VACCINE INFORMATION
The MMR vaccine is a "3-in-1" vaccine that protects against measles, mumps, and rubella -- all of which are potentially serious diseases of childhood.

IMMUNIZATION SCHEDULE
The MMR is one of the recommended childhood immunizations. Generally, proof of MMR vaccination is required for school entry.

The first shot is recommended at 12-15 months. A second MMR is recommended prior to school entry at 4-6 years or prior to entry into junior high at 11-13 years. Some states require a second MMR at kindergarten entry.

Adults 18 years or older who were born after 1956 should also receive MMR if they are uncertain of their immunization status or if they have only had one MMR prior to school entry. Adults born during or prior to 1956 are presumed to be immune. Many people within that age group had the actual diseases during childhood.

BENEFITS
One MMR will protect the vast majority of individuals receiving the immunization from contracting measles, mumps, or rubella throughout their lives. The second MMR is recommended to cover those individuals who may not have received adequate protection from the first MMR.

Measles is a virus which causes a rash, cough, runny nose, eye irritation, and fever in most people, but can also lead to pneumonia, seizures, brain damage, and death in some cases.

Mumps virus causes fever, headache, and swollen glands, but can also lead to deafness, meningitis, swollen testicles or ovaries, and death in some cases.

Rubella, also known as the German Measles, is generally a mild disease, but can cause serious birth defects in the child of a woman who becomes infected while pregnant.

RISKS
Most people who receive the MMR will have no associated problems. Others may have minor problems, such as soreness and redness at the injection site or fevers. Serious problems associated with receiving the MMR are rare.

Potential mild to moderate adverse effects include:

• fever (1 in 6 children)
• rash (1 in 20)
• swollen glands (rare)
• seizure (1 in 3,000)
• joint pain/stiffness (1 in 4, usually young women)
• low platelet count/bleeding (1 in 30,000)

Severe adverse effects may include:

• allergic reaction (less than 1 per million)
• long-term seizure/brain damage/deafness (so rare that the association with the vaccine is questionable)

Despite considerable publicity, there is no evidence linking MMR vaccination with the development of autism. The Centers for Disease Control & Prevention (CDC) website provides extensive information on this matter.

The potential benefits from receiving the MMR vaccine far outweigh the potential adverse effects. Measles, mumps, and rubella are all very serious illnesses and each may have complications resulting in lifetime disabilities or even death.

The incidence of such complications, related to having the actual diseases, is far greater than the potential of developing serious, or even moderate, adverse effects due to the MMR vaccine.

DELAY OR DO NOT GIVE (CONTRAINDICATIONS)
If the child is ill, with something more serious than just a cold, immunization may be delayed. Health care providers need to be informed of any problems that may have occurred with the first MMR injection prior to receiving the second MMR.

MMR should not be given to individuals with:

• an allergy to gelatin or the antibiotic neomycin serious enough to require medical treatment
• an immune deficiency caused by cancer, leukemia, lymphoma, or HIV
• an immune deficiency caused by taking prednisone, other steroids, chemotherapy, radiation therapy, or other immunosuppressant drugs
• a woman who is, or possibly may become pregnant within the next few months

People who have received transfusions or other blood products (including gamma globulin) or who have had low platelet counts should discuss the proper timing of MMR vaccine with their physician.

POSTIMMUNIZATION SYMPTOMS AND CARE
Watch for and be familiar with how to care for a fever, arthralgia (joint pain/stiffness), minor gland enlargement/tenderness, or minor redness/soreness at the injection site. If a rash develops without other symptoms, no treatment is necessary, and it should resolve within several days.

CALL THE PRIMARY HEALTH CARE PROVIDER IF:

• uncertain if the MMR should be given, withheld, or delayed for a specific individual
• moderate or serious adverse effects are noted after an MMR injection
• other symptoms, not commonly associated with potential adverse effects of the MMR, develop
• for any questions or concerns related to MMR immunizations