Pediatrics

MMR vaccination (measles, mumps, rubella)

definition

The MMR vaccine is a live attenuated vaccine and consists of a mixture of a mumps, measles, and rubella vaccine.

These each contain the virus that is weakened in its strength (virulence). The vaccine has existed since the 1970s and is injected either into the muscle (intramuscular) or under the skin (subcutaneous) into the adipose tissue.

This vaccination then causes a non-communicable infection with mumps, measles and rubella that is usually not noticed by the vaccinated person. The vaccination usually triggers a lifelong vaccination reaction of the immune system, so that the dreaded disease complications do not arise in the event of renewed contact with the pathogen.

When should vaccinations start?

The Standing Vaccination Commission (STiKO) of Robert Koch Institute (RKI) recommends basic immunization against mumps, measles and rubella.

The 1. Vaccination between the 11th and 14th month of life respectively. The 2. Vaccination should be between the 15th and 23rd month of life respectively. The first vaccination is usually sufficient for a lifelong reaction of the immune system to these pathogens. The second vaccination is therefore not, as is often assumed, a booster, but should be used if necessary Vaccination failurewho did not have an adequate immune system response at the first vaccination.

In principle, it is also advisable to vaccinate against mumps, measles and rubella Varicella (chickenpox) get vaccinated, however in a different part of the body, since it has been observed that the already low Risk of febrile seizure could be further reduced after 4-fold vaccination.

However, this was only observed for the first vaccination, which is why the 2. Vaccination without problems also as 4-fold vaccine can give. If the baby comes to a children's facility at the age of under 11 months, in which other older children are also housed, whose vaccination status is unclear, you can consider vaccinating the baby earlier.

However, it does before the 9th month of life no point since the baby is still at this point enough antibodies from the mother in his blood, which would neutralize the vaccine viruses and thus would not lead to a desired vaccination success.

If the baby has not been vaccinated against mumps or measles and there has been reliable contact with a child suffering from these two diseases or, in rare cases, an adult, you can do a maximum of this 3-5 days after the first contact a so-called Post-exposure vaccination (also PEP - post exposure prophylaxis called). This can prevent the onset of the disease or mitigate its course. The post-exposure vaccination is also carried out as a combination vaccination against Mumps, measles, and rubella (MMR) plus possibly Varicella (MMRV).

When does a refresher need to take place?

Basically one is Booster vaccination not required, the 1. Vaccination between the 11th and 14th month of life of the baby is usually enough to produce a lifelong immune system response.

Studies have shown that more than 95% of vaccinated babies have already formed a sufficient number of antibodies against these pathogens after the first vaccination. The 2nd vaccination is therefore not used, as is often assumed, to refresh the 1st vaccination, but should reach those who did not develop any antibodies during the 1st vaccination - so-called vaccination failures. With this 2nd vaccination, the success rate according to studies is over 99%, that a successful reaction of the immune system could be induced.

Side effects of the MMR vaccination

Side effects that can occur after a vaccination are called short-term if they disappear again within 72 hours. These include a local reddening around the puncture site of the injection needle, a slight swelling, as well as muscle soreness-like pain, also both at the puncture site.

In addition, flu-like symptoms such as muscle and limb pain can occur. These reactions are normal and to a certain extent necessary for the immune system to build up adequate protection. Medium-term side effects are those that disappear after 1-4 weeks.

In connection with the vaccination against mumps, measles and rubella, the so-called vaccination disease should be mentioned here. This leads to a weakened course of the disease that was vaccinated against. However, this can only happen with live vaccines. In about 2-5% of vaccinated babies, a vaccine disease is seen after vaccination against measles, so-called vaccination measles.

This leads to a fleeting rash (exanthem) on the body, the parotid glands can swell slightly and temperatures can rise slightly. This form of measles is non-contagious and self-limiting.

This means that the disease will stop on its own without further therapeutic measures. All other side effects with modern vaccines are extremely rare. Severe complaints should therefore always be clarified by a doctor.

With the vaccination against measles one would like to prevent the sometimes fatal complications of a measles infection.

Now, of course, the justified question arises: If the vaccination can also lead to an illness of vaccine measles, as just described, then the deadly complications are not also as they are with an infection with the so-called wild type (pathogens occurring in the wild ) of measles occur, possible?

It should be said that the most feared side effect of measles is subacute sclerosing panencephalitis (SSPE). This occurs about 2-10 years after infection with measles. The SSPE is a generalized inflammation of the brain, which always ends fatally. In children suffering from SSPE, however, the virus that was vaccinated has never been detected, but rather the wild type, i.e. the measles virus found in the wild.

Read more on the topic: Measles vaccination

Diarrhea is one of the side effects of vaccinations in babies. Read our main article about this: Diarrhea After Vaccination In Baby - Is It Dangerous?

Fever after MMR vaccination

fever After a vaccination against mumps, measles and rubella - in addition to swelling and redness around the injection needle injection site, as well as flu-like symptoms - are among the normal complications this vaccination.

These symptoms are usually of short term duration and should be a Do not exceed 3 days. If in addition to the fever after about 1-4 weeks brownish-pink rash occurs on the body, it is very likely to be Vaccine fibers.

This form of burl disease is not infectious and self-limiting, that means the disease without further therapeutic measures stops by itself. If the fever cannot be reduced by common home remedies / medicines and is very high for several days, you should consult a doctor. Another illness that is not related to the vaccination, but which occurs at the same time by chance, must also be ruled out by a doctor.

Rash after MMR vaccination

A rash after vaccination against mumps, measles, and rubella is normal and can occur 1 to 4 weeks after vaccination and affects about 2-5 out of 100 babies vaccinated.

This is either a reddening of the needle puncture site or a fleeting rash all over the body. Brownish-pink spots are typical. If the whole body is affected, it is very likely that it is the symptoms of so-called vaccine measles.

MMR vaccination in adults

Since more than half of all measles illnesses affect adolescents or young adults today, the Standing Vaccination Commission (STiKO) of the Robert Koch Institute (RKI) recommended in 2010 that all adults born after 1970 be vaccinated against mumps, measles and rubella with an unclear vaccination status (with no vaccination or only one of both vaccinations).

Even if no vaccination against one of these pathogens can be proven or if only one pathogen was not vaccinated, the vaccination should preferably be carried out as a combination vaccine against mumps, measles and rubella, as there are also frequent vaccinations for rubella and mumps.

Furthermore, STiKO recommends all people who work in health care (for example doctors and nurses, but also people in the rescue service), people who work in community facilities, such as in kindergartens or schools, but also people who are very sick and weakened Supervise the immune system to make a vaccination.

Read more on the topic: Vaccinations for adults or measles for adults

MMR vaccination before or during pregnancy

Every woman planning on getting pregnant should do so inquire beforehand whether she was vaccinated against mumps, measles, and rubella in her childhood.

If this is not the case, you should Make up for the vaccination, because if you get infected with the pathogens during pregnancy and no vaccination protection of the mother there can be severe damage and malformations of the unborn child.

In pregnant women should be vaccinated against mumps, burl and rubella not be madeas it is a live attenuated vaccine acts and thus theoretically these vaccine viruses could also cause damage. For the same reason, one should wait up to 3 months after vaccinating against measles, mumps and rubella before planning a pregnancy.

If a pregnancy does occur and the mother-to-be has not been vaccinated against mumps, measles and rubella and she then becomes infected with the pathogens, you have the option of a so-called Post-exposure passive immunization with immunoglobulins perform. This is up to 6 days after first contact with measles possible. “Ready-made” antibodies, so to speak, which are supposed to neutralize the pathogen in the body, are called immunoglobulins. It should be noted that these immunoglobulins would also intercept the weakened viruses of a later vaccination and thus no adequate vaccination action of the immune system can be achieved.

Diarrhea after MMR vaccination

If after vaccination against mumps, measles and rubella Gastrointestinal problems As diarrhea occurs, it is crucial to the baby enough liquid and consult a doctor if the general condition deteriorates. If the diarrhea occurs immediately after the vaccination, another infection is more likely than a side effect of the vaccination. Side effects of this type are only expected after about a week.

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What are the costs of the vaccination?

Depending on the vaccine preparation, the cost of one vaccination may vary. There are currently (as of May 2017) preparations from several suppliers. The vaccine with the name MMR Vax Pro against mumps, measles and rubella from the manufacturer MSD Sharp & Dohme costs 32,41€, since you need 2 doses of vaccine, it amounts to total price on 64,84€. Another supplier of vaccines against mumps, measles and rubella is GlaxoSmithKline (GSK), the vaccine made by this manufacturer under the name Priorix runs currently costs (as of May 2017) 34,51€ and is therefore slightly more expensive than the competing product, here too you need twice the dose, which means that the total cost on 67,02€ amount.

Who bears the costs for the MMR vaccination?

The Standing Vaccination Commission (STiKO) The Robert Koch Institute (RKI) recommended vaccination against mumps, measles and rubella in all adults born after 1970 with an unclear vaccination status, with no vaccination or only one of the two vaccinations.

Ever since then the costs of the vaccination are covered by all statutory health insurance companies. Up to now, the costs of vaccination against mumps, measles and rubella have only been borne by the statutory health insurance companies until the age of 18.

Advantages and disadvantages of the MMR vaccination

Advantages and disadvantages Vaccinations are always discussed passionately. One should always weigh the disadvantages against the advantages of vaccination.

Now if you look specifically at vaccination against mumps, measles and rubella, you could be considered one disadvantage cite that there too local side effects, as a Redness around the puncture site of the injection needle, one slight swelling, such as sore muscles, both can also occur at the puncture site.

Furthermore, there may be an occurrence of Flu-like symptoms, such as muscle and limb pain, come. However, these reactions are normal and to a certain extent necessary so that the immune system can build up adequate protection.

In connection with the vaccination against mumps, measles and rubella is also the so-called Vaccine disease to call. It comes to one weakened course of the diseaseagainst which was vaccinated. At about 2-5% of vaccinated babies is seen to have a vaccine disease after vaccination against measles, called vaccine measles. It comes to one flee rash (exanthema) on the body that Parotid glands can swell slightly and it can too slightly elevated temperatures come. This is form of measles disease not infectious and self-limiting, this means that the disease will stop by itself without further therapeutic measures.

Complications that can occur with measles, for example, are Inflammation of the lungs (pneumonia) or Inflammation of the meninges (meningitis) or the brain (Encephalitis).

The most dreaded side effect of measles is that Subacute Sclerosing Panencephalitis (SSPE), Which approx. 2-10 years after infection occurs with measles. The SSPE is one generalized inflammation of the brainwhich always ends fatally.

So you can as Advantages of vaccination against mumps, measles and rubella list these complications no longer occur and thus actually no child would have to suffer or die from them anymore.

Furthermore, a vaccination against mumps can also be a complication caused by the virus, the Infertility in boys, be prevented.

To a so-called Herd immunity to achieve it is necessary that approx. 95% of the population vaccinated is to protect those who cannot be vaccinated, like for example baby, or immunocompromised people, for example due to serious illnesses or old peoplewhich per se is a weaker immune system to have.

Since vaccination rates are not so high everywhere in Germany, it happens again and again local measles outbreaks. It is noticeable that in most cases outbreaks occur in facilities such as Waldorf schools, where experience has shown that people tend to be reluctant to receive vaccinations.

In general it can be said that humanity is through Introduction of vaccinations Pathogens such as the smallpox was able to completely eradicate and is on the verge of other pathogens.

Furthermore, you keep hearing that Vaccinations trigger autism. This "thesis" has appeared again and again for years when it comes to vaccinations and is repeatedly used by vaccination opponents used as an argument against vaccination.

This can be attributed to the British doctor Andrew Wakefield. This one owned in 1997 Patent on an allegedly safe measles vaccine developed by him. In order to be able to market this better, it was of course in his interest to put the combination vaccination against mumps, measles and rubella in a bad light. Wakefield's investigation was based on only 12 children. He published his results in 1998 in the journal "The Lancet". In 2004, 10 out of 13 authors who participated in the study distanced themselves from the results. All subsequent studies refuted the results and could not establish a connection between the vaccination and the occurrence of autism. It should also be mentioned that the journal "The Lancet" has officially revoked the article. In addition, the British medical association Wakefield has withdrawn his license as a doctor. Wakefield presented his results in "dishonest" and "irresponsible" ways.

Pain after an MMR vaccination

Pain after vaccination for mumps, measles, and rubella normal to some extent. There may be local side effects such as redness around the puncture site of the injection needle, slight swelling, as well as sore muscles-like pain, also both at the injection site. Besides, it comes to one too Occurrence of flu-like symptoms like muscle and limb pain all over the body. However, these reactions are normal and to a certain extent necessary so that the immune system can build up adequate protection. Usually the symptoms disappear again after 3 days.

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Further information