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measles mumps and rubella vaccine, live (Rx)Brand and Other Names:M-M-R-II

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

measles virus/mumps virus/rubella virus

injection

  • ≥1000 TCID50/≥20000 TCID50/≥1000 TCID50

Immunization Against Measles, Mumps & Rubella

Adults born before 1957 are considered immune to measles and mumps; all adults born in 1957 or later should have documentation of 1 or more doses of MMR vaccine unless contraindicated, or laboratory evidence of immunity to each of the 3 diseases

19-49 years old: 0.5 mL SC; second dose may be administered 28 days apart

>50 years old: 0.5 mL SC; administer 1 dose only

2nd dose recommendations

  • Student in postsecondary eduction
  • Recent exposure
  • Occupational risk
  • Previously vaccinated with killed measles vaccine
  • Vaccinated with unknown type of measles vaccine during 1963-67
  • International travelers
  • Healthcare personnel should consider receiving 2 doses of MMR vaccine at the appropriate interval for measles and mumps or 1 dose of MMR vaccine for rubella

Immunization in Pregnancy

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

Pregnancy should be avoided for 28 days following vaccine administration

Vaccination Schedules

Up-to-date vaccination schedules available at www.cdc.gov/nip/publications

Immunization Against Measles, Mumps & Rubella

Routine vaccination: First dose of 0.5 mL SC between age 12-15 months; administer second dose between 4-6 yr

Minimum age for 1st dose is 12 months

International travel

  • 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 disease risk is high), and the second dose at least 4 weeks later
  • >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)
  • Minimum time between 1st and 2nd dose is 4 wk

Perinatal HIV infection

  • Revaccinate persons who were vaccinated before 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

Administration

Inject SC into outer aspect of upper arm

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Interactions

Interaction Checker

measles mumps and rubella vaccine, live and

No Results

     
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    Interactions Found

    Contraindicated

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        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967

            Frequency Not Defined

            Fever

            Syncope

            Ataxia

            Pain at site

            Headache

            Rash

            Lymphadenopathy

            Myalgia

            Stevens-Johnson syndrome

            Thrombocytopenia

            Optic neuritis

            Encephalitis

            Malaise

            Irritability

            Guillain-Barre synd

            Subacute sclerosing panencephalitis (rare)

            Seizures

            Parotitis

            Bronchospasm

            Leukocytosis

            Conjunctivitis

            Otitis media

            Nerve deafness

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            Warnings

            Contraindications

            Allergy to neomycin or gelatin

            Pregnancy

            HIV: CD4+ count <200 cells/mcL

            Severely immunocompromised patients

            Receiving imunosuppressive therapy other than corticosteroids or replacement therapy

            Current febrile respiratory illness or febrile infection

            Patients diagnosed with blood dyscrasias, leukemia, lymphomas or other malignant neoplasms

            Cautions

            Syncope accompanied by by transient visual disturbances reported with vaccines

            Pospone vaccination on patients with moderate to severe acute illness (with or without fever); may consider on patients with mild illness

            Use caution in patients with history of cerebral injuries, seizures, or conditioins where stress to fever should be avoided

            Measles vaccine may provide some protection if administered within 72 hr of exposure

            Rubella and mumps vaccine does not alter course of the disease following postexposure to either virus

            Postpone vaccination in patients with active untreated tuberculosis

            Immune globulins may interfere with immune response if administered recently or concurrently

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Uot known if measles and mumps excreted in breast milk; rubella is excreted in milk; use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Live, attenuated viruses stimulate active immunity to disease caused by measles, rubella, and mumps viruses

            Pharmacokinetics

            Duration: >15 years after 2 doses

            Onset: Active immunity detected after 1 dose

            Pharmacogenomics

            HLA-B7, HLA-B51, HLA-DRB1*13, and HLADQA1*01 is associated with a measles vaccine response

            Homozygosity at HLA-B, HLA-DR, and HLA-DQA1 has been associated with a measles vaccine nonresponse

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            Images

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
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            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
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