 2021 |archive-url=https://web.archive.org/web/20210417185159/https://books.google.com/books?id=hgFkDwAAQBAJ&pg=PA2 |url-status=live }}</ref>
}}

<!-- Definition and medical use -->
The '''MMR vaccine''' is a [[vaccine]] against [[measles]], [[mumps]], and [[rubella]] (German measles), abbreviated as ''MMR''.<ref name=Mau2005/> The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, with at least four weeks between the doses.<ref name="CDC2021">{{cite web |title=Measles, Mumps, and Rubella (MMR) Vaccination: What Everyone Should Know |url=https://www.cdc.gov/vaccines/vpd/mmr/public/index.html |publisher=U.S. [[Centers for Disease Control and Prevention]] (CDC)|date=26 January 2021 |archive-date=26 April 2020 |archive-url=https://web.archive.org/web/20200426105545/https://www.cdc.gov/vaccines/vpd/mmr/public/index.html |url-status=live }}</ref><ref name=WHO2017Pos>{{cite journal | vauthors =  | title = Measles vaccines: WHO position paper – April 2017 | journal = Relevé Épidémiologique Hebdomadaire | volume = 92 | issue = 17 | pages = 205–227 | date = April 2017 | pmid = 28459148 | hdl = 10665/255149 }}</ref><ref>{{cite journal | title = Measles vaccines: WHO position paper, April 2017 - Recommendations | journal = Vaccine | volume = 37 | issue = 2 | pages = 219–222 | date = January 2019 | pmid = 28760612 | doi = 10.1016/j.vaccine.2017.07.066 | s2cid = 205605355 | last1 = World Health Organization }}</ref> After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella.<ref name="CDC2021"/> The vaccine is also recommended for those who do not have evidence of [[immunity (medical)|immunity]],<ref name="CDC2021"/> those with well-controlled [[HIV/AIDS]],<ref>{{cite web |vauthors=Kinney R |title=Core Concepts – Immunizations in Adults – Basic HIV Primary Care – National HIV CurriculumImmunizations in Adults |url=https://www.hiv.uw.edu/go/basic-primary-care/immunizations/core-concept/all |website=www.hiv.uw.edu |date=2 May 2017 |access-date=10 September 2018 |archive-date=2 September 2018 |archive-url=https://web.archive.org/web/20180902191739/https://www.hiv.uw.edu/go/basic-primary-care/immunizations/core-concept/all |url-status=live }}</ref><ref name=ACIP1998>{{cite journal | vauthors = Watson JC, Hadler SC, Dykewicz CA, Reef S, Phillips L | title = Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP) | journal = MMWR. Recommendations and Reports | volume = 47 | issue = RR-8 | pages = 1–57 | date = May 1998 | pmid = 9639369 | url = <!-- Official URL --> https://www.cdc.gov/mmwr/PDF/rr/rr4708.pdf | access-date = 26 January 2020 | url-status = live | archive-url = https://web.archive.org/web/20191030190011/https://www.cdc.gov/mmwr/PDF/rr/rr4708.pdf | archive-date = 30 October 2019 }}</ref> and within 72 hours of exposure to measles among those who are incompletely immunized.<ref name=WHO2017Pos/> It is given by [[Injection (medicine)|injection]].<ref name="CDCAdmin">{{cite web |title=Administering MMR Vaccine |url=https://www.cdc.gov/vaccines/vpd/mmr/hcp/administering-mmr.html |website=Centers for Disease Control and Prevention |access-date=28 December 2021 |date=26 January 2021 |archive-date=28 December 2021 |archive-url=https://web.archive.org/web/20211228081247/https://www.cdc.gov/vaccines/vpd/mmr/hcp/administering-mmr.html |url-status=live }}</ref>

<!-- Frequency of use and effects -->
The MMR vaccine is widely used around the world. As of 2012, 575 million doses had been administered since the vaccine's introduction worldwide.<ref name=EU2018>{{cite web |title=Addressing misconceptions on measles vaccination |url=https://ecdc.europa.eu/en/measles/prevention-and-control/addressing-misconceptions-measles |website=European Centre for Disease Prevention and Control |date=15 April 2014 |access-date=10 September 2018 |archive-date=11 September 2018 |archive-url=https://web.archive.org/web/20180911002527/https://ecdc.europa.eu/en/measles/prevention-and-control/addressing-misconceptions-measles |url-status=live }}</ref> Measles resulted in 2.6 million deaths per year before immunization became common.<ref name=EU2018/> This has decreased to 122,000 deaths per year {{as of|2012|lc=y|post=,}} mostly in low-income countries.<ref name=EU2018/> Through vaccination, {{as of|2018|lc=y}}, rates of measles in North and South America are very low.<ref name=EU2018/> Rates of disease have been seen to increase in populations that go unvaccinated.<ref name=EU2018/> Between 2000 and 2018, vaccination decreased measles deaths by 73%.<ref name="WHO Measles Fact Sheet">{{cite web | url=https://www.who.int/en/news-room/fact-sheets/detail/measles | title=Measles Fact Sheet | website=[[World Health Organization]] (WHO) | date=5 December 2019 | access-date=28 November 2022 | archive-date=28 November 2022 | archive-url=https://web.archive.org/web/20221128010546/https://www.who.int/en/news-room/fact-sheets/detail/measles | url-status=live }}</ref>

<!-- Side effects and mechanisms -->
Side effects of immunization are generally mild and resolve without any specific treatment.<ref name="CDC2021Vis">{{cite web |title=MMR (Measles, Mumps, and Rubella) Vaccine Information Statement |url=https://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html |publisher=U.S. [[Centers for Disease Control and Prevention]] (CDC) |access-date=16 August 2021 |date=August 2021 |archive-date=3 September 2018 |archive-url=https://web.archive.org/web/20180903141726/https://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html |url-status=live }}</ref> These may include [[fever]], as well as pain or redness at the injection site.<ref name="CDC2021Vis"/> [[Severe allergic reaction]]s occur in about one in a million people.<ref name="CDC2021Vis"/> Because it contains live viruses, the MMR vaccine is not recommended during [[pregnancy]] but may be given during [[breastfeeding]].<ref name="CDC2021"/> The vaccine is safe to give at the same time as other vaccines.<ref name="CDC2021Vis"/> 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.<ref name="CDC2021"/> There is no evidence of an association between MMR immunisation and [[Autism spectrum|autistic spectrum disorders]].<ref name="pmid 34806766">{{cite journal | vauthors = Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V | title = Vaccines for measles, mumps, rubella, and varicella in children | journal = The Cochrane Database of Systematic Reviews | volume = 2021 | issue = 11 | pages = CD004407 | date = November 2021 | pmid = 34806766 | pmc = 8607336 | doi = 10.1002/14651858.CD004407.pub5 }}</ref><ref>{{cite journal | vauthors = Hussain A, Ali S, Ahmed M, Hussain S | title = The Anti-vaccination Movement: A Regression in Modern Medicine | journal = Cureus | volume = 10 | issue = 7 | pages = e2919 | date = July 2018 | pmid = 30186724 | pmc = 6122668 | doi = 10.7759/cureus.2919 | doi-access = free }}</ref><ref name=AFP2017>{{cite journal | vauthors = Spencer JP, Trondsen Pawlowski RH, Thomas S | title = Vaccine Adverse Events: Separating Myth from Reality | journal = American Family Physician | volume = 95 | issue = 12 | pages = 786–794 | date = June 2017 | pmid = 28671426 }}</ref> The MMR vaccine is a mixture of live [[attenuated virus|weakened virus]]es of the three diseases.<ref name="CDC2021"/>

<!-- History and culture -->
The MMR vaccine was developed by [[Maurice Hilleman]].<ref name=Mau2005>{{cite journal | vauthors =  | title = Maurice R. Hilleman, PhD, DSc | journal = Seminars in Pediatric Infectious Diseases | volume = 16 | issue = 3 | pages = 225–226 | date = July 2005 | pmid = 16044396 | doi = 10.1053/j.spid.2005.05.002 }}</ref> It was licensed for use in the US by [[Merck & Co.|Merck]] in 1971.<ref name=Good2015/> Stand-alone [[measles vaccine|measles]], [[mumps vaccine|mumps]], and [[rubella vaccine]]s had been previously licensed in 1963, 1967, and 1969, respectively.<ref name=Good2015>{{cite journal | vauthors = Goodson JL, Seward JF | title = Measles 50 Years After Use of Measles Vaccine | journal = Infectious Disease Clinics of North America | volume = 29 | issue = 4 | pages = 725–743 | date = December 2015 | pmid = 26610423 | doi = 10.1016/j.idc.2015.08.001 }}</ref><ref>{{cite web |title=Measles: information about the disease and vaccines Questions and Answers |url=https://www.immunize.org/catg.d/p4209.pdf |website=Immunization Action Coalition | date=November 2018 |access-date=28 November 2022 |archive-date=28 November 2022 |archive-url=https://web.archive.org/web/20221128011445/https://www.immunize.org/catg.d/p4209.pdf |url-status=live }}</ref> Recommendations for a second dose were introduced in 1989.<ref name=Good2015/> The [[MMRV vaccine]], which also covers [[chickenpox]], may be used instead.<ref name="CDC2021"/> An [[MR vaccine]], without coverage for mumps, is also occasionally used.<ref name=WHO2014Sheet>{{cite web |title=Information Sheet Observed Rate of Vaccine Reactions, Measles, Mumps, and Rubella Vaccines |url=http://fdaghana.gov.gh/img/vacine/MMR%20vaccine%20information.pdf |website=fdaghana.gov.gh |access-date=30 April 2022 |date=May 2014 |archive-date=27 December 2021 |archive-url=https://web.archive.org/web/20211227095245/https://fdaghana.gov.gh/img/vacine/MMR%20vaccine%20information.pdf |url-status=live }}</ref>