Formulary
Measles, mumps and rubella vaccine: Indications, Dosing, Side Effects and Interactions
For measles, mumps and rubella vaccine Measles, mumps and rubella vaccine is a live, attenuated combination vaccine.
MedNext Academy | 6 min read
Measles, mumps and rubella vaccine: Indications, Dosing, Side Effects and Interactions
For measles, mumps and rubella vaccine Measles, mumps and rubella vaccine is a live, attenuated combination vaccine.
Drug action
For measles, mumps and rubella vaccine Measles, mumps and rubella vaccine is a live, attenuated combination vaccine.
Indications and dose
**Primary immunisation against measles, mumps, and rubella [first dose]**
- **Child** (By Intramuscular Injection): 1 year 0.5 mL for 1 dose.
**Primary immunisation against measles, mumps, and rubella [second dose**
- **Child** (By Intramuscular Injection): for children born before 1 July 2024] 40 months 0.5 mL for 1 dose.
**Immunisation against measles, mumps, and rubella [patients with unknown or incomplete immunisation status]**
- **Child** (By Intramuscular Injection): 18 months-17 years 0.5 mL for 2 doses, doses to be separated by an interval of at least 4 weeks.
- **Adult** (By Intramuscular Injection): 0.5 mL for 2 doses, doses to be separated by an interval of at least 4 weeks.
**Primary immunisation against measles, mumps, and rubella [first dose] for measles, mumps and rubella vaccine**
- **Child 1 year** (By intramuscular injection): 0.5 mL for 1 dose.
**Primary immunisation against measles, mumps, and rubella [second dose for children born on or after 1 July 2024] for measles, mumps and rubella vaccine**
- **Child 18 months** (By intramuscular injection): 0.5 mL for 1 dose.
**Primary immunisation against measles, mumps, and rubella [second dose for children born before 1 July 2024] for measles, mumps and rubella vaccine**
- **Child 40 months** (By intramuscular injection): 0.5 mL for 1 dose.
**Immunisation against measles, mumps, and rubella [patients with unknown or incomplete immunisation status] for measles, mumps and rubella vaccine**
- **Child 18 months-17 years** (By intramuscular injection): 0.5 mL for 2 doses, doses to be separated by an interval of at least 4 weeks.
Cautions
For all vaccines, general Acute illness; minor illnesses Cautions, further information Illness UKHSA advises vaccination may be postponed if the individual is suffering from an acute illness; however, it is not necessary to postpone immunisation in patients with minor illnesses without fever or systemic upset. Predisposition to neurological problems UKHSA advises: when there is a personal or family history of febrile convulsions, there is an increased risk of these occurring during fever from any cause including immunisation, but this is not a contra-indication to immunisation. In children who have had a seizure associated with fever without neurological deterioration, immunisation is recommended; advice on the management of fever should be given before immunisation. When a child has had a convulsion not associated with fever, and the neurological condition is not deteriorating, immunisation is recommended; children with stable neurological disorders (e.g. spina bifida, congenital brain abnormality, and peri-natal hypoxic-ischaemic encephalopathy) should be immunised according to the recommended schedule; when there is a still evolving neurological problem, including poorly controlled epilepsy, immunisation should be deferred and the child referred to a specialist. Immunisation is recommended if a cause for the neurological disorder is identified. If a cause is not identified, immunisation should be deferred until the condition is stable. Impaired immune response and drugs affecting immune response Immune response to vaccines may be reduced in immunosuppressed patients, UKHSA advises consider seeking specialist advice. Cautions For all vaccines, live Cautions, further information Impaired immune response and drugs affecting immune response There is a risk of generalised infection with live vaccines. UKHSA advises seek specialist advice for immunosuppressed patients, including those who are: taking high doses of corticosteroids (dose equivalents of prednisolone: adults, at least 40 mg daily for more than 1 week or at least 20 mg daily for more than 14 days; children, 2 mg/kg (or more than 40 mg) daily for more than 1 week or 1 mg/ kg (or more than 20 mg) daily for more than 14 days); taking immunosuppressive drugs; receiving treatment for malignant or non-malignant conditions with chemotherapy or generalised radiotherapy. UKHSA advises live vaccines should be postponed until at least 3 months after stopping high-dose systemic corticosteroids, or non-biological oral immune modulating drugs; and at least 6 months after stopping other immunosuppressive drugs, or generalised radiotherapy; and at least 12 months after discontinuing immunosuppressive biological therapy. Cautions For measles, mumps and rubella vaccine Antibody response to measles component may be reduced after immunoglobulin administration or blood transfusion-leave an interval of at least 3 months before MMR immunisation Cautions, further information Administration with other vaccines advises MMR and yellow fever vaccines should not be administered on the same day; there should be a 4-week minimum interval between the vaccines. When protection is rapidly required, the vaccines can be given at any interval; an additional dose of MMR should be considered and re-vaccination with the yellow fever vaccine can also be considered in those at on-going risk. advises MMR and varicella-zoster vaccines can be given on the same day or separated by a 4-week minimum interval. When protection is rapidly required, the vaccines can be given at any interval and an additional dose of the vaccine given second may be considered.
Contraindications
For all vaccines, live Contra-indications, further information Impaired immune response UKHSA advises severely immunosuppressed patients should not be given live vaccines (including those with severe primary immunodeficiency).
Side effects
For all vaccines, general Common or very common Abdominal pain; appetite decreased; arthralgia; diarrhoea; dizziness; fatigue; fever; headache; lymphadenopathy; malaise; myalgia; nausea; skin reactions; vomiting Uncommon Hypersensitivity Side-effects For all vaccines, live Common or very common Abdominal pain; arthralgia; diarrhoea; fever; headache; myalgia; nausea; skin reactions; vomiting Uncommon Dizziness Side-effects For measles, mumps and rubella vaccine Uncommon Crying; increased risk of infection; rhinorrhoea Frequency not known Angioedema; arthritis; ataxia; bronchospasm; cough; encephalopathy; eye inflammation; irritability; meningitis aseptic; nerve deafness; nerve disorders; oculomotor nerve paralysis; oedema; panniculitis; papillitis; paraesthesia; pneumonitis; regional lymphadenopathy; seizures; Stevens-Johnson syndrome; subacute sclerosing panencephalitis; syncope; throat pain; thrombocytopenia; vasculitis Side-effects, further information Malaise, fever, or a rash can occur after the first dose of MMR vaccine-most commonly about a week after vaccination and lasting about 2 to 3 days. Febrile seizures occur rarely 6 to 11 days after MMR vaccination (the incidence is lower than that following measles infection). Idiopathic thrombocytopenic purpura Idiopathic thrombocytopenic purpura has occurred rarely following MMR vaccination, usually within 6 weeks of the first dose. The risk of idiopathic thrombocytopenic purpura after MMR vaccine is much less than the risk after infection with wild measles or rubella virus. Children who develop idiopathic thrombocytopenic purpura within 6 weeks of the first dose of MMR should undergo serological testing before the second dose is due; if the results suggest incomplete immunity against measles, mumps or rubella then a second dose of MMR is recommended. Samples should be sent to the Virus Reference Laboratory of the. Frequency of side effects Adverse reactions are considerably less frequent after the second dose of MMR vaccine than after the first.
Pregnancy
For all vaccines, live UKHSA advises live vaccines should not be administered routinely to pregnant women because of the theoretical risk of fetal infection, but where there is a significant risk of exposure to disease the need for vaccination may outweigh any possible risk to the fetus. Termination of pregnancy following inadvertent immunisation is not recommended.
Breast feeding
For all vaccines, live Although there is a theoretical risk of live vaccine being present in breast milk, vaccination is not contra-indicated for women who are breast-feeding when there is significant risk of exposure to disease.
Medicinal forms
Solution,Injection
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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