What is the MR vaccine?
Measles and Rubella vaccine together is called the MR vaccine.
What is the MMR Vaccine?
MMR vaccine has Measles, Mumps, and Rubella.
Updated 14th January 2023
This was not previously included in the Universal Immunization Programme(UIP) in India. Only Measles was included in UIP in the government sector. Now in the Revised National Immunization Programme Measles/MR is being given in a phased manner. This new MR drive aims to have Rubella too. So that eventually, MR, that is, measles and Rubella, will be a part of UIP. The MR vaccine drive aims to immunize 100% of at-risk children.
According to the Indian Association of Pediatrics (IAP), the MMR vaccine should be a part of all kid’s immunization programs after one-to-one discussions with parents.
Doses of MMR :
- Two doses with at least 4 weeks gap.
- As early as 9 months(IAP recommendation)
- The second dose must follow in the 2nd year of life. Can be given at any time, 4-8 weeks after the 1st dose.
- No need to give a stand-alone measles vaccine
- Maternal immunity is said to be there until 9 months.
Benefits of MMR :
Protection against, Measles, Mumps and Rubella.
Measles can cause:
Serious complications and death.
- Encephalitis
- SSPE(Subacute sclerosing panencephalitis) is a very serious long-term sequela
- Pneumonia
- Otitis media
- Diarrhea
Mumps can cause:
- Fever with painful parotid inflammation
- Brain infection(encephalitis)
- Infection of gonads(oophoritis/orchitis) can lead to sterility in pubertal kids.
Other complications of Mumps
- Pancreatitis
- Deafness
- Aseptic meningitis
Rubella can cause:
- Mild infection in adults.
- Most common presentation: Low-grade fever, Lymph node swelling, and malaise.
- Up to 50% infections may be subclinical.
Complications of Rubella infection :
- Encephalitis
- Thrombocytopenic purpura
The danger of Rubella infection :
Teratogenic infection in pregnant women. If infection occurs in unimmunized mothers in the first trimester, it can cause Congenital Rubella syndrome if the mother gets a Rubella infection in early pregnancy. These preconception tests are recommended to check for Rubella antibody levels.
- miscarriage
- stillbirth
- Birth defects include cataracts, hearing loss, mental retardation, and congenital heart defects.
Measles is very infectious. It is mainly transmitted from person to person by a cough and cold. Through large respiratory droplets. Transmission through aerosol for up to 2 hours after a person with measles occupied the area has been documented.
After exposure, 90% or more susceptible people can have measles. The virus is transmitted from 4 days before the rash becomes visible to 4 days after the rash appears.
The measles vaccine is now provided free in India’s Universal Immunisation Programme in all Government Immunization facilities.
About Measles vaccine
- Two doses
- 1st at 9 to 12 months
- Second, at 15 to 18 months
- At least four weeks gap between the two doses.
The second dose is not a booster. 2% and 5% of children don’t develop measles immunity after the first dose. The second dose of the measles vaccine aims to immunize those, not protected by the first dose.
In India, children are given the measles vaccine (MV) after nine months of age. Measles has serious mortality and morbidity stats.
Seroconversion for measles is lower in children receiving the first dose before or at 12 months of age. This is suspected to be due to persisting maternal antibodies. But even then, it is given as early as nine months because of the severe nature of the infection.
The rate of seroconversion with different ages of measles vaccination:
- 87% at nine months,
- 95% at 12 months
- 98% at 15 months
Infants who receive the measles vaccine before 12 months of age, should be given two additional doses of measles antigen-containing vaccine at 12-15 months and 4-6 yr of age(2,3).
Mumps is as infectious as Influenza and Rubella but less than measles or varicella.
2 Doses of mumps vaccine are needed for long-lasting protection(4)
RA27/3 vaccine for rubella is highly seroconverting. Immunity after a single dose is lifelong. But rubella antibodies may fall below detectable levels with time
The MR Vaccine Campaign: Why are they doing it?
Polio, Measles, and Rubella are three diseases that occur in humans. So if it’s controlled in humans, we have a great chance of eradication. On 5th February 2017, the Union Health Ministry launched the measles-rubella (MR) vaccination campaign in Bengaluru.
This campaign started in Karnataka, Tamil Nadu, Puducherry, Goa, and Lakshadweep. That’s about 3.6 crore children. Following the campaign, the measles-rubella vaccine will be introduced in routine universal immunization.
Kerala started the Measles-Rubella (MR) vaccine drive campaign in October of that year (part of National Immunisation Programme).
MR Vaccine campaign plan :
Children between 9 months and less than 15 years: a single shot of measles-rubella vaccination.
Will they need it even if they have earlier vaccinated against Measles and Rubella?
Yes, irrespective of their previous measles/rubella vaccination status or measles/rubella disease status this vaccine will be given.
How much will this cost?
MR vaccine will be free across the states. At school, health facilities.
Does the extra dose cause problems ?
The vaccine contains attenuated (non-virulent) viruses. If a child is already immune, the body will not respond to the extra dose.So the new MR in already vaccinated children is unnecessary, but harmless.
If a child has received no MMR vaccine previously, they should get the MR vaccine.
If a child has received 2 doses of MMR vaccine, with at least 4 weeks gap in between, then he/she need not take any further dose of MMR /MR. But the government recommends blanket coverage irrespective of earlier immunization status.
MMR was given only in the private healthcare sector. The private sector covers only 25% of children. So it makes administrative sense to try for universal coverage through this special drive.
Also read vaccine and immunity
FAQ:
1)If a child has no previous Measles vaccine, MMR vaccine: Child gets MR vaccine
2)If a child has a previous one dose of the measles vaccine: The child gets MR vaccine
3)If a child has one previous MMR Vaccine:
- The child needs the other dose of MMR vaccine for complete protection against mumps. Since two doses of the mumps vaccine are needed for adequate protection.
- The child gets the MR vaccine. The Government suggests blanket coverage. It will be an extra dose, but experts opine it is harmless.
4)The child is less than 15 years and has received all doses of the measles vaccine or MMR vaccine
- The child gets the MR vaccine. Again the Government suggests blanket coverage.
5.If it’s a girl child and has her periods, can she get the vaccine?
Yes, she can. Having periods is not a contraindication to receiving the MR vaccine.
6. If the Child has a history of a severe allergy to MMR or MR vaccine previously, what will the parents do?
In that case, the MR vaccine may be avoided in case of a history of allergy to previous doses.
7. Who doesn’t get the vaccine now?
Any seriously ill child hospitalized, unconscious, or has seizures will not be given this vaccine at the present time . Consult your doctor about this.
The Government aims to give immunization to schools, hospitals, and health centers. Proper vaccine chain, sterility, and infrastructure for managing any vaccine-related event must be adequately planned (especially in schools) to avoid MR Vaccine side effects and complications. The lack of drive awareness or poor planning should not cripple an otherwise great initiative.
For parents: Don’t forget to talk to your doctor before deciding.
Do you know about the MR vaccine? What’s your child’s immunization status? Comment below to let me know.
Healthwealthbridge Disclaimer health information provided on this blog is for general awareness and doesn’t in any way replace a doctor’s professional medical advice. Kindly consult your doctor in case of any decision regarding your health, and diet.
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Reader Query :
T K ANUJEE
Dr. Amrita, your article is very informative. I would like to know other than preventing diseases, does vaccination boost the immunity of children? if vaccination is aimed at boosting immunity, by announcing blanket MR, should we infer that the earlier MMR was futile? You have stated the experts opined the extra dose is” harmless”. Is it the same as taking one more roti for company’s sake, on a full stomach?
Our Answer
Vaccination does provide protection and improves the immunity of an adequately vaccinated person. But there are exceptions. Government health policy recommends the best practices. Blanket MR helps to avoid confusion and missed dose. Your pediatrician can help you decide accordingly. In cases like these, an inadvertent miss is more worrying than the extra dose.
Disclaimer:
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All information provided is for awareness and educational purposes. All immunization or health decisions should be taken after consultation.
Reference:
1)http://www.newindianexpress.com/nation/2017/feb/05/union-health-ministry-launches-vaccine-for-dual-protection-against-measles-rubella-1567286–1.html0
2)Mason WH. Measles. In: Kliegman RM, Behrman RE, Stanton BF, Jenson HB, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia Pa: Saunders Elsevier; 2007. pp. 1331–7.
3)Response to second dose of MMR vaccine in Indian children Sunil Gomber, Shilpa Khanna Arora, Shukla Das, and V. G. Ramachandran Pubmed
4) Antibody response to measles immunization in India J. S. Job, T. J. John, and A. Joseph Pubmed
6)FAQ about MR vaccine campaign
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hi mam…thanks for the information..my son is now 19 months..he got his 9 month n 24 month mmr vaccination. on last dec 22,2018 he was vaccinate 2nd mmr dose.. is it necesary to gv mr right now or after some months..please suggest me mam
As per Government policy, all children are recommended for immunization for MR .irrespective of previous vaccination status. Kindly consult Pediatrician for specifics. Thank you for visiting. Do subscribe to the blog for future updates.
I am extremely worried to hear a lot of controversies over the MR vaccine drive. I will surely check with my doctor about the same. Got a little relief by reading this post. Thanks a bunch, Amrita.
Hi Supriya, glad you found this useful. This post will be soon updated as this drive is now being rolled out in a lot of places.
Very educative post Amrita. Though both my kids have crossed this stage, I remember having given them MMR at age appropriate time. However its only today that I learnt about it at great length!
Thanks for sharing the info.
– Anagha From Team MocktailMommies
Good information. Will check with my peds doc, next time I visit them.
Loved his detailed information. To be frank this is the first time I am hearing about Rubella. I always get to learn something new form your blog 🙂
Dr amritha , your article is very informative. I would like to know other than preventing diseases, does vaccination boost the immunity of children? if vaccination is aimed at boosting the immunity , by announcing blanket MR, should we infer that the earlier MMR was futile? You have stated the experts opined the extra dose ” harmless”. Is it same as taking one more roti for company sake, on a full stomach?
Vaccination does provide protection and improves the immunity of an adequately vaccinated person.But there are exceptions.Government health policy recommends the best practices.Blanket MR helps to avoid confusion and missed dose .Your pediatrician can help you decide accordingly .In cases like these an inadvertent miss is more worrying than the extra dose.Hope this helps.Thank you for visiting.
Thanks Doc for such detailed information about the disease & its vaccine course. I have got this my little one as per her pead’s recommendation. Many people still think this is just a way of minting money by the hosp./doc. Hope this awareness spreads and all kids stay healthy against such diseases.
Thanks Dipika. Glad you found this useful.
As per the IAP recommendation, two doses of MMR should be given with at least 4 weeks gap. My child got the 1st dose of MMR only 15 days back, so is it required to have this MR vacccine now in MR vaccination drive?
According to IAP guidelines and best practices,the answer is No.But all decision has to be discussed with family pediatician.You are obviously a very motivated and aware parent.Thanks for visiting.
Hi Amrita,
So much interest in your post!
Thank you for bringing your post to the Blogger’s Pit Stop last week.
Janice, Pit Stop Crew
Thanks Janice
Thanks for sharing the detailed information and creating awareness about MR vaccine drive. I’m just curious to know that if any adult has never got these vaccines, then what they should do?
For women of child bearing age ,Rubella vaccine may be needed.You can get a Rubella Immunoglobulin G level done .If not adequate get immunized or get vaccinated at least 3 months before planning a baby.Rubella is extraordinarily simple appearing in adults and horrible in unborn child.Talking with your G&O can help in these cases.
So much great info about vaccines here!!! Getting your kids vaccinated is so important
Yes they are very important.
Vaccines are SO important to our individual health and therefore so important in our societies today, thanks for sharing science based info 🙂
Yes very important
This is very important vaccination information. I am sharing it with all my Mom friends because of its importance.
Beth || http://www.TheStyleBouquet.com
Thanks Beth
I had these immunizations as a child. My children also had them given. I can’t remember if this is the one they get a booster from when they are older but they got one for something as a young teen.
As long as they are protected.
This is such an informative post! Thanks for sharing this information. Nikki x
Thanks Nikki
This is a very important vaccination that everyone should have. I am glad you shared this and I am sharing to my fb page.
Thanks Nicole
This post is really helpful. I have to discuss this with my doctor.
Thanks Tasheena
Great tips on vaccines! Although I’m not big into taking them. I enjoy sticking with a super healthy lifestyle with the foods I eat that naturally fight off diseases and sickness, and I haven’t had any illnesses since then… yay for that!
http://www.imagineyourart.org
Thats a good way too,but not in India unfortunately.
Thanks Chanelle
This is important to get! I did wait until my daughter was older to get hers, just because I felt more comfortable that way, but she eventually got her two doses.
Good that she got her doses.
Immunizations is becoming more and more of a controversial topic. With some parents debating whether or not they should allow their child to receive vaccines and weighing the pros and cons.
Intersting point of view definitely.Unfortunately in India it can prove to be a difficult decision.
This comes at the perfect time for me Amrita! Just had a conversation with my little one’s doctor last week about the different vaccinations we need, what is necessary and when. I am glad you shared this as many parents, especially first time parents are not aware of when the shots are needed and in what intervals. This is excellent information I will be sharing on Pinterest for other first time moms.
Thanks Sheri .Glad you found this helpful.
I’m so happy that I came across your blog 🙂
Thanks for the information ????
Thanks Zainab
That was quite a detailed information and I’m so glad you shared it with everyone out there. It’s always good to take preventive measures.
Thanks Molly.
So much great info here!!! Vaccines are so important for our little ones!
Thanks
Very thorough post with lots of important information for parents. Glad to hear this is being done in India.
Thanks Ava.
Thanks for the information. Sounds like a critically important vaccine!
Yes it is
Wow Amrita, you did some thorough research there. I had no idea about these points. Keep spreading awareness. ????
Thanks for reading
Thank you for sharing this lady, My mother-in-law was just talking about different kind of vaccine and I had no idea how many vaccine there is. I am definitely gonna be doing my research.
Great Anna
Thanks for linking up Amrita
Rubella vaccine is must specially for the girl child as this brings handful of infections & woman are easily prone to rubella . Measles is common among Indian kids .thanks for sharing informative post
Thanks Dew
This is really helpful information for parents! I’ll have to remember to do my research on this stuff if I ever have kids.
Yes do research ????
Thanks a lot Amrita for this helpful post. Many doubts of parents like me who are confused will be cleared after reading this.
Thanks Deepa
Had no idea about the vaccine. Thanks for the info. Good to know.
Hope to spread awareness.