What does MMR mean?

MMR stands for measles, mumps and rubella. These are three different diseases which are caused by three different viruses. The vaccines used to immunise against measles, mumps and rubella are all combined into one injection - the MMR vaccine.

Even if you think your child has already had one of these diseases, your child should still have MMR immunisation.

Timetable for measles, mumps and rubella immunisation

• The first dose of vaccine is usually given between 12 and 13 months. It is usually given at the same time as the Hib/MenC vaccine - this stands for 'Haemophilus influenzae type b/meningitis C' and the pneumoccocal vaccine (given as separate injections).
• A second dose is usually given at age 3 years and 4 months to 5 years at the same time as the DTaP/IPV(polio) injection - this stands for 'diphtheria, tetanus, pertussis (whooping cough)/polio' (given as a separate injection).

Even if a dose of MMR is delayed for any reason it can still be given at a later age. If necessary, MMR vaccine can be given at any age.

Are there any side-effects?

Most children are perfectly well after having a dose of MMR vaccine. However:

• Some children develop a mild fever (temperature) and a faint rash 7-10 days later. This should only last for 2-3 days and is of no concern.
• A few children develop a mild swollen face (like a mild form of mumps) about three weeks later. Any swelling will gradually go down.

Neither of these reactions is infectious nor serious. If necessary, you can give paracetamol or ibuprofen to ease pain and fever. Serious reactions are very rare. Any reaction to the vaccine is much less after the second vaccine is given.

The MMR vaccine should not be given if you are pregnant. It is safe to give if you are breast-feeding though. It is also safe to give if you are allergic to eggs.

MMR, autism and inflammatory bowel disease

In the past, there was been speculation that the MMR vaccine may somehow cause autism or inflammatory bowel disease. Recent large studies have all concluded that there is no evidence to link MMR immunisation to either of these conditions.

How serious are the illnesses prevented?

Measles

This is a highly infectious illness caused by the measles virus. Beginning like a bad cold, the child then develops a fever and a rash. The child feels miserable and may be unwell for a week or so with a bad cough and a high temperature. Complications occur in about 1 in 15 children with measles.

Measles is much more serious than many people think. In fact, of all childhood infections, it is the one most likely to cause the complication of encephalitis (inflammation of the brain), sometimes resulting in brain damage. It can also cause convulsions, ear infections, bronchitis and pneumonia, which can lead to long-term lung problems. Each year a number of children die from measles. In developing countries it is a major cause of childhood death. Unfortunately, measles is becoming more common again in children in some areas of the UK. This is due to some children not receiving the MMR vaccine.

Mumps

This infection typically causes inflammation and swelling of the glands around the face, neck and jaw. It is usually a mild illness but complications occur in some children, such as pancreatitis (inflammation of the pancreas), orchitis (inflammation of the testes), meningitis and encephalitis (inflammation of the brain). Mumps may cause permanent deafness in one ear. Mumps is equally dangerous for boys and girls.

There has been a marked increase in mumps cases since 2003 in the UK. This is because some children did not receive the two doses of the vaccine, or even never received it.

Rubella (German measles)

This is usually a mild illness causing a rash, sore throat and swollen glands. However, if a pregnant women has rubella, the virus is likely to cause serious damage to the unborn child. Rubella can lead to damage to the heart, brain, hearing and sight. The baby is likely to be born with a very serious condition called the congenital rubella syndrome. Since rubella immunisation was introduced in 1970 there has been a dramatic fall in the number of babies born with the congenital rubella syndrome.

Further information

Information on immunisation from the NHS

Web: www.nhs.uk/Planners/vaccinations/Pages/Vaccinationchecklist.aspx

Rubella and MMR

Web: www.sense.org.uk/what_is_deafblindness/rubella_mmr/
Information from Sense about rubella, congenital rubella syndrome, and immunisation against rubella. Sense was founded in 1955 as a support group for the parents of children born deafblind as a result of their mothers catching rubella in pregnancy.

References

• Immunisation against infectious disease - 'The Green Book', Dept of Health (various dates)
• McIntyre P, Leask J; Improving uptake of MMR vaccine. BMJ. 2008 Apr 5;336(7647):729-30. Epub 2008 Feb 28.
• Routine childhood immunisations from November 2010, Dept of Health