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1 “How many doses of MMR are required, and when should they be given?”
For adequate protection, two doses must be given, separated by an interval of at least four weeks. The first dose that “counts” must be given after the age of one year; and the second dose that “counts” must be given after the age of 18 months. In certain circumstances additional doses may be recommended (see below).
2 “Does my 9 month old baby need to have an MMR vaccination?”
In certain situations (such as a measles outbreak at a nursery) MMR may be offered to babies aged between 9-12 months; but if it is given before the first birthday then the dose may not provide long term immunity and should not be counted as part of the usual vaccine schedule. Two further doses need to be given at recommended times. Situations like this should be discussed with the Health Protection Unit (01372 227331) and additional doses should not be offered routinely.
3 “My 16 month old baby had his 1st MMR at 14 months. Can he have his second MMR early?”
Yes, where protection against measles is urgently required (eg during a local outbreak as above, or in situations when herd immunity is very low), the second dose can be given one month after the first. However, if the child is under 18 months of age when the second dose is given, then this dose should be discounted and a third dose should be given in line with the normal routine once the child has reached 18 months of age and with a minimum of 4 weeks between the second and third dose to ensure adequate protection.
4 “My 3 year old had his first MMR at 15 months, can he have his second MMR now?”
Yes, the second MMR can be given now. As it will have been given at least four weeks after the first dose, and after the age of 18 months, this will count as the second dose, and there will be no need for the child to have the routine pre-school dose of MMR.
5 “Do adults need an MMR?”
MMR vaccination can be given to individuals of any age. People born before 1970 should have some degree of immunity either through vaccination or as a result of measles disease acquired during childhood. However, we have seen confirmed cases in older people. MMR can be offered to these adults on request, particularly if they are considered to be a high risk of exposure ie, health care workers, nursery staff (although an item of service or LES fee will not necessarily be payable for this). Individuals who were born after 1970 who have no documented history of Measles, MR or MMR vaccination should be offered 2 MMR vaccinations; especially if they are at high risk of exposures to measles. There is no need to test for immunity first.
6 “I can’t remember if I have had measles or have ever been vaccinated against measles?”
MMR vaccine can be given irrespective of a history of measles, mumps or rubella infection or previous MMR vaccination. There are no ill effects from immunising such individuals because if they have pre-existing immunity it will inhibit replication of the vaccine viruses.
7 “My child has not be vaccinated and has been in contact with a case of measles, what can I do?”
Vaccine-induced measles protection develops more rapidly than that following natural infection, MMR vaccine should be used to protect susceptible contacts. To be effective against this exposure, the MMR vaccine must be administered very promptly, ideally with three days. Even where it is too late to provide effective post-exposure prophylaxis with MMR, the vaccine can provide protection against future exposure to all three infections. If this is the first dose of MMR a second should be given once the child is older than 18 months, or if they are already over 18 months, a second MMR can be given a month after the first. If the individual is already incubating measles, mumps or rubella, MMR vaccination will not exacerbate the symptoms.
Please ring us at Surrey Health Protection Unit if you have any further queries about the MMR or measles: 01372 227331. Further information on MMR can also be found in the “Green Book” od the DH website: www.dh.gov.uk
Prompt notification of measles, mumps and rubella to the local health protection unit (HPU) is required to ensure public health action can be taken promptly. Notification should be based on clinical suspicion and should not await laboratory confirmation
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