The MMR vaccine (abbreviated as MMR) is a combination vaccine against measles, mumps, and rubella (German measles). It contains the combined measles vaccine, mumps vaccine, and rubella vaccine into a single injection. After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella. The vaccine is also recommended for those who do not have evidence of immunity, those with well-controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized. It is given by injection. Measles is a highly contagious viral illness that can lead to serious complications, including pneumonia, acute encephalitis, and, in rare cases, long‑term neurological disease. Pregnant women are at increased risk of severe respiratory complications and adverse pregnancy outcomes such as pregnancy loss and premature birth. The MMR vaccine is widely used around the world. As of 2012, 575 million doses had been administered since the vaccine's introduction worldwide. Measles resulted in 2.6 million deaths per year before immunization became common. This has decreased to 122,000 deaths per year as of 2012, mostly in low-income countries. Through vaccination, as of 2018, rates of measles in North and South America are very low. Rates of disease have been seen to increase in populations that go unvaccinated. Between 2000 and 2018, vaccination decreased measles deaths by 73%. Side effects of immunization are generally mild and resolve without any specific treatment. These may include fever, as well as pain or redness at the injection site. Severe allergic reactions occur in about one in a million people. Because it contains live viruses, the MMR vaccine is not recommended during pregnancy but may be given during breastfeeding. The vaccine is safe to give at the same time as other vaccines. Being recently immunized does not increase the risk of passing measles, mumps, or rubella on to others: That is, even though the vaccine contains live viruses, they are not transmitted. There is no evidence of an association between MMR immunization and autistic spectrum disorders. The MMR vaccine is a mixture of live weakened viruses of the three diseases. The MMR vaccine was developed by Maurice Hilleman. It was licensed for use in the US by Merck in 1971. Stand-alone measles, mumps, and rubella vaccines had been previously licensed in 1963, 1967, and 1969, respectively. Recommendations for a second dose were introduced in 1989. The MMRV vaccine, which also covers chickenpox, may be used instead. An MR vaccine, without coverage for mumps, is also occasionally used.
Medical use
Cochrane concluded that the "Existing evidence on the safety and effectiveness of MMR and MMRV vaccine supports current policies of mass immunisation aimed at global measles eradication to reduce morbidity and mortality associated with measles mumps rubella and varicella." The combined MMR vaccine induces immunity less painfully than three separate injections at the same time, and sooner and more efficiently than three injections given on different dates. Public Health England reports that providing a single combined vaccine as of 1988, rather than giving the option to have them also done separately, increased uptake of the vaccine.
Measles
Before the widespread use of a vaccine against measles, rates of disease were so high that infection was felt to be "as inevitable as death and taxes." Reported cases of measles in the United States fell from hundreds of thousands to tens of thousands per year following introduction of the vaccine in 1963. Increasing uptake of the vaccine following outbreaks in 1971, and 1977, brought this down to thousands of cases per year in the 1980s. An outbreak of almost 30,000 cases in 1990 led to a renewed push for vaccination and the addition of a second vaccine to the recommended schedule. Fewer than 200 cases have been reported in the US each year between 1997 and 2013, and the disease is no longer considered endemic there. The benefit of measles vaccination in preventing illness, disability, and death has been well documented. The first 20 years of licensed measles vaccination in the US prevented an estimated 52 million cases of the disease, 17,400 cases of intellectual disability, and 5,200 deaths. During 1999–2004, a strategy led by the World Health Organization and UNICEF led to improvements in measles vaccination coverage that averted an estimated 1.4 million measles deaths worldwide. Between 2000 and 2018, measles vaccination resulted in a 73% decrease in deaths from the disease. Measles is common in many areas of the world. Although it was declared eliminated from the US in 2000, high rates of vaccination and good communication with people who refuse vaccination are needed to prevent outbreaks and sustain the elimination of measles in the US. Of the 66 cases of measles reported in the US in 2005, slightly over half were attributable to one unvaccinated individual who acquired measles during a visit to Romania. This individual returned to a community with many unvaccinated children. The resulting outbreak infected 34 people, mostly children and virtually all unvaccinated; 9% were hospitalized, and the cost of containing the outbreak was estimated at $167,685. A major epidemic was averted due to high rates of vaccination in the surrounding communities. In 2017, an outbreak of measles occurred among the Somali-American community in Minnesota, where MMR vaccination rates had declined due to the misconception that the vaccine could cause autism. The US Centers for Disease Control and Prevention recorded 65 affected children in the outbreak by April 2017.
Rubella
Rubella, also known as German measles, was also very common before widespread vaccination. The major risk of rubella is during pregnancy when the baby may contract congenital rubella, which can cause significant congenital defects.
Mumps Mumps is another viral disease that was once very common, especially during childhood. If mumps is acquired by a male who is past puberty, a possible complication is bilateral orchitis, which can in some cases lead to sterility.
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