Measles mumps rubella vaccine schedule
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Measles, Mumps, Rubella (MMR) Vaccine Schedule: Insights from Recent Research
Introduction to MMR Vaccine Schedule
The Measles, Mumps, and Rubella (MMR) vaccine is a critical component of childhood immunization programs worldwide. The standard schedule typically involves two doses, which are essential for ensuring long-term immunity against these diseases. This article synthesizes recent research findings on the immunogenicity, safety, and optimal scheduling of the MMR vaccine.
Immunogenicity and Long-Term Protection
One-Dose vs. Two-Dose Regimen
Research indicates that a single dose of the MMR vaccine induces significant antibody responses, but a two-dose regimen is more effective in maintaining long-term immunity. A study involving 1887 children showed that antibodies against measles and rubella declined moderately but remained above the seropositivity threshold for at least 10 years post-vaccination. In contrast, anti-mumps antibody levels remained relatively stable, and a second dose had a boosting effect on seropositivity rates1.
Age of Administration
The age at which the first dose is administered can influence the vaccine's effectiveness. Studies have shown that administering the first dose at 12 months results in higher seroconversion rates compared to doses given at 9 months. However, if early protection is required, a dose at 9 months followed by a second dose at a minimum interval of 3 months is recommended3 5.
Safety and Efficacy of MMR and MMRV Vaccines
Comparative Studies
Comparative studies between different MMR vaccines, such as MMR-RIT (Priorix) and MMR II, have demonstrated non-inferiority in terms of immunogenicity and safety. Both vaccines showed robust immune responses and comparable reactogenicity profiles, with common adverse events being mild and infrequent2 7.
Combined MMRV Vaccine
The combined MMRV vaccine, which includes varicella, has been shown to be as effective and safe as separate MMR and varicella vaccines. Studies indicate that the MMRV vaccine induces high seropositivity rates and is well-tolerated, making it a viable option for the second dose in children previously vaccinated with MMR and varicella vaccines6 10.
Recommendations and Global Practices
WHO and National Guidelines
The World Health Organization (WHO) recommends a two-dose MMR vaccination strategy, which is widely adopted in many countries. The first dose is typically administered at 12-15 months, followed by a second dose at 4-6 years. This schedule has been effective in significantly reducing the incidence of measles, mumps, and rubella globally4 8.
Catch-Up Vaccination
In light of recent outbreaks, catch-up vaccination with an additional dose of MMR vaccine is recommended to control outbreaks and enhance community protection. This approach is particularly important in areas with low vaccination coverage or where immunity has waned over time2 7.
Conclusion
The MMR vaccine remains a cornerstone of public health efforts to control measles, mumps, and rubella. Research supports the effectiveness and safety of the two-dose regimen, with flexibility in the age of administration to accommodate early protection needs. Continued adherence to recommended vaccination schedules and catch-up programs is essential for maintaining high immunity levels and preventing outbreaks.
Sources and full results
Most relevant research papers on this topic
Long-term immunogenicity of measles, mumps and rubella-containing vaccines in healthy young children: A 10-year follow-up.
One or two doses of MMR-containing vaccines in children aged 2 years can induce long-lasting immunity against measles, mumps, and rubella viruses, with a second dose boosting anti-mumps antibody levels.
RCT
Large Human Trial
Rigorous JournalImmunogenicity and safety of a second dose of a measles-mumps-rubella vaccine administered to healthy participants 7 years of age or older: A phase III, randomized study
A second dose of MMR-RIT vaccine is not inferior to MMR II in inducing robust immune responses and is well-tolerated by healthy individuals aged 7 years and older.
RCTLarge Human TrialImmunogenicity and safety of a two-dose regimen of a combined measles, mumps, rubella and varicella live vaccine (ProQuad(®)) in infants from 9 months of age.
The first dose of ProQuad may be given at 11 months of age for early protection, or at 9 months for early protection, but a second dose is required promptly with a minimum of 3-month interval between doses.
RCTVaccines for measles, mumps, rubella, and varicella in children.
The trivalent MMR vaccine is highly effective in preventing measles in children aged up to 15 years, with 95% effectiveness after one dose.
Systematic Review
Very Rigorous Journal
Highly CitedSimilar immunogenicity of measles-mumps-rubella (MMR) vaccine administrated at 8 months versus 12 months age in children.
The MMR vaccine is well-tolerated and immunogenic against measles, mumps, and rubella with a first dose at 8 months and a second dose at 18 months in infants.
RCTSafety and immunogenicity of a measles-mumps-rubella-varicella vaccine given as a second dose in children up to six years of age.
The MMRV vaccine has non-inferior immunogenicity and similar safety profiles as a second dose of licensed MMR and varicella vaccine in children aged 15-75 months.
RCTLarge Human TrialMeasles, Mumps, Rubella Vaccine (PRIORIX): Recommendations of the Advisory Committee on Immunization Practices — United States, 2022
PRIORIX is a safe, immunogenic, and noninferior alternative to M-M-R II for preventing measles, mumps, and rubella in individuals aged 12 months.
Immunogenicity and safety of early vaccination with two doses of a combined measles-mumps-rubella-varicella vaccine in healthy Indian children from 9 months of age: a phase III, randomised, non-inferiority trial
Early vaccination with two doses of combined MMRV vaccine or MMR followed by MMRV vaccine is non-inferior to MMR/MMR+V for all antigens and has an acceptable safety profile in Indian children aged 9-15 months.
RCTRigorous JournalProtection against varicella with two doses of combined measles-mumps-rubella-varicella vaccine or one dose of monovalent varicella vaccine: 10-year follow-up of a phase 3 multicentre, observer-blind, randomised, controlled trial.
Two doses of MMRV or MMR + V provide effective 10-year protection against varicella in children aged 12-22 months, with a higher vaccine efficacy against moderate or severe varicella.
RCTLarge Human TrialRigorous JournalImmunogenicity and safety of measles-mumps-rubella-varicella (MMRV) vaccine followed by one dose of varicella vaccine in children aged 15 months-2 years or 2-6 years primed with measles-mumps-rubella (MMR) vaccine.
The MMRV vaccine is an immunogenic and safe substitute for a second dose of MMR vaccine in young children, supporting a two-dose schedule for varicella-containing vaccines.
RCTLarge Human Trial