Measles Mumps and Rubella Vaccine, Live

Measles Mumps and Rubella Vaccine, Live is a vaccine used for the immunization against Measles, Mumps, and Rubella.

• Measles Mumps and Rubella Vaccine, Live is available under the following different brand names: M-M-R-II

Adult and pediatric dosage

Injection, lyophilized powder for reconstitution

• Above 1000 TCID50/Above 12,500 TCID50/Above 1000 TCID50

Immunization Against Measles, Mumps & Rubella

Adult dosage

• Adults between 9-49 years old: 0.5 mL SC; second dose administered 28 days later for high-risk adults (see 2nd dose recommendations below)
• Adults above 50 years old: 0.5 mL SC; administer 1 dose only
• Additional dose during a mumps outbreak
• During an outbreak, persons identified as being at increased risk who have received less than 2 doses of mumps virus-containing vaccine or have unknown vaccination status should receive 1 dose

Pediatric dosage

• Routine vaccination: First dose of 0.5 mL SC between age 12-15 months; administer the second dose between 4-6 yr
• The minimum age for 1st dose is 12 months

International travel

• Children between 6-12 months: Administer 1 dose of MMR before departure from the United States for international travel; revaccinate with 2 doses of MMR, the first at age 12-15 months (12 months if the child remains in an area where the disease risk is high), and the second dose at least 4 weeks later
• Children above 12 months: Administer 2 doses of MMR before departure from the United States for international travel; the first dose should be administered on or after age 12 months and the second dose at least 4 weeks later

Catch-up vaccination

• Ensure all school-aged children and adolescents received 2 doses (0.5 mL SC each)
• The minimum time between 1st and 2nd dose is 4 wk

Perinatal HIV infection

• Revaccinate persons who were vaccinated before the establishment of effective antiretroviral therapy with 2 appropriately spaced doses of MMR vaccine once effective ART has been established
• 12 months or older with HIV infection
• Vaccinate all persons with HIV infection who do not have evidence of current severe immunosuppression

Additional dose during a mumps outbreak

• During an outbreak, persons identified as being at increased risk who have received less than 2 doses of mumps virus-containing vaccine or have unknown vaccination status should receive 1 dose
• Infants aged 6-12 months
  • Infants should receive a second dose of MMR between the aged of 12-15 months followed by revaccination at elementary school entry

Immunization in Pregnancy

Adult dosage

• Pregnant women who do not have evidence of immunity should receive the MMR vaccine upon completion or termination of pregnancy and before discharge from the healthcare facility

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of the Measles Mumps and Rubella Vaccine, Live include:

• headache,
• dizziness,
• nausea,
• vomiting,
• diarrhea,
• runny nose,
• sore throat,
• not feeling well,
• muscle pain,
• joint pain or stiffness, and
• feeling irritable (fussiness in a young child).

Serious side effects of the Measles Mumps and Rubella Vaccine, Live include:

• red, tender bumps under your skin,
• lightheadedness,
• high fever (within a few hours or a few days after the vaccine),
• easy bruising or bleeding,
• new or worsening cough,
• trouble breathing,
• problems with balance or muscle movement,
• convulsions (seizure),
• numbness,
• pain,
• tingling,
• weakness,
• burning or prickly feeling,
• vision problems,
• hearing problems, and
• trouble breathing

Rare side effects of the Measles Mumps and Rubella Vaccine, Live include:

• none

This is not a complete list of side effects and other serious side effects or health problems that may occur due to the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Measles Mumps and Rubella Vaccine, Live have severe interactions with the following drugs:
  • belimumab
  • certolizumab pegol
  • ibrutinib
  • ifosfamide
  • ixekizumab
  • lomustine
  • mechlorethamine
  • melphalan
  • methotrexate
  • onasemnogene abeparvovec
  • oxaliplatin
  • procarbazine
  • secukinumab
  • ustekinumab
• Measles Mumps and Rubella Vaccine, Live have serious interactions with at least 62 other drugs.
• Measles Mumps and Rubella Vaccine, Live have moderate interactions with the following drugs:
  • anthrax immune globulin
  • belatacept
  • cytomegalovirus immune globulin (CMV IG)
  • dengue vaccine
  • hepatitis B immune globulin (HBIG)
  • immune globulin IM (IGIM)
  • immune globulin IV (IGIV)
  • immune globulin SC
  • obinutuzumab
  • rabies immune globulin, human (RIG)
  • tetanus immune globulin (TIG)
  • vaccinia immune globulin intravenous
• Measles Mumps and Rubella Vaccine, Live have minor interactions with the following drugs:
  • chloroquine
  • Rho(D) immune globulin

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity
  • History of anaphylactic reaction to neomycin (may consult allergist/immunologist if absolutely necessary, give in setting where anaphylactic reaction can be immediately controlled)
  • Hypersensitivity to gelatin or any other component
• Immunosuppression
  • Individuals with blood dyscrasias, leukemia, lymphomas of any type, or malignancy affecting the bone marrow/lymphatic system
  • Primary and acquired immunodeficiency states including AIDS, cellular immune deficiencies, hypogammaglobulinemia, and dysgammaglobulinemic states, or family history of congenital or hereditary immunodeficiency
  • Individuals taking immunosuppressive drugs; may be used with topical corticosteroids or low-dose corticosteroids (as commonly used for asthma prophylaxis) or in patients who are receiving corticosteroids as replacement therapy (eg, Addison disease)
• Concurrent illness
• Active untreated TB
  • Fever of more than 101.3°F (38.5°C)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Measles Mumps and Rubella Vaccine, Live?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Measles Mumps and Rubella Vaccine, Live?”

Cautions

• Caution when administering MMRV to persons with a history of cerebral injury, individual or family history of convulsions, or any other condition in which stress due to fever should be avoided
• History of anaphylactic or other immediate hypersensitivity reactions (e.g., hives, laryngeal edema, difficulty breathing, hypotension, or shock) after egg ingestion may be at an enhanced risk of immediate-type hypersensitivity reactions after receiving vaccines containing traces of chick embryo antigen; carefully evaluate the potential risk-to-benefit ratio before considering vaccination
• Neomycin allergy most often manifests as contact dermatitis, which is not a contraindication to receiving the vaccine
• Transient thrombocytopenia reported within 4-6 weeks following vaccination with measles, mumps, and rubella vaccine; carefully evaluate potential risk and benefit of vaccination in children with thrombocytopenia or in those who experienced thrombocytopenia after vaccination with a previous dose of measles, mumps, and rubella vaccine
• Safety and efficacy for postexposure prophylaxis have not been established
• Safety and efficacy in HIV-infected children have not been established
• Vaccination should be deferred in individuals with a family history of congenital or hereditary immunodeficiency until the individual’s immune status has been evaluated and the individual is immunocompetent
• Postmarketing reports suggest transmission of vaccine virus may occur to high-risk individuals (e.g., immunocompromised, pregnant women without positive varicella history or vaccination, or newborn infants of mothers without positive varicella history)
• Contains albumin; theoretical risk for transmission Creutzfeldt-Jacob disease
• Febrile seizures
  • There is a risk of fever and associated febrile seizure in the first 2 weeks following immunization with the M-M-RII vaccine; for children who have experienced a previous febrile seizure (from any cause) and those with a family history of febrile seizures there is a small increase in the risk of febrile seizure following receipt of M-M-RII vaccine
  • Administration of MMRV (dose 1) to children aged 12-23 months who have not been previously vaccinated against measles, mumps, rubella, or varicella, nor had a history of the wild-type infections, is associated with higher rates of fever and febrile seizures at 5-12 days after vaccination when compared with children vaccinated with dose 1 of both MMR and varicella vaccine administered separately

Pregnancy and Lactation

• Contraindicated during pregnancy; avoid pregnancy for 3 months following vaccination
• In a 10-year survey involving over 700 pregnant women who received rubella vaccine within 3 months before or after conception (of whom 189 received the Wistar RA 27/3 strain), none of the newborns had abnormalities compatible with congenital rubella syndrome
• Mumps infection during the first trimester of pregnancy may increase the rate of spontaneous abortion
• Although the mumps vaccine virus has been shown to infect the placenta and fetus, there is no evidence that it causes congenital malformations in humans
• Reports have indicated that contracting wild-type measles during pregnancy enhances fetal risk; increased rates of spontaneous abortion, stillbirth, congenital defects, and prematurity have been observed after infection with wild-type measles during pregnancy
• There are no adequate studies of the attenuated (vaccine) strain of measles virus in pregnancy; however, it would be prudent to assume that the vaccine strain of the virus is also capable of inducing adverse fetal effects
• Lactation
  • Unknown if measles or mumps vaccine is secreted in human milk
  • The prescribing information describes studies that have shown lactating postpartum women immunized with live attenuated rubella vaccine may secrete the virus in breast milk and transmit it to breastfed infants