CDC recommends that people get MMR vaccine to protect against measles, mumps, and rubella. Children should get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults should also be up to date on their MMR vaccination. Children may also get MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Who Should Get MMR Vaccine?

Children

CDC recommends all children get two doses of MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

Learn about MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Students at post-high school educational institutions

Students at post-high school educational institutions who do not have presumptive evidence of immunity need two doses of MMR vaccine, separated by at least 28 days.

Adults

Adults who do not have presumptive evidence of immunity should get at least one dose of MMR vaccine.

Certain adults may need 2 doses. Adults who are going to be in a setting that poses a high risk for measles or mumps transmission should make sure they have had two doses separated by at least 28 days. These adults include

• students at post-high school education institutions
• healthcare personnel
• international travelers

International travelers

People 6 months of age and older who will be traveling internationally should be protected against measles. Before any international travel—

• Infants 6 through 11 months of age should receive one dose of MMR vaccine. Infants who get one dose of MMR vaccine before their first birthday should get two more doses (one dose at 12 through 15 months of age and another dose separated by at least 28 days).
• Children 12 months of age and older should receive two doses of MMR vaccine, separated by at least 28 days.
• Teenagers and adults who do not have presumptive evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.

Healthcare personnel

Healthcare personnel should have documented presumptive evidence of immunity, according to the recommendations of the Advisory Committee on Immunization Practices. Healthcare personnel without evidence of immunity should get two doses of MMR vaccine, separated by at least 28 days.

Women of Childbearing Age

Women of childbearing age should check with their doctor to make sure they are vaccinated before they get pregnant. Women of childbearing age who are not pregnant and do not have presumptive evidence of immunity should get at least one dose of MMR vaccine.

It is safe for breastfeeding women to receive MMR vaccination. Breastfeeding does not interfere with the response to MMR vaccine, and the baby will not be affected by the vaccine through breast milk.

Groups at increased risk for mumps because of a mumps outbreak

During a mumps outbreak, public health authorities might recommend an additional dose of MMR vaccine for people who belong to groups at increased risk for getting mumps. These groups are usually those who are likely to have close contact, such as sharing sport equipment or drinks, kissing, or living in close quarters, with a person who has mumps. Your local public health authorities or institution will communicate to the groups at increased risk that they should receive this dose. If you already have two doses of MMR, it is not necessary to seek out vaccination unless you are part of this group.

Who Should Not Get MMR Vaccine?

Measles, Mumps, and Rubella (MMR) vaccine

Some people should not get MMR vaccine or should wait.

Tell your vaccine provider if the person getting the vaccine:

• Has any severe, life-threatening allergies. A person who has ever had a life-threatening allergic reaction after a dose of MMR vaccine, or has a severe allergy to any part of this vaccine, may be advised not to be vaccinated. Ask your health care provider if you want information about vaccine components.
• Is pregnant or thinks she might be pregnant. Pregnant women should wait to get MMR vaccine until after they are no longer pregnant. Women should avoid getting pregnant for at least 1 month after getting MMR vaccine.
• Has a weakened immune system due to disease (such as cancer or HIV/AIDS) or medical treatments (such as radiation, immunotherapy, steroids, or chemotherapy).
• Has a parent, brother, or sister with a history of immune system problems.
• Has ever had a condition that makes them bruise or bleed easily.
• Has recently had a blood transfusion or received other blood products. You might be advised to postpone MMR vaccination for 3 months or more.
• Has tuberculosis.
• Has gotten any other vaccines in the past 4 weeks. Live vaccines given too close together might not work as well.
• Is not feeling well. A mild illness, such as a cold, is usually not a reason to postpone a vaccination. Someone who is moderately or severely ill should probably wait. Your doctor can advise you.

Learn who should not get MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Who Does Not Need MMR Vaccine?

You do not need measles, mumps, and rubella (MMR) vaccine if you meet any of these criteria for presumptive evidence of immunity*:

• You have written documentation of adequate vaccination:
  • at least one dose of a measles, mumps, and rubella virus-containing vaccine administered on or after the first birthday for preschool-age children and adults not at high risk for exposure and transmission
  • two doses of measles and mumps virus-containing vaccine for school-age children and adults at high risk for exposure and transmission, including college students, healthcare personnel, international travelers, and groups at increased risk during outbreaks
• You have laboratory confirmation of past infection or had blood tests that show you are immune to measles, mumps, and rubella.
• You were born before 1957.**

If you do not have presumptive evidence of immunity against measles, mumps, and rubella, talk with your doctor about getting vaccinated. If you’re unsure whether you’ve been vaccinated, you should first try to find your vaccination records. If you do not have written documentation of MMR vaccine, you should get vaccinated. The MMR vaccine is safe, and there is no harm in getting another dose if you may already be immune to measles, mumps, or rubella.

If you received a measles vaccine in the 1960s, you may not need to be revaccinated. People who have documentation of receiving LIVE measles vaccine in the 1960s do not need to be revaccinated. People who were vaccinated prior to 1968 with either inactivated (killed) measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine. This recommendation is intended to protect those who may have received killed measles vaccine, which was available in 1963-1967 and was not effective.

*Except during a mumps outbreak. During a mumps outbreak public health authorities might recommend an additional dose of MMR vaccine for people who belong to groups at increased risk for getting mumps, regardless if they meet the criteria listed above.

**Birth before 1957 provides only presumptive evidence for measles, mumps, and rubella. Before vaccines were available, nearly everyone was infected with measles, mumps, and rubella viruses during childhood. The majority of people born before 1957 are likely to have been infected naturally and therefore are presumed to be protected against measles, mumps, and rubella. Healthcare personnel born before 1957 without laboratory evidence of immunity or disease should consider getting two doses of MMR vaccine.

How Well Does the MMR Vaccine Work?

MMR vaccine is very effective at protecting people against measles, mumps, and rubella, and preventing the complications caused by these diseases. People who receive MMR vaccination according to the U.S. vaccination schedule are usually considered protected for life against measles and rubella. While MMR provides effective protection against mumps for most people, immunity against mumps may decrease over time and some people may no longer be protected against mumps later in life. An additional dose may be needed if you are at risk because of a mumps outbreak.

One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella.

Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps.

MMR is an attenuated (weakened) live virus vaccine. This means that after injection, the viruses cause a harmless infection in the vaccinated person with very few, if any, symptoms before they are eliminated from the body. The person’s immune system fights the infection caused by these weakened viruses, and immunity (the body’s protection from the virus) develops.

Some people who get two doses of MMR vaccine may still get measles, mumps, or rubella if they are exposed to the viruses that cause these diseases. Experts aren’t sure why; it could be that their immune systems didn’t respond as well as they should have to the vaccine or their immune system’s ability to fight the infection decreased over time. However, disease symptoms are generally milder in vaccinated people.

• About 3 out of 100 people who get two doses of MMR vaccine will get measles if exposed to the virus. However, they are more likely to have a milder illness, and are also less likely to spread the disease to other people.
• Two doses of MMR vaccine are 88% (range 32% to 95%) effective at preventing mumps. Mumps outbreaks can still occur in highly vaccinated U.S. communities, particularly in settings where people have close, prolonged contact, such as universities and close-knit communities. During an outbreak, public health authorities may recommend an additional dose of MMR for people who belong to groups at increased risk for mumps. An additional dose can help improve protection against mumps disease and related complications.
• While there are not many studies available, most people who do not respond to the rubella component of the first MMR dose would be expected to respond to the second dose.

What is MMRV Vaccine?

MMRV vaccine protects against four diseases: measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children 12 months through 12 years of age.

CDC recommends that children get one dose of MMRV vaccine at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose of MMRV vaccine earlier than 4 through 6 years. This second dose of MMRV vaccine can be given 3 months after the first dose. A doctor can help parents decide whether to use this vaccine or MMR vaccine.

MMRV is given by shot and may be given at the same time as other vaccines.

Should You Get Vaccinated After Being Exposed to Measles, Mumps, or Rubella?

If you do not have immunity against measles, mumps, and rubella and are exposed to someone with one of these diseases, talk with your doctor about getting MMR vaccine. It is not harmful to get MMR vaccine after being exposed to measles, mumps, or rubella, and doing so may possibly prevent later disease.

If you get MMR vaccine within 72 hours of initially being exposed to measles, you may get some protection against the disease, or have milder illness. In other cases, you may be given a medicine called immunoglobulin (IG) within six days of being exposed to measles, to provide some protection against the disease, or have milder illness.

Unlike with measles, MMR has not been shown to be effective at preventing mumps or rubella in people already infected with the virus (i.e., post-exposure vaccination is not recommended).

During outbreaks of measles or mumps, everyone without presumptive evidence of immunity should be brought up to date on their MMR vaccination. And some people who are already up to date on their MMR vaccination may be recommended to get an additional dose of MMR for added protection against disease.

What are the Childcare and School Requirements for MMR Vaccine?

All 50 states and the District of Columbia (DC) have state laws that require children entering childcare or public schools to have certain vaccinations. There is no federal law that requires this.

The Advisory Committee on Immunization Practices recommends that all states require children entering childcare, and students starting school, college, and other postsecondary educational institutions to be up to date on MMR vaccination:

• 1 dose is recommended for preschool-aged children 12 months or older
• 2 doses are recommended for school-aged children in kindergarten through grade 12 as well as students attending colleges or other post-high school educational institutions

Measles is a very contagious disease caused by a virus. It spreads through the air when an infected person coughs or sneezes. Measles starts with a cough, runny nose, red eyes, and fever. Then a rash of tiny, red spots breaks out. It starts at the head and spreads to the rest of the body.

Measles can be prevented with MMR vaccine. The vaccine protects against three diseases: measles, mumps, and rubella. CDC recommends children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults should also be up to date on their MMR vaccination.

The MMR vaccine is very safe and effective. Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.

Children may also get MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Before the measles vaccination program started in 1963, an estimated 3 to 4 million people got measles each year in the United States. Of these, approximately 500,000 cases were reported each year to CDC; of these, 400 to 500 died, 48,000 were hospitalized, and 1,000 developed encephalitis (brain swelling) from measles. Since then, widespread use of measles virus-containing vaccine has led to a greater than 99% reduction in measles cases compared with the pre-vaccine era. However, measles is still common in other countries. Unvaccinated people continue to get measles while abroad and bring the disease into the United States and spread it to others.

CDC recommends that children get two doses of MMR vaccine:

• the first dose at 12 through 15 months of age, and
• the second dose at 4 through 6 years of age.

Teens and adults should also be up to date on MMR vaccinations.

Pre-vaccine era

In the 9th century, a Persian doctor published one of the first written accounts of measles disease.

Francis Home, a Scottish physician, demonstrated in 1757 that measles is caused by an infectious agent in the blood of patients.

In 1912, measles became a nationally notifiable disease in the United States, requiring U.S. healthcare providers and laboratories to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year.

In the decade before 1963 when a vaccine became available, nearly all children got measles by the time they were 15 years of age. It is estimated 3 to 4 million people in the United States were infected each year. Also each year, among reported cases, an estimated 400 to 500 people died, 48,000 were hospitalized, and 1,000 suffered encephalitis (swelling of the brain) from measles.

Vaccine development

In 1954, John F. Enders and Dr. Thomas C. Peebles collected blood samples from several ill students during a measles outbreak in Boston, Massachusetts. They wanted to isolate the measles virus in the student’s blood and create a measles vaccine. They succeeded in isolating measles in 13-year-old David Edmonston’s blood.

In 1963, John Enders and colleagues transformed their Edmonston-B strain of measles virus into a vaccine and licensed it in the United States. In 1968, an improved and even weaker measles vaccine, developed by Maurice Hilleman and colleagues, began to be distributed. This vaccine, called the Edmonston-Enders (formerly “Moraten”) strain has been the only measles vaccine used in the United States since 1968. Measles vaccine is usually combined with mumps and rubella (MMR), or combined with mumps, rubella and varicella (MMRV). Learn more about measles vaccine.

Measles elimination

In 1978, CDC set a goal to eliminate measles from the United States by 1982. Although this goal was not met, widespread use of measles vaccine drastically reduced the disease rates. By 1981, the number of reported measles cases was 80% less compared with the previous year. However, a 1989 measles outbreaks among vaccinated school-aged children prompted the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) to recommend a second dose of MMR vaccine for all children. Following widespread implementation of this recommendation and improvements in first-dose MMR vaccine coverage, reported measles cases declined even more.

Measles was declared eliminated (absence of continuous disease transmission for greater than 12 months) from the United States in 2000. This was thanks to a highly effective vaccination program in the United States, as well as better measles control in the Americas region. For more information, see Frequently Asked Questions about Measles in the U.S.

Two doses of the MMR vaccine are recommended for children by healthcare providers as the best way to protect against measles, mumps, and rubella.

When should my child get the MMR shot?

One dose at each of the following ages:

• 12 - 15 months
• 4 - 6 years

Before traveling to another country, infants 6 to 11 months should get 1 dose of the MMR shot.

Why should my child get the MMR shot?

• Protects your child from measles, a potentially serious disease, as well as mumps and rubella.
• Protects your child from getting an uncomfortable rash and high fever from measles.
• Keeps your child from missing school or child care and you from missing work.

The measles shot is safe.

The measles shot is very safe and is effective at preventing measles. Vaccines, like any medicine, can have side effects. These are usually mild and go away on their own.

There is no link between the MMR shot and autism.
Scientists in the United States and other countries have carefully studied the MMR shot. None has found a link between autism and the MMR shot.

What are the side effects of the shot?

Most children don’t have any side effects from the shot. The side effects that do occur are usually mild and may include:

• Soreness, redness, or swelling where the shot was given
• Fever
• Mild rash
• Temporary pain and stiffness in the joints

More serious side effects are rare. These may include high fever that could cause a seizure.

What is measles?

• Measles is a serious respiratory disease (in the lungs and breathing tubes)
• It causes a rash and fever.
• It is very contagious.
• In rare cases, it can be deadly.

What are the symptoms of measles?

Measles starts with a fever that can get very high. Some of the other symptoms that may occur are:

• Cough, runny nose, and red eyes
• Rash of tiny, red spots that start at the head and spread to the rest of the body
• Diarrhea
• Ear infection

Is measles serious?

Measles can be dangerous, especially for babies and young children.

For some children, measles can lead to:

• Pneumonia (a serious lung infection)
• Lifelong brain damage
• Deafness
• Death

 How does measles spread?

• Measles spreads when a person infected with the measles virus breathes, coughs, or sneezes.
• It is very contagious.
• You can catch measles just by being in a room where a person with measles has been, up to 2 hours after that person is gone.
• And you can catch measles from an infected person even before they have a measles rash.

Almost everyone who has not had the MMR shot will get measles if they are exposed to the measles virus.

Is measles in the United States?

Every year, unvaccinated U.S. residents get measles while they are abroad and bring the disease into the United States and spread it to others.

Measles is common in other parts of the world, including countries in Europe, Asia, the Pacific Islands, and Africa. When people with measles travel into the United States, they can spread the disease to unvaccinated people including children too young to be vaccinated.

How many measles cases are there in the United States each year?

From year to year, measles cases can range from roughly less than 100 to a couple hundred.

However, in some years, there were more measles cases than usual. In 2019, 1282 people from 31 states were reported as having measles. These measles outbreaks are a key reminder of how quickly diseases can spread when children aren’t vaccinated. Most of these people got measles in the United States after being exposed to someone who got measles while in another country.

Mumps is a contagious disease that is caused by a virus. Mumps typically starts with fever, headache, muscle aches, tiredness, and loss of appetite. Then, most people will have swelling of their salivary glands (often referred to as parotitis when the parotid gland, in front and below the ear, swells). This is what causes the puffy cheeks and a tender, swollen jaw.

Mumps can be prevented with MMR vaccine. This protects against three diseases: measles, mumps, and rubella. CDC recommends children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults also should also be up to date on their MMR vaccination.

MMR vaccine is very safe and effective. The mumps component of the MMR vaccine is about 88% (range: 32-95%) effective when a person gets two doses; one dose is about 78% (range: 49%−92%) effective.

Children may also get MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Before the U.S. mumps vaccination program started in 1967, mumps was a universal disease of childhood. Since the pre-vaccine era, there has been a more than 99% decrease in mumps cases in the United States. Mumps outbreaks can still occur in highly vaccinated U.S. communities, particularly in settings where people have close, prolonged contact, such as universities and close-knit communities. However, high vaccination coverage helps to limit the size, duration, and spread of mumps outbreaks. In the event of an outbreak, public health authorities may recommend that people at increased risk for mumps get a third dose of MMR or MMRV vaccine to improve their protection against the disease.

CDC recommends that children get two doses of MMR vaccine:

• the first dose at 12 through 15 months of age, and
• the second dose at 4 through 6 years of age.

Teens and adults should also be up to date on MMR vaccinations.

Mumps is an acute viral illness. Parotitis and orchitis were described by Hippocrates in the 5th century BCE. In 1934, Claud Johnson and Ernest Goodpasture showed that mumps could be transmitted from infected patients to rhesus monkeys and demonstrated that mumps was caused by a filterable agent present in saliva. This agent was shown to be a virus in 1935. Mumps was one of the most common causes of aseptic meningitis and sensorineural hearing loss in childhood in the United States until the introduction of a vaccine in 1967. In 1971, mumps vaccine was licensed in the United States as a combined measles, mumps, and rubella (MMR) vaccine. In 2005, a combination measles, mumps, rubella, and varicella (MMRV) vaccine was licensed.

During World War I, only influenza and gonorrhea were more common than mumps as causes of hospitalization among soldiers. A successful 2-dose vaccination program in the United States led to a greater than 99% reduction in the number of mumps cases reported annually. However, starting in 2006, there has been an increase in mumps cases and outbreaks, particularly in close-contact settings, with many occurring among fully vaccinated persons.

Quick facts

• Acute viral illness
• Parotitis and orchitis described by Hippocrates in 5th century BCE
• Viral etiology described by Johnson and Goodpasture in 1934
• Before vaccine, one of the most common causes of aseptic meningitis and hearing loss among children and hospitalization among military
• Vaccination led to over 99% reduction in mumps cases

Two doses of the MMR shot are recommended for children by doctors as the best way to protect against measles, mumps, and rubella.

When should my child get the MMR shot?

One dose at each of the following ages:

• 12 – 15 months
• 4 – 6 years

Before traveling to another country, infants 6 to 11 months should get 1 dose of the MMR shot.

Why should my child get the MMR shot?

• Protects your child from mumps, a potentially serious disease, as well as measles and rubella.
• Protects your child from getting a fever and swollen glands under the ears or jaw from mumps.
• Keeps your child from missing school or childcare and you from missing work.

Almost everyone who has not had the MMR shot will get mumps if they are exposed to the mumps virus.

The MMR shot is safe.

The MMR shot is very safe, and is effective at preventing mumps. Vaccines like a medicine, can have side effects. These are usually mild and go away on their own.

There is no link between the MMR shot and autism.
Scientists in the United States and other countries have carefully studied the MMR shot. None has found a link between autism and the MMR shot.

What are the side effects of the shot?

Most children don’t have any side effects from the shot. The side effects that do occur are usually mild, and may include:

• Soreness, redness, or swelling where the shot was given
• Fever
• Mild rash
• Temporary pain and stiffness in the joints

More serious side effects are rare. These may include high fever that could cause a seizure.

What is mumps?

Mumps is best known for the puffy cheeks and swollen jaw that it causes.

Mumps spreads easily through coughing and sneezing. There is no treatment for mumps, and it can cause long-term health problems.

What are the symptoms of mumps?

Mumps usually causes the following symptoms for about 7 to 10 days:

• Fever
• Headache
• Musc­­le aches
• Tiredness
• Loss of appetite (not wanting to eat)
• Swollen glands under the ears or jaw

Some people who get mumps do not have symptoms. Others may feel sick but will not have swollen glands.

Is it serious?

Mumps can be dangerous. Before there was a vaccine, mumps was one of the most common causes of deafness and meningitis. Mumps can also lead to encephalitis.

In most children, mumps is pretty mild. But it can cause serious, sometimes lasting problems, including:

• Meningitis (swelling of the tissue covering the brain and spinal cord)
• Deafness (temporary or permanent)
• Encephalitis (swelling of the brain)
• Orchitis (swelling of the testicles) in males who have reached puberty
• Oophoritis (swelling of the ovaries) and/or mastitis (swelling of the breasts) in females who have reached puberty

In rare cases, mumps is deadly.

How does mumps spread?

Mumps is a contagious disease caused by a virus. It spreads through direct contact with saliva or respiratory droplets from the mouth, nose, or throat. An infected person can spread the virus by

• coughing, sneezing, or talking
• sharing items that may have saliva on them, such as water bottles or cups
• participating in close-contact activities with others, such as playing sports, dancing, or kissing
• touching objects or surfaces with unwashed hands that are then touched by others

An infected person can likely spread mumps from two days before their salivary glands begin to swell to up to five days after the swelling begins. A person with mumps should limit their contact with others during this time. For example, stay home from school and do not attend social events.

Rubella is a contagious disease caused by a virus. It is also called German measles, but it is caused by a different virus than measles. Most people who get rubella usually have mild illness, with symptoms that can include a low-grade fever, sore throat, and a rash that starts on the face and spreads to the rest of the body. Some people may also have a headache, pink eye, and general discomfort before the rash appears. Rubella can cause a miscarriage or serious birth defects in an unborn baby if a woman is infected while she is pregnant.

Rubella can be prevented with MMR vaccine. This protects against three diseases: measles, mumps, and rubella. CDC recommends children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults also should also be up to date on their MMR vaccination.

MMR vaccine is very safe and effective. One dose of the MMR vaccine is about 97% effective at preventing rubella.

Children may also get MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Before the availability of rubella vaccines in the United States, rubella was a common disease that occurred primarily among young children. The last major epidemic in the United States occurred during 1964 to 1965, when there was an estimated 12.5 million rubella cases in the United States. Because of successful vaccination programs, rubella has been eliminated from the United States since 2004. However, rubella is still common in other countries. Unvaccinated people can get rubella while abroad and bring the disease to the United States and spread it to others.

CDC recommends that children get two doses of MMR vaccine:

• the first dose at 12 through 15 months of age, and
• the second dose at 4 through 6 years of age.

Teens and adults should also be up to date on MMR vaccinations.

The name rubella is derived from Latin, meaning “little red.” Rubella was initially considered to be a variant of measles or scarlet fever. It was not until 1814 that it was first described as a separate disease in the German medical literature, hence the common name “German measles.” In 1914, Alfred F. Hess postulated a viral etiology based on his work with monkeys. Following a widespread epidemic of rubella infection in 1940, Norman Gregg, an Australian ophthalmologist, reported in 1941 the occurrence of congenital cataracts among infants born following maternal rubella. This was the first published recognition of congenital rubella syndrome (CRS). Rubella virus was first isolated in 1962 by two independent groups, Paul D. Parkman and colleagues and Thomas H. Weller and Franklin A. Neva. The first rubella vaccines were licensed in 1969. In 1971, a combined measles, mumps, and rubella (MMR) vaccine was licensed for use in the United States. In 2005, a combination measles, mumps, rubella, and varicella (MMRV) vaccine was licensed.

Quick facts

• Initially thought to be variant of measles or scarlet fever
• First described as distinct disease in German literature in 1814 (hence “German measles”)
• Congenital rubella syndrome (CRS) first described 1941
• Rubella virus isolated in 1962

Two doses of the MMR shot (measles, mumps, and rubella) are recommended for children by doctors as the best way to protect against rubella.

When should my child get the MMR shot?

One dose at each of the following ages:

• 12 – 15 months
• 4 – 6 years

Before traveling to another country, infants 6 to 11 months should get 1 dose of the MMR shot.

Why should my child get the rubella shot?

• Protects your child from rubella, a potentially serious disease, as well as measles and mumps.
• Prevents your child from spreading rubella to a pregnant woman whose unborn baby could develop serious birth defects or die if the mother gets rubella.
• Prevents your child from getting a rash and fever from rubella.
• Keeps your child from missing school or childcare and you from missing work to care for your sick child.

The MMR shot is safe.

The MMR shot is very safe, and is effective at preventing rubella. Vaccines like a medicine, can have side effects. These are usually mild and go away on their own.

There is no link between the MMR shot and autism.
Scientists in the United States and other countries have carefully studied the MMR shot. None has found a link between autism and the MMR shot.

What are the side effects of the shot?

Most children don’t have any side effects from the shot. The side effects that do occur are usually very mild, and may include:

• Fever
• Soreness, redness, or swelling where the shot was given
• Temporary pain and stiffness in the joints (mostly in teens and adults)
• Mild rash

More serious side effects are rare. These may include high fever that could cause a seizure.

What is rubella?

Rubella, sometimes called “German measles,” is a disease caused by a virus. The infection is usually mild with fever and a rash.

Are you planning a pregnancy?

Even before becoming pregnant, make sure you are up to date on all your vaccines. If you aren’t up to date, you’ll need the MMR vaccine before you get pregnant.

Infection during pregnancy can cause miscarriage, or birth defects like deafness, blindness, intellectual disability, heart defects, and liver or spleen damage.

If you are not up to date on MMR vaccine, but you are already pregnant, consult your healthcare provider about ways to reduce your risk of exposure to rubella.

What are the symptoms of rubella?

In children, rubella usually causes the following symptoms that last 2 or 3 days:

• Rash that starts on the face and spreads to the rest of the body
• Low fever (less than 101 degrees)

Before the rash appears, older children and adults may also have:

• Swollen glands
• Cough, runny nose, and redness or swelling of the white of the eye
• Aching joints (especially in young women)

About half of the people who get rubella do not have symptoms.

Is rubella serious?

Rubella is usually mild in children. Complications are not common, but they occur more often in adults. In rare cases, rubella can cause serious problems, including brain infections and bleeding problems.

How does rubella spread?

Rubella spreads when an infected person coughs or sneezes and touches objects or surfaces with unwashed hands.

The disease is most contagious when the infected person has a rash. But it can spread up to 7 days before the rash appears and up to 7 days after. People without symptoms can still spread rubella.

Rubella is rare in the United States but can be brought to the U.S. by travelers.

Measles, Mumps, and Rubella Diseases and How to Protect Against Them

Measles causes fever, rash, cough, runny nose, and red, watery eyes. Complications can include ear infection, diarrhea, pneumonia, brain damage, and death.

Mumps causes fever, headache, muscle aches, tiredness, loss of appetite, and swollen salivary glands. Complications can include swelling of the testicles or ovaries, deafness, inflammation of the brain and/or tissue covering the brain and spinal cord (encephalitis/meningitis) and, rarely, death.

Rubella, causes fever, sore throat, rash, headache, and red, itchy eyes. If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects.

You can protect against these diseases with safe, effective vaccination.

MMR Vaccine Side Effects

The MMR vaccine is very safe, and it is effective at preventing measles, mumps, and rubella. Vaccines, like any medicine, can have side effects. Most people who get MMR vaccine do not have any serious problems with it. Getting MMR vaccine is much safer than getting measles, mumps or rubella.

Common Side Effects of MMR Vaccine

• Sore arm from the shot
• Fever
• Mild rash
• Temporary pain and stiffness in the joints, mostly in teenage or adult women who did not already have immunity to the rubella component of the vaccine

MMR vaccine has been linked with a very small risk of febrile seizures (seizures or jerking caused by fever). Febrile seizures following MMR are rare and are not associated with any long-term effects. Because the risk of febrile seizures increases as infants get older, it is recommended that they get vaccinated as soon as recommended.

Some people may experience swelling in the cheeks or neck. MMR vaccine rarely causes a temporary low platelet count, which can cause a bleeding disorder that usually goes away without treatment and is not life threatening.

Extremely rarely, a person may have a serious allergic reaction to MMR vaccine. Anyone who has ever had a life-threatening allergic reaction to the antibiotic neomycin, or any other component of MMR vaccine, should not get the vaccine.

A Closer Look at the Safety Data

• Two recent studies (Rowhani-Rahbar et al, 2013; Klein et al, 2010) indicate that for every 10,000 children who get their first MMR and varicella vaccines as separate shots when they are 12-23 months old, about four will have a febrile seizure during the 7-10 days following vaccination. Children of the same age who get the combined measles, mumps, rubella and varicella (MMRV) vaccine as their first vaccine against these diseases are twice as likely to have a febrile seizure during the same time period.
• Studies have shown that for children younger than 7 years old, there is a very small increased risk of febrile seizures approximately 6 to 14 days after MMR vaccination; this happens in about 1 in 3,000 to 4,000 children.
• Joint pain is associated with the rubella portion of MMR vaccine among people who do not have immunity to rubella. Joint pain and temporary arthritis happen more often after MMR vaccination in adults than in children. Women also experience this reaction more often than men. Joint pain or stiffness occurs in up to 1 in 4 of females past puberty who were not previously immune to rubella; their symptoms generally begin 1 to 3 weeks after vaccination, are usually mild and last about 2 days. These symptoms rarely come back.
• Immune thrombocytopenic purpura (ITP) is a disorder that decreases the body’s ability to stop bleeding. It can happen after both natural measles infection as well as after getting the MMR vaccine. However, it is usually not life threating. Treatment may include blood transfusion and medications. The risk of ITP has been shown to be increased in the six weeks following an MMR vaccination, with one study estimating 1 case per 40,000 vaccinated children.
• Measles inclusion body encephalitis, or severe brain swelling caused by the measles virus, is a complication of getting infected with the wild-type measles virus. While rare, this disorder almost always happens in patients with weakened immune systems. The illness usually develops within 1 year after initial measles infection and has a high death rate. There have been three published reports of this complication happening to vaccinated people. In these cases, encephalitis developed between 4 and 9 months after MMR vaccination. In one case, the measles vaccine strain was identified as the cause.
• Some parents might worry that the vaccine causes autism. Signs of autism typically appear around the same time that children are recommended to receive the MMR vaccine. Vaccine safety experts, including experts at CDC and the American Academy of Pediatrics (AAP), agree that MMR vaccine is not responsible for increases in the number of children with autism. Read more about vaccines and autism.

Early vaccination is important to prevent diseases

Vaccines are the best defense against infections that may have serious complications such as pneumonia, meningitis, cancer, and even death. CDC recommends vaccinations before the age of two years to protect children against 14 infectious diseases: measles, mumps, rubella (German measles), varicella (chickenpox), hepatitis A, hepatitis B, diphtheria, tetanus, pertussis (whooping cough), Haemophilus influenzae Type b (Hib), polio, influenza (flu), rotavirus, and pneumococcal disease.

Children are given shots (vaccines) at a young age because this is when they are at highest risk of getting sick or dying if they get these diseases. Newborn babies are immune to some diseases because they have antibodies they get from their mothers, usually before they are born. However, this immunity lasts a few months. Most babies do not get protective antibodies against diphtheria, whooping cough, polio, tetanus, hepatitis B, or Hib from their mothers. This is why it’s important to vaccinate a child before she or he is exposed to a disease.

Vaccines contain weakened or killed versions of the germs that cause a disease. These elements of vaccines, and other molecules and micro-organisms that stimulate the immune system, are called “antigens.” Babies are exposed to thousands of germs and other antigens in the environment from the time they are born. When a baby is born, his or her immune system is ready to respond to the many antigens in the environment and the selected antigens in vaccines.

Different childhood vaccines can be given at the same time.

Many vaccines are recommended early in life to protect young children from dangerous infectious diseases. In order to reduce the number of shots a child receives in a doctor’s visit, some vaccines are offered as combination vaccines. A combination vaccine is two or more different vaccines that have been combined into a single shot. Combination vaccines have been in use in the United States since the mid-1940s. Examples of combination vaccines are: DTap (diphtheria-tetanus-pertussis), trivalent IPV (three strains of inactivated polio vaccine), MMR (measles-mumps-rubella), DTap-Hib, and Hib-Hep B.

Often, more than one shot will be given during the same doctor’s visit, usually in separate limbs (e.g. one in each arm). For example, a baby might get DTaP in one arm or leg and IPV in another arm or leg during the same visit.

Giving a child several vaccines during the same visit offers two advantages.

First, children should be given their vaccines as quickly as possible to give them protection during the vulnerable early months of their lives. Second, giving several shots at the same time means fewer office visits. This saves parents time and money, and can be less traumatic for the child.

Getting multiple vaccines at the same time has been shown to be safe.

Scientific data show that getting several vaccines at the same time does not cause any chronic health problems. A number of studies have been done to look at the effects of giving various combinations of vaccines, and when every new vaccine is licensed, it has been tested along with the vaccines already recommended for a particular aged child. The recommended vaccines have been shown to be as effective in combination as they are individually. Sometimes, certain combinations of vaccines given together can cause fever, and occasionally febrile seizures; these are temporary and do not cause any lasting damage. Based on this information, both the Advisory Committee on Immunization Practices and the American Academy of Pediatrics recommend getting all routine childhood vaccines on time.

CDC’s recommended childhood vaccine schedule ensures children get the best protection during the many different stages in growth and development.

From the moment babies are born, they are exposed to numerous bacteria and viruses on a daily basis. Eating food introduces new bacteria into the body; numerous bacteria live in the mouth and nose; and an infant places his or her hands or other objects in his or her mouth hundreds of times every hour, exposing the immune system to still more germs. When a child has a cold, he or she is exposed to up to 10 antigens, and exposure to “strep throat” is about 25 to 50 antigens. Each vaccine in the childhood vaccination schedule has between 1-69 antigens. A child who receives all the recommended vaccines in the 2018 childhood immunization schedule may be exposed to up to 320 antigens through vaccination by the age of 2.

In fact, a 1994 report from the Institute of Medicine, Adverse Events Associated with Childhood Vaccines, states: “In the face of these normal events, it seems unlikely that the number of separate antigens contained in childhood vaccines …would represent an appreciable added burden on the immune system that would be immunosuppressive.”

Measles is one of the most contagious respiratory diseases in the world that has the potential to be life-threatening. It is caused by a virus and is still common in many countries.

Vaccines approved by the U.S. Food and Drug Administration for the prevention of measles are proven both safe and effective. Most people who get the recommended two doses of a vaccine to prevent measles will have lifelong protection and will never get sick with measles, even if they’re exposed to the virus.

Still, outbreaks in the U.S. continue to occur. One main reason is an increase in measles incidence globally, resulting in unvaccinated people abroad being exposed to the virus and bringing it to the U.S. Another is because of the spread of measles in communities that include unvaccinated people.

According to the Centers for Disease Control and Prevention, before the U.S. measles vaccination program started in 1963, about 3 million to 4 million people nationwide got measles each year. Of those, 400 to 500 people died, 48,000 were hospitalized, and 1,000 developed encephalitis (swelling of the brain) because of measles yearly. In the U.S., widespread use of the vaccine has led to a 99% reduction in measles cases compared with before the vaccination program began.

Those who are particularly at risk for measles are people who cannot get vaccinated because they are too young or have certain health conditions. After an infected person leaves a location, the virus can remain in the air and on surfaces for up to two hours and infect other people. Measles spreads so easily that if one person has it, 90% of the people close to that person who are not vaccinated or otherwise immune will also become infected.

Measles, along with mumps and rubella (German measles), can be prevented with the Measles, Mumps, and Rubella Virus Vaccine Live (MMR). The FDA has approved two vaccines, M-M-R II and Priorix, for use in people ages 12 months and older. Children ages 12 months through 12 years may also get the Measles, Mumps, Rubella and Varicella Virus Vaccine Live (ProQuad, also called MMRV). This FDA-approved vaccine also prevents chickenpox. All these vaccines are safe and highly effective.

The CDC recommends that children get two doses of the MMR vaccine, starting with the first dose at age 12 through 15 months, and the second dose at ages 4 to 6 years. Alternatively, for those who receive ProQuad instead of MMR, the CDC recommends that children get one dose of ProQuad vaccine at 12 to 15 months of age, and the second dose at ages 4 to 6 years. A health care provider can help you decide whether to get the MMR vaccine or ProQuad.

Vaccines that Prevent Measles Are Safe and Effective

The FDA plays a vital role in ensuring the safety and effectiveness of all vaccines approved for use in the U.S., including those that prevent measles.

FDA-approved vaccines to prevent measles are safe and effective. Before each vaccine’s approval, data from animal studies and from clinical trials in humans were evaluated by FDA scientists and doctors. Like many medical products, vaccines that prevent measles have known potential side effects. But those are generally mild and short-lived, such as rash and fever.

The FDA pays careful attention in evaluating the quality of raw materials and other ingredients used to make vaccines, the production process, and the methods and procedures for assessing their safety and effectiveness.

The bottom line is that there are safe and effective vaccines that provide lasting protection against measles. These vaccines contain live but weakened versions of the measles virus, triggering your immune system to produce antibodies against the virus without causing you to contract the illness. Should you be exposed to the actual measles virus, those antibodies will protect you against the disease.

Some people are concerned that autism may be linked to the MMR vaccine or other childhood vaccines. This has been refuted. Several organizations in addition to the CDC — including the World Health Organization, the Institute of Medicine (now known as the National Academy of Medicine), and the American Academy of Pediatrics — have conducted multiple studies. All those studies failed to show a causal relationship between vaccines and autism. In fact, one of the largest studies to date, published in March 2019, provided further evidence of MMR vaccine safety, concluding that the vaccine does not increase the risk of autism, or trigger autism in susceptible children.

Who Should Get a Vaccine to Prevent Measles

Measles is caused by the rubeola virus. It spreads through the air when an infected person coughs or sneezes. Measles starts with a fever, cough, runny nose, red eyes and sore throat. Soon after, a rash of tiny, red spots breaks out. It starts at the head and spreads to the rest of the body. If you have those symptoms, see your health care provider for an evaluation.

Measles is not a harmless childhood disease. It’s dangerous and can be life-threatening. Complications include ear infection, diarrhea, brain damage, pneumonia, and death. According to the CDC, of children with measles:

• 1 in every 20 will get pneumonia.
• 1 in 1,000 will develop brain swelling.
• 1 to 3 in 1,000 will die.

Teenagers and adults should also be up-to-date on their vaccines to prevent measles, the CDC recommends.

If you’re not vaccinated, it’s very easy to get infected with measles. People who contract measles are contagious for about eight days: four days before they show any signs of the virus, such as a rash, and four days after they develop symptoms. So, someone with measles might be infecting others without knowing they are sick, and they can be contagious long before they have a measles diagnosis.

Measles typically strikes children but can infect all age groups. Children younger than 5 years and adults older than 20 years are more likely to suffer from measles complications.
Vaccines to prevent measles not only protect children but also other people who can’t be vaccinated, including:

• Young infants.
• People with weakened immune systems caused by illness, such as cancer patients receiving chemotherapy.

Measles Is a Preventable Disease

There’s no specific treatment for measles. Health care providers can help measles patients by relieving their symptoms and addressing complications, such as bacterial infections.

The most effective measure against measles is prevention through vaccination.