MMR vaccine

The MMR vaccine is the safest and most effective way to protect your child against measles, mumps and rubella.

Measles, mumps and rubella are highly infectious diseases that can leave children suffering serious medical complications. However, the high uptake of the MMR vaccine in Scotland means there has been a big reduction in the number of people catching these diseases.

Over 500 million doses of MMR have been used in over 90 countries around the world since the early 1970s.

MMR is given in two doses. First when your child is between 12 and 13 months, and then at the same time as other routine childhood immunisations – from 3 years 4 months of age. Although normally given at these times, if it is missed it can be given at any age. Teenagers who haven’t had two doses of the vaccine are also being offered the MMR vaccine during their routine teenage immunisations. 

Questions and answers:

What is measles?

Measles is highly infectious. It can spread quickly through the air. If your child is not vaccinated and they are near someone who has measles there is a high chance they will catch the disease.

A person who catches measles will first have a runny nose, high fever and tiny white spots inside their mouth. After a few days a rash will develop on the neck and spread downwards.

There is no treatment for measles but most people will recover after two to three weeks. Measles can cause problems including blindness, encephalitis (inflamation of the brain), severe diarrhoea, ear infection and pneumonia. In very serious cases, measles kills.

Complications are far more likely to happen after a child catches measles than from having the MMR vaccine.

Before immunisation was widely available half a million children caught measles and a hundred died from it each year, in the UK.

According to the World Health Organization (external link): 'In 2008, there were 164 000 measles deaths globally – nearly 450 deaths every day or 18 deaths every hour.'

Measles can only be prevented by immunisation.

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What is mumps?

Mumps causes fever, headache, swelling of the cheeks, sides of the jaw and swollen glands.

Mumps is spread in the same way as measles - through the air. It is about as infectious as flu.

Though most people will recover from mumps in seven to 10 days it can result in permanent deafness, viral meningitis (swelling of the lining of the brain) and encephalitis (inflamation of the brain).

When an adult catches mumps serious complications are more likely. Four in 10 men with mumps will have painful swelling of the testicles.

Mumps can only be prevented by immunisation.

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What is rubella?

For small children Rubella will cause a rash and fever for a few days. Adults might develop arthritis and joint pain.

Rubella (German measles) can have devastating effects on unborn children. This condition is called congenital rubella syndrome (CRS).

CRS can seriously damage an unborn child’s sight, hearing, heart and brain. Rubella infection in the first three months of pregnancy causes damage to the unborn baby in nine out of 10 cases. Since the introduction of the mumps, measles and rubella (MMR) vaccine CRS is now very rare in the UK. 

Pregnant women can check with their GP if they are immune against rubella and then offered MMR if they are not immune, after their baby is born to give protection to the mother in the future.  

Rubella is spread in the same way as measles, through the air. Rubella can only be prevented by immunisation.

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How does the MMR vaccine work?

The MMR vaccine provides long lasting protection against measles, mumps and rubella.

The MMR vaccine is made from weakened forms of the natural viruses. The viruses in the vaccine have been changed so in most cases they will cause none or only very mild symptoms.

The vaccine makes your child’s immune system respond to and ‘remember’ the viruses.

This means that if your child is infected with the real viruses their immune system will quickly recognise them and act to stop the infection.

Immunisation can also provide 'population protection'.

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What are the benefits of a combined vaccine?

The combined MMR vaccine means your child is protected from measles, mumps and rubella as quickly and safely as possible.

To immunise against each of the three diseases separately would mean six injections over a longer period of time.

The result would be:

  • more risk of catching a disease
  • more risk of missing a dose completely
  • more risk of pain where the injections are given
  • more trauma for your child.

MMR has been responsible for a huge reduction in measles, mumps and rubella in children since it was introduced in the UK in 1988. Single vaccines against measles, mumps and rubella are not younavailable in the UK immunisation programme.

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When is the MMR vaccine given?

MMR is offered to a child at between 12 and 13 months of age after the immunity a baby gets from their mother fades. The vaccine is injected into the muscle of the thigh or upper arm.

A second dose is given at the same time as other routine childhood immunisations – when children are aged from 3 years 4 months old.

Teenagers who haven’t had two doses of the vaccine are also being offered the MMR vaccine during their routine teenage immunisations at school. 

Although normally given at these times, if it is missed it can be given at any age. To find out more about the MMR booster immunisation offered in secondary school the 'Measles, mumps and rubella (MMR) Making sure young people are protected' information leaflet is available to download. 

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What is the second dose?

The second dose of the MMR vaccine gives the best level of protection to the most number of children.

After the first dose, between five per cent and 10 per cent of children are not protected against each of the diseases because their immune system has not responded to the vaccine. After two doses of MMR, less than 1 per cent of children are left unprotected against measles.

To give the public the best protection, at least 95 per cent of the population need to be immunised against the virus. Because of the children who do not respond to the first dose and those who do not attend for immunisation, this number can only be achieved with a second dose being given to every child.

Almost all children who did not respond to the first dose will be protected against measles, mumps and rubella with a second dose.

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Are there any side effects?

All medicines can cause side effects, but vaccines are among the safest.

The MMR vaccine has been used worldwide for nearly 40 years with an excellent safety record. As with all vaccines MMR has been through a very strict licensing process to check its safety, quality and effectiveness.

Side effects of MMR may be:

  • mild rash (this rash is not infectious) or fever that develops a week or two after the vaccine and lasts one to three days
  • swollen lymph glands that develop two to three weeks later
  • sore or stiff joints that can last from a couple of days to a few weeks.

These side effects will pass in a short time.

MMR causes serious side effects only very rarely, and the numbers are small compared to the side effects caused by the real diseases.

For example a child with measles has a one in a thousand chance of developing meningitis. The chance of a child developing meningitis after the first dose of MMR is less than one in a million.

Read more about the common side effects of immunisations.

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What if my child has a medical condition or allergy?

There are some serious medical conditions that mean your child should not have the MMR vaccine.

Your child should not have MMR if they have:

  • significant immunosupression
  • severe allergies to neomycin or kanamycin (types of antibiotic)
  • had a severe reaction to MMR before.

In some cases having the MMR vaccine should be put off until a later date.

Your child should wait to have MMR if they have:

  • had another live vaccine (including BCG) in the last four weeks
  • had an injection of immunoglobulin (antibodies) in last three months
  • a very high fever.

Your child should have MMR even if they have:

  • asthma, eczema, hay fever or ‘snuffles’
  • been given antibiotics, or is using a cream or inhaler that contains steroids
  • minor infections without fever
  • an egg allergy.

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How effective is the MMR vaccine?

Over 500 million doses of MMR have been used in over 90 countries around the world since the early 1970s.

The World Health Organization states that MMR is a highly effective vaccine with an outstanding safety record (WHO, 2001).

There is now no country in the world that offers single vaccines in preference to MMR.

There is no evidence that MMR is unsafe or that it causes serious illnesses in children who have it.

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Why not use single vaccines instead of one combined vaccine?

There is no country in the world that recommends immunisation against measles, mumps and rubella in three single vaccines instead of MMR.

The way the MMR vaccine works means it will not harm the immune system of a normal, healthy child. Only children suffering from some severe medical conditions and allergies should not have MMR.

To immunise against each of the three diseases separately would mean six injections over a longer period of time.

The result would be:

  • more risk of catching a disease
  • more risk of missing a dose completely
  • more risk of pain where the injections are given
  • more trauma for your child.

There are no single vaccines for measles, mumps and rubella licensed for use in the UK.

UK-licensed single vaccines, for measles, mumps or rubella, have not been manufactured or supplied for the UK market for many years.

The only single vaccines against those illnesses available in the UK at present are unlicensed products imported into the UK under the provisions of 'Specials' regulations.

These regulations permit import of unlicensed medicines, by licensed importers, to meet the special clinical needs of individual patients when licensed alternatives are not available.

As these are unlicensed, the use of such products remains the responsibility of individual prescribers.

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Does the MMR vaccine contain pork (porcine) gelatin?

Gelatin is an essential ingredient in many medicines, including some vaccines. Porcine gelatin is an ingredient in one of the MMR vaccines currently used in Scotland. If you have any concerns about this, please speak to your GP as there are alternative MMR vaccines available which do not contain porcine gelatin. Many faith groups have approved the use of gelatin-containing vaccines. It is, however, an individual choice whether or not to receive this vaccine and we recognise there will be diversity of thought within different communities. The following statements from representatives of the Jewish and Muslim communities may help you reach a decision about having this vaccine:

Rabbi Abraham Adler from the Kashrus and Medicines Information Service, said: 

"It should be noted that according to Jewish laws, there is no problem with porcine or other animal derived ingredients in non-oral products. This includes vaccines, including those administered via the nose, injections, suppositories, creams and ointments."

"In 2001, the World Health Organization consulted with over 100 Muslim scholars and confirmed that the gelatin used is considered halal and there is no religious reason not to receive vaccination."

The findings of more than one hundred Islamic legal scholars who met in 1995 to clarify Islamic purity laws states the following: 

“Transformation which means the conversion of a substance into another substance, different in characteristics, changes substances that are judicially impure into pure substances, and changes substances that are prohibited into lawful and permissible substances.”

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What safety trials and licensing processes have been carried out?

MMR vaccines have been through a rigorous licensing process that needs a high standard of safety, quality and effectiveness to be proved before a license is given. The agency responsible for safety of all drugs in the UK is the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA also continuously monitors the safety of products in use.

When MMR was introduced in the UK in 1988 it had already been in use for many years in some other parts of the world. This practical experience of tens of millions of MMR doses showed that it was highly effective and very safe.

The MMR vaccines being used now in the UK’s immunisation programme have been thoroughly tested with thousands of people taking part in the trials.

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MMR in the media

Over 10 years ago, there were many stories in the media that suggested there was a link between MMR and autism. These reports were based on a study, published in the Lancet by Wakefield et al., that reported on 12 children with gasterointestinal problems and behavioural symptoms (similar to signs of autism), which it suggested were linked to the MMR vaccination.

The Wakefield et al. study said, 'We did not prove an association between MMR vaccine and the syndrome described'. None of the studies since have proved a link and there have been many studies that cannot find a link.

The scientific evidence is that MMR does not cause autism.

In 2004, 10 of the 13 co-authors of the study published a statement retracting the interpretation of the study and the Editor of the Lancet said that with hindsight the journal would not have published the paper.

Following investigations of Dr Wakefield’s study by General Medical Council and the GMC’s findings, the Lancet retracted the study in February 2010 and released the following statement:

'It has become clear that several elements of the 1998 paper by Wakefield et al. are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were 'consecutively referred' and that investigations were 'approved' by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.'

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Last reviewed on 15 July 2016

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