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MMR VACCINE
What is MMR vaccine given for?
MMR vaccine is given for protection against 3 common childhood viral diseases namely measles, mumps & rubella (German Measles).

How is MMR vaccine given?
MMR vaccine is given subcutaneous over the thigh or over the arm.

Why is MMR vaccine essential?
Measles though a mild disease in children can occasionally lead to pneumonia and brain damage (SSPE). Mumps is a common cause of morbidity in children with occasional chances of complications like encephalitis & pancreatitis. Rubella or German measles though a benign disease can lead to congenital rubella syndrome if it occurs during pregnancy. Such a child will have cataract, deafness, heart disease, small head, mental retardation & many other complications. Hence MMR vaccine is essential.

When is MMR vaccine given?
MMR vaccine has best efficacy when given beyond 12 months especially the mumps & the rubella part of it. If you wait till that age, measles can occur as it can occur after 9 months. Hence it is recommended to give measles vaccine at 9 months, which will protect early against measles followed by MMR vaccine at 15 months of age, which will act best against mumps & rubella & will act as a booster for measles.

Is there a need to give booster dose of MMR vaccine?
As of today there is no need to give booster dose of MMR vaccine in India. This is because the routine coverage by measles & MMR vaccine is poor. Therefore naturally occurring subclinical measles, mumps & rubella are common which act like natural booster in vaccinees. A time may come in coming years when the routine coverage of MMR will go up which will lead to drastic reduction in natural infections & hence decrease natural boosting against measles, mumps & rubella. This has been the experience in western countries. At such time a booster of MMR at 5 years (school entry) or 15 years (school exit) is recommended, as is practiced by USA.

What are the side effects of MMR vaccine?
MMR vaccine is a very safe vaccine. If at all, it leads to mild pain, swelling, induration or fever. It is seen in less than 10% of patients, are transient & mild, lasts for < 24 hours & responds well to paracetamol. It can occur from the day of injection till 5-7 days. Sometimes a patient can develop measles like infection with cough, cold, red eyes & rash over skin. Again it lasts for 2-5 days & is self-limiting.


What are the contraindications of MMR vaccine?
In patients, with mild egg allergy MMR vaccine can cause allergic reactions. In cases of severe egg allergy, measles & MMR vaccines are contraindicated. In case with mild egg allergy, measles or MMR vaccines can be given but with strict medical supervision and all the measures of resuscitation & drugs kept ready should the patient develop reaction.

What if patient comes late for MMR vaccine?
Measles mostly occurs till 5 – 15 years of age. Mumps & rubella can occur at any age. Hence if a patient comes late he can be given MMR till 5-15 years of age after which MR (Mumps, Rubella) vaccine can be given. As MR vaccine is not available MMR can be given even to older individuals as no harm is done by measles part. If a patient has already developed measles, mumps & rubella he does not need a vaccine against them.

Can MMR be given along with other vaccines?
Yes, MMR can be given simultaneously with other vaccines. A combination vaccine containing MMR + chicken pox vaccine is available. Like with measles, MMR vaccine can lead to temporary suppression of immunity for 4-6 weeks. Hence BCG should not be given with MMR & no other vaccine should be given within 4-6 weeks of MMR vaccine.

 


 
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