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M-M-R II Vaccine

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Last reviewed
September 22, 2021
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M-M-R II Vaccine Description

Merck's M-M-R II vaccine is known as the Measles, Mumps, and Rubella Virus Vaccine Live, which contains weakened forms of measles, mumps, and rubella. The M-M-R II vaccine (Priorix, MMRVAXPRO) works by helping the human immune system protect itself from these viruses, says the company.

The vaccine's active ingredients include weakened forms of measles, mumps, and rubella viruses. The inactive ingredients include sorbitol, sucrose, hydrolyzed gelatin, recombinant human albumin, fetal bovine serum, and others buffer media ingredients.

Clinical studies of 284 triple-seronegative children between 11 months to 7 years of age demonstrated that M-M-R II is highly immunogenic and generally well-tolerated. A single injection of the vaccine-induced measles hemagglutination-inhibition (HI) antibodies in 95% of the participants, mumps neutralizing antibodies in 96%, and rubella HI antibodies in 99% of susceptible persons in these studies.

However, a small percentage (1%-5%) of vaccinees may fail to seroconvert after the primary dose. The most common side effect of vaccination with M-M-R II is pain at the shot site for a short time. Other side effects may include fever or rash. The anatomical therapeutic chemical code: J07BD52.

The MMR vaccine was developed by Maurice Hilleman and was licensed for use by Merck in 1971. For 130 years, Merck (known as MSD outside of the US and Canada) has been inventing for life, bringing forward medicines and vaccines for many of the world's most challenging diseases to pursue their mission to save and improve lives.

M-M-R II Vaccine Indication

The M-M-R II vaccine is indicated for simultaneous vaccination against measles (rubeola), mumps, and rubella (German measles). This vaccine is usually given to people 1-year of age or older.

The M-M-R II vaccine is contraindicated in specific individuals, including those with: a history of hypersensitivity to any component of the vaccine, including gelatin; a history of anaphylactic or anaphylactoid reaction to neomycin; blood dyscrasias, leukemia, lymphomas of any type, or other malignant neoplasms affecting the bone marrow or lymphatic systems; primary or acquired immunodeficiency conditions; family history of congenital or hereditary immunodeficiency or receiving immunosuppressive therapy; an active febrile illness; or those who are pregnant.

Caused by a highly contagious virus, measles spreads from person to person by breathing, coughing, or sneezing. Signs and symptoms of measles include rash, high fever, cough, runny nose, or red, watery eyes. People can spread measles up to 4 days before and four days after they have a rash. Measles can lead to serious complications, such as pneumonia (infection of the lungs) and even death, says the US CDC.

Rubella can cause a miscarriage or serious congenital disabilities in a developing baby if a woman is infected while pregnant, says the US CDC. Therefore, if MMR vaccination of postpubertal females is undertaken, pregnancy should be avoided for 3-months following immunization.

The European Medicines Agency updated M-M-RVAXPRO's product information on July 14, 2021. Pregnant women should not be vaccinated with M-M-RVAXPRO. Studies have not been conducted with M-M-RVAXPRO in pregnant women. Therefore, it is not known whether M-M-RVAXPRO can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. However, fetal damage has not been documented when measles or mumps vaccines have been given to pregnant women.

The WHO published its MEASLES OUTBREAKS STRATEGIC RESPONSE PLAN for 2021-2023.

The PAHO reported on September 11, 2021; there have been 578 confirmed measles cases in 2021. The US CDC confirmed 13 individual cases of measles were confirmed in 8 jurisdictions in 2020. And during 2019, 1,282 individual cases of measles were confirmed in 31 US states.

M-M-R II Vaccine Dosage

The US CDC's ACIP committee recommends administering the 1st dose of M-M-R II at 12 to 15 months of age and administering the second dose of M-M-R®II at 4 to 6 years ago.

The M-M-R II vaccine is given as a shot administered subcutaneously, preferably into the arm's outer aspect. The dose of the vaccine is the same for everyone. Children who received an initial dose of measles, mumps and rubella vaccine prior to their first birthday should receive additional doses of vaccine at 12-15 months of age and at 4-6 years of age to complete the vaccination series Often, the 2nd dose is given right before the child goes to elementary school (4 to 6 years of age). If your child is less than one year old when they first get the shot, a second dose should be given when 12 to 15 months old. If a 3rd vaccination is prescribed, a dose should be given between 4 and 6.

M-M-R II Vaccine Side Effects

MMR vaccine has been linked with minimal risk of febrile seizures (seizures or jerking caused by fever). Febrile seizures following MMR are rare and are not associated with any long-term effects. However, because the risk of febrile seizures increases as infants get older, it is recommended that they get vaccinated as soon as recommended, says the CDC.

Some people may experience swelling in the cheeks or neck. MMR vaccine rarely causes a temporary low platelet count, which can cause a bleeding disorder that usually goes away without treatment and is not life-threatening. Extremely rarely, a person may have a serious allergic reaction to the MMR vaccine.  Anyone who has ever had a life-threatening allergic reaction to the antibiotic neomycin, or any other component of the MMR vaccine, should not get the vaccine. An M-M-R II vaccination may result in a temporary depression of purified protein derivative tuberculin skin sensitivity, says the US FDA.

M-M-RVAXPRO has not been evaluated in fertility studies.

M-M-R II Vaccine News

September 20, 2021 - The US CDC issued a Health Advisory to the Health Alert Network with updated guidance for clinicians caring for individuals recently evacuated from Afghanistan. The CDC recommends clinicians be on alert for cases of measles that meet the case definition, as well as other infectious diseases, including mumps, leishmaniasis, and malaria.

September 20, 2021 - Politico reported the US CDC is recommending the US administration halt flights of Afghan evacuees from military bases overseas for at least 21 days following measles vaccination.

September 16, 2021 - The US CDC is reporting of September 13, 2021, six cases of measles in three jurisdictions.

September 14, 2021 - The Virginia Department of Health has identified five individuals diagnosed with measles. The people confirmed to have measles recently traveled from Afghanistan as part of the United States government's emergency evacuation efforts.

September 5, 2021 - The WHO Africa Region reported of the 2,049 suspected measles cases recorded in the DRC during 2021, 230 were confirmed with four associated deaths (case fatality ratio: 0.2%). Of the 230 measles confirmed cases, 109 cases have no history of vaccination despite the national vaccination campaign organized in response to the measles outbreak in 2020. Of these confirmed cases, 62 tested IgM positive for measles, 157 were epidemiologically linked and 11 were compatible cases. The epidemic has affected more than half of the country’s 35 HDs with a high prevalence in the capital Bangui, the west and the centre-east

August 16, 2021 - Doctors Without Borders launched an urgent measles vaccination campaign to contain a rapidly growing number of cases in Jebel Marra, South Darfur.

August 6, 2021 - The US CDC reported two measles cases had been confirmed during 2021.

June 30, 2021 - The US CDC issued a Level 1 Travel Alert regarding measles outbreaks in various African countries.

June 25, 2021 - The urgent measles and rubella vaccination campaign was launched in Kajiado County by the Government of Kenya, with the support of the WHO, UNICEF, Gavi, and US CDC. 

June 17, 2021 - The AAP published a new study that reported the number of vaccine doses, including the measles vaccine, given to children declined dramatically during the COVID-19 pandemic, resulting in decreases in vaccination coverage that persisted or worsened among several age cohorts as well as worsening decreases in measles vaccination coverage in young children. 

June 11, 2021 - The US CDC published: Progress Toward Rubella Elimination — World Health Organization European Region, 2005–2019. During 2005–2019, the estimated EUR RCV1 coverage was 93%–95%. In 2019, 31 (58%) countries had achieved ≥95% RCV1 coverage. As a result, rubella incidence declined from 234.9 cases per 1 million in 2005 to 0.7 cases by 2019.

June 8, 2021 - Science Direct published a news study: Childhood immunization during the COVID-19 pandemic in Texas. After analyzing state-wide immunization register data for Texas, we observed a 47% relative decline in immunization rates between 2019 and 2020 among 5-month-olds and a 58% decline among 16-month-olds.

May 7, 2021 - A new study reported, About 36.7% (n=90) of the participants were found to be COVID-19 positive by PCR, among which the non-vaccinated cases had higher rates of COVID-19 seropositivity than the vaccinated cases (40.6% vs. 15.8%) (OR=3.6, 95%CI: 1.5– 9.0, p=0.004). Based on these results, we cautiously predict that immunity produced by MMR vaccination boosters may provide some degree of protection against COVID-19 in the adult population.

May 4, 2021 - A non-peer-reviewed study found 'SARS-CoV-2 re-activates memory T cells generated by Tdap and MMR vaccines, which may reduce disease severity.'

April 29, 2021 - Merck confirmed MMR-II sales only increased by 2% last year.

April 27, 2021 - Study: Measles under-vaccinations in the USA.

April 23, 2021 -  The WHO reported in 2020, 13.9% fewer children (379,208 in total) received their dose of MMR1 vaccine against measles, mumps, and rubella, compared to 2019.

April 13, 2021 - A study published in BMC Public Health leverages frontline responders' firsthand experience to address the operational components of the measles outbreak response.

March 13, 2021 - Since the previous monthly measles update by the ECDC's Communicable Disease Threats Report, issued on February 12, 2021, two countries have reported five new measles cases in the EU/EEA: Germany (4) and Spain (1). However, in 2021, EU/EEA countries have reported no new deaths, says the ECDC.

March 11, 2021 - A SARS-CoV-2 vaccine candidate developed by researchers from The Ohio State University (OSU) is potentially leveraging a measles virus to protect people from COVID-19. Using a measles virus (rMeV) vaccine strain as the backbone, they developed a series of recombinant attenuated vaccine candidates expressing various forms of the SARS-CoV-2 spike (S) protein and its receptor-binding domain evaluated their efficacy animals. The OSU researchers found that rMeV expressing stabilized prefusion S protein (rMeV-preS) was more potent in inducing SARS-CoV-2–specific neutralizing antibodies than rMeV expressing full-length S protein (rMeV-S).

March 1, 2021 - The PAHO reported between the epidemiological week (EW)1 and EW 6 that one country and one territory in the Americas had confirmed measles cases: Brazil with 54 confirmed cases and French Guiana with two confirmed cases.

March 1, 2021 - Recent increases in incident measles cases in the United States and across the globe underscore the need to more fully understand the societal cost of measles cases and outbreaks and the economic consequences of under vaccination. The overall societal cost of the 2019 Clark County measles outbreak was ∼$3.4 million ($47,479 per case or $814 per contact). The majority of the costs (∼$2.3 million) were incurred by the public health response to the outbreak, followed by productivity losses (∼$1.0 million) and direct medical costs (∼$76 000).

March 1, 2021 - The US CDC reported that health officials in certain African countries had reported measles outbreaks, which means that the number of measles cases is higher than normal. Therefore, all African travelers, including infants and pre-school-aged children, should be fully protected against measles.

March 1, 2021 - The Lancet published a commentary: Measles: the long walk to elimination drawn out by COVID-19. Dr. Wariri and colleagues offer valuable insight into the situation of measles control in west Africa over the past two decades. A global mobilization is necessary to fight against the scourge of measles in the post-COVID-19 era. Alongside proven strategies, innovative actions and research must be carried out to ensure that vaccination reaches all children and ensure that no one is left behind.

February 8, 2021 - GAVI researched the long-term effects of measles on the human immune system. Researchers collected blood samples from 77 unvaccinated children before and after getting infected with the virus during an outbreak in the Netherlands. They tracked the antibodies' changes (the particles that fight off pathogens) in the children's bloodstream. They found that measles wipes out up to 73% of these antibodies, leaving these children unprotected against other diseases for months and sometimes years. This study's findings further show the importance of vaccination.

February 4, 2021 - Merck Announces Fourth-Quarter and Full-Year 2020 Financial Results.

January 25, 2021 - Merck announced that the company is discontinuing developing its SARS-CoV-2/COVID-19 vaccine candidates, V590 and V591. This decision follows Merck's review of findings from Phase 1 clinical studies for the vaccines. Both V590 and V591 were generally well-tolerated in these studies, but the immune responses were inferior to those seen following natural infection and those reported for other SARS-CoV-2/COVID-19 vaccines. 

January 7, 2021 - Pandemic-Related MMR Vaccine Decline Persists. From March 2017 to March 2020, the researchers found that the average proportion of 16-month-old children with MMR vaccination was 72 percent, which decreased to 66.8 percent from April to May 2020 and then to 62.4 percent from June to August 2020.

December 25, 2020 - Washington DC legislation: B23-0171 - Minor Consent for Vaccinations Amendment Act of 2019. BILL SUMMARY - As introduced, this bill permits a minor of any age to consent to receive a vaccine where the vaccination is recommended by the US Advisory Committee on Immunization Practices. It also establishes that informed consent is confirmed if a minor can comprehend the need for, the nature of, and any significant risks inherent in medical care.

December 17, 2020 - In this study, researchers focused on the first MMR vaccination because they hypothesized that any changes in vaccination rates due to COVID-19 pandemic-related closures likely would be identified earliest among young children who require frequent preventive visits. From March 2017 to March 2020, the average proportion of 16-month-old children with MMR vaccination was 72.0%, which decreased to 62.4% (P = .02) by August 2020. It is too soon to evaluate whether there has been a decrease in the second MMR vaccination.

December 16, 2020 - A new study published in Nature by a team led by researchers from the Institute for Health Metrics and Evaluation at the University of Washington found MCV1 coverage estimates show overall progress from 2000 to 2019. Moreover, 62 out of 101 countries in the study increased national-level MCV1 coverage while reducing subnational geographical inequalities over time, which is a noteworthy achievement.

December 1, 2020 - The Journal Pediatrics published a study found in Ohio, from March 2017 to March 2020, the average proportion of 16-month-old children with MMR vaccination was 72.0%, which decreased to 62.4% in August 2020.

November 30, 2020 - Study: the bivalent MeV/SARS-CoV-2 vaccine candidate has several desirable properties concerning its immunogenicity and efficacy against SARS-CoV-2. Furthermore, the concurrent induction of anti-MeV immunity would allow its use in the context of routine measles immunization schedules. In addition, such a MeV-based COVID-19 vaccine could be included in the currently applied MMR (measles, mumps, rubella) vaccine, providing additional protection against SARS-CoV-2.

November 20, 2020 - Study: Analysis of Measles-Mumps-Rubella Titers of Recovered COVID-19 Patients. These results demonstrate a significant inverse correlation between mumps titers from MMR II and COVID-19 severity. This study's significance is that it showed that mumps titers related to the MMR II vaccine are significantly and inversely correlated with the severity of COVID-19-related symptoms, supporting the theorized association between the MMR vaccine and COVID-19 severity.

October 23, 2020 - Vaccination Coverage by Age 24 Months Among Children Born in 2016 and 2017 — National Immunization Survey-Child, United States, 2017–2019.

October 23, 2020 - A study published in the American Journal of Medicine suggested 'the MMR vaccine may protect against COVID-19, including high-risk individuals, such as the elderly with comorbidities, and health care workers and first responders with COVID-19 patients, especially individuals living in long-term care facilities and the related institutional staff.' These findings suggest the MMR vaccine may protect against COVID-19, including high-risk individuals, such as the elderly with comorbidities, and health care workers and first responders with COVID-19 patients, especially individuals living in long-term care facilities and the related institutional staff.

October 14, 2020 - A research team led by Dr. Larenas-Linnemann, working at Medica Sur, Mexico City, reported their clinical observations in 255 subjects vaccinated measles-mumps-rubella (MMR) vaccines the COVID-19) pandemic. The concept of trained immunity based on a heterologous immune response with nonspecific memory dates back about a decade ago. It refers to the enhanced immune response to a certain pathogen after being exposed (by vaccination or natural illness) to another nonrelated pathogen1. Matricardi analyzed this in the context of the COVID‐pandemic. Conclusive evidence of the MMR vaccine's value to reduce COVID-19 complications requires a prospective, randomized trial.

October 11, 2020 - The two measles vaccination campaigns in the Central African Republic appear to have been largely successful in slowing the measles outbreak declared at the start of 2020. However, children aged 6 months to 10 years will have received only one measles vaccination dose. The lack of a second dose has led to declining immunity elsewhere in the region, considering when planning future activities.

October 7, 2020 - The Philipines Department of Health and Local Government Units will conduct nationwide measles, rubella, and polio supplemental immunization activity starting October 26, 2020. In the Philippines, an estimated 2.4M children under five are susceptible to the measles virus.

September 23, 2020 - BMJ commentary: Containing measles in conflict-driven humanitarian settings

September 15, 2020 - According to CDC immunization schedules, all travelers to Africa, including infants and pre-school-aged children, should be fully vaccinated against measles.

September 3, 2020 - Global trial to test whether the MMR vaccine protects front-line healthcare workers against COVID-19.

September 3, 2020 - An international research network announced it is launching the CROWN CORONATION phase 3 clinical trial to evaluate whether the vaccine for measles, mumps, and rubella (MMR) can protect front-line healthcare workers against infection from SARS-CoV-2, the virus that causes COVID-19.

September 1, 2020 - A study was published in The Lancet: Immunogenicity and persistence of trivalent measles, mumps, and rubella vaccines: a systematic review and meta-analysis. Our meta-analysis provides estimates of primary and secondary vaccine failure, which are essential to improve mathematical and statistical modeling accuracy to understand and predict the occurrence of future measles, mumps, and rubella outbreaks in countries with high vaccine uptake.

July 30, 2020 - The Lancet published: Persistence of US measles risk due to vaccine hesitancy and outbreaks abroad.

June 19, 2020 - A  study published in the journal mBio suggests that the measles, mumps, rubella (MMR) vaccine could reduce the inflammation associated with COVID-19. These researchers stated: 'There is mounting evidence that lives attenuated vaccines provide nonspecific protection against lethal infections unrelated to the target pathogen of the vaccine by ... inducing "trained" nonspecific innate immune cells for improved host responses against subsequent infections.'

May 20, 2020 - The MMR Vaccine Appears to Confer Strong Protection from COVID-19: Few Deaths from SARS-CoV-2 in Highly Vaccinated Populations. Published epidemiological data suggest a correlation between patients who receive measles-rubella-containing vaccines such as the commonly available MMR vaccine and reduced COVID-19 death rate. Similar observations were recently noted in a Cambridge Study by Young et al., who noted protein homology between the COVID-19 virus and the rubella virus, corroborating this report's evidence. The epidemiologic associations suggest that a measles-rubella-containing vaccine, as currently produced, may be protective against severe disease and death from COVID-19 exposure.

According to a report published Monday, May 18, 2020 - Routine vaccinations for young children in the US fell during the first half of this year as more Americans skipped routine doctor visits due to the coronavirus pandemic by the Centers for Disease Control and Prevention. 

May 3, 2020 - The report MMR Vaccine Link to COVID-19: Fewer Deaths and Milder Cases from SARS-CoV-2 in Measles-Rubella Vaccinated Populations reveals that the MMR vaccine launched in 1971 (49 years ago) could explain why those 49 and under are much less likely to have bad outcomes from COVID-19 compared to those 50 and over, according to report co-contributor Dr. Larry P. Tilley, an Advisory Board Member of World Organization.

April 28, 2020 – Mexico's public health officials have identified a measles virus outbreak in various states in Mexico.

April 27, 2020 – A recent review of the existing evidence on the safety and effectiveness of measles-related vaccines supports their continued use for mass immunization worldwide.

April 10, 2020 - A non-peer-reviewed study stated, 'As an initial test of this hypothesis, we identified that 1.) age groups that most likely lack MMR vaccine-induced immunity had the poorest outcome. COVID-19, and 2.) COVID-19 disease burden correlates with rubella antibody titers, potentially induced by SARS-CoV2 homologous sequences. Therefore, we propose that vaccination of 'at risk' age groups with an MMR vaccination merits further consideration as a time appropriate and safe intervention.'

Measles, Mumps, and Rubella FAQs

Ask the Experts at Immuninize Action Coalition 

M-M-R II Vaccine Clinical Trials

Merck's MMR vaccine has been involved in many clinical trials over the years.