MMR vaccination

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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MMR vaccination is the abbreviation for measles-mumps-rubella vaccination. Doctors recommend this combination vaccination for all babies. In certain cases, the MMR vaccine should also be given to adults. Read everything you need to know about the MMR vaccination here: How often is it administered? Who should or must receive it? What side effects can the MMR vaccination cause?

What is the MMR vaccination?

The MMR vaccination is a triple vaccination that simultaneously protects against infection with measles, mumps and rubella viruses. It is a live vaccination: The MMR vaccine still contains reproductive but weakened measles, mumps and rubella viruses. These can no longer trigger the respective disease. Nevertheless, the immune system reacts to them with the formation of specific antibodies for defense.

The MMR vaccination can also be given if someone already has adequate protection against one or two of the three diseases. For example, anyone who has already had mumps and is therefore immune to the pathogen can still receive the MMR vaccination - there is no increased risk of side effects.

To a certain extent, an extension of the measles-mumps-rubella vaccination (MMR vaccination) is the MMRV vaccination. This quadruple vaccine also protects against varicella disease - the chickenpox pathogen.

Advantages of the combination vaccination

A combination vaccine like the MMR vaccine has several advantages over single vaccines (single vaccines):

Prick less often: If you were to be vaccinated against measles, mumps and rubella individually, a total of six injection syringes would be required for adequate protection. For the same result, two syringes are sufficient for the MMR vaccination - a welcome advantage, especially for small children.
Fewer side effects: Reducing the number of injections required also has the advantage that the person vaccinated has to "endure" less of a possible vaccination reaction due to the MMR vaccination.
Just as compatible, just as effective: The MMR vaccination is just as compatible and effective as the individual vaccinations.

Individual vaccines against measles, mumps and rubella are currently not available in Germany.

MMR vaccination if measles vaccination is compulsory

In principle, vaccinations against measles, mumps and rubella (usually administered in combination as an MMR vaccination) are only recommended in Germany by the Standing Vaccination Commission (STIKO) at the Robert Koch Institute (RKI).

In addition to the recommended measles vaccination, measles vaccination has been mandatory for certain cases since March 2020. Because no single vaccine against measles is available in this country, doctors also administer the MMR vaccine here.

According to the Measles Protection Act, vaccination against measles exists in the following cases:

In the case of children over the age of one, the parents must prove before entering a community facility (such as a daycare center, school, training facility for young people) that their offspring is fully vaccinated against measles or has had measles disease. Evidence is provided, for example, with the help of a vaccination card or a medical certificate.
For children and adolescents who were already cared for in a community facility when the Measles Protection Act came into force (March 1, 2020), proof of the measles vaccination or the measles disease they had experienced must be available by July 31, 2021 at the latest.
The measles vaccination also applies to adolescents and adults who work or want to work in medical or community facilities (also as part of a regular volunteer or internship) if they have not yet had measles and were born after 1970.
Likewise, all persons who were accommodated in a children's home or in a collective accommodation for asylum seekers, refugees or repatriates for at least four weeks on March 1, 2020 must prove that they are completely vaccinated against measles.

MMR vaccination for infants

The Standing Vaccination Commission recommends that all infants be vaccinated against measles, mumps and rubella before their second birthday. Doctors use a combination vaccine for this.

MMR vaccination: how often and when are babies vaccinated?

For a complete vaccination protection (basic immunization) two vaccination doses are necessary for the MMR vaccination. The STIKO recommends the following vaccination schedule for infants:

The first MMR vaccination should be given between the ages of 11 and 14 months. Pediatricians usually inject the MMR vaccine at one point and the varicella vaccine at another point - usually in the left and right lateral thigh muscles. The MMRV quadruple vaccine showed a slightly increased risk of febrile seizures if it was used as part of the primary vaccination.

The second MMR vaccination is usually given by the end of the second year of life, i.e. before the second birthday (i.e. at the latest at 23 months). It is important that there are at least four weeks between the two vaccination appointments - otherwise a weakened immune response is to be expected. Instead of the triple vaccine, the MMRV quadruple vaccine can easily be injected for the second vaccination.

Early MMR vaccination before the age of 11 months

In principle, the MMR vaccination can also be given before the eleventh month of life, namely from the ninth month of life. This is necessary, for example, if the parents want to give their child to a community facility at this age - complete vaccination against measles is then mandatory.

However, the experts recommend that all babies who receive the first MMR vaccination before the eleventh month have the second vaccination at the beginning of their second year of life. Maternal antibodies that were still effective in the child's blood could have weakened the immune response of the first MMR vaccination to such an extent that the initial vaccination did not provide adequate protection. The longer you wait with the second vaccination, the higher the risk of an actual infection and illness.

Lifelong (even if not 100%) protection against measles, mumps and rubella is provided by complete basic immunization by means of two MMR vaccinations. A refresher at a later point in time is therefore not necessary.

MMR vaccination for older children and adolescents

In older children and adolescents who were not (sufficiently) vaccinated against measles, mumps and / or rubella as infants, doctors recommend that they catch up with the immunization as soon as possible:

Anyone who did not receive an MMR vaccination as a baby needs the complete basic immunization with two doses of the MMR vaccination at least four weeks apart.
If someone received at least one MMR vaccination as a child, doctors give the missing second dose to complete the basic immunization (MMR catch-up vaccination).

The same applies to adolescents who are required to be vaccinated against measles - because they have never had measles and, for example, want to attend a school or training facility or do an internship in a kindergarten.

MMR vaccination for adults

The MMR vaccination is often also given to adults if they were not vaccinated against measles, mumps and / or rubella as a child, or only vaccinated once, or if the vaccination status is unclear. An unclear vaccination status is when someone is not sure whether and how often they were vaccinated against a certain disease as a child.

Sometimes the MMR vaccination for adults is purely a recommendation - for example, for adequate rubella protection against pregnancy. In order to fulfill the measles vaccination obligation, it can also be absolutely necessary (because there is no individual vaccine against measles).

Keyword rubella

Experts recommend the MMR vaccination to all women of childbearing potential if they were not vaccinated against rubella or only once as a child, or if their rubella vaccination status is unclear. The same applies to employees in pediatric, obstetrics, pregnant women or community facilities.

Keyword mumps

For all those born after 1970 who were not or only once vaccinated against mumps as a child or whose mumps vaccination status is unclear, the STIKO recommends a one-time MMR vaccination for professional reasons in the following cases:

Work in the health service in direct patient care (e.g. in nursing)
Activity in a community facility or training facility

Keyword measles

The STIKO recommends a one-time MMR vaccination for those born after 1970 if someone was not vaccinated against measles or was vaccinated only once as a child or if the measles vaccination status is unclear.

The situation is different if a measles vaccination is compulsory - for example, because an adult born after 1970 wants to work in a doctor's office or in a kindergarten. Then the following applies:

A single MMR vaccination is only sufficient if the person concerned received at least one vaccination against measles as a child.
If the person in question was never vaccinated against measles as a child or if the vaccination status is unclear, two measles vaccinations (i.e. two doses of the MMR vaccination) are necessary.

MMR vaccination: side effects

Most people tolerate the MMR vaccination well. A vaccination reaction after the second MMR vaccination is less common than after the first.

In the first few days after vaccination, reactions at the injection site, such as redness, swelling and pain, often develop temporarily. They signal that the immune system is responding to the vaccination.

Occasionally, neighboring lymph nodes swell. In addition, brief general symptoms such as tiredness, headache, gastrointestinal complaints or an increased body temperature can occur. The latter can also be accompanied by a febrile seizure in infants and young children. However, this usually has no consequences.

As a live vaccine, the MMR vaccine contains strongly weakened, but still reproductive pathogens. Therefore, after vaccination, you may develop slight signs of the actual disease. The so-called "vaccine measles" are observed in around two to five out of 100 people who are vaccinated: One to four weeks after the MMR vaccination, those affected develop a fever and a mild measles-like rash. The vaccine measles are not contagious and will subside on their own after a few days.

Sometimes there is a slight swelling of the parotid gland after the MMR vaccination. Occasionally, adolescents and adults (but very rarely children) also report joint problems. A slight swelling of the testicles after the MMR vaccination is also possible, but rare.

Very rarely, people who have been vaccinated have an allergic reaction to the MMR vaccine or with prolonged inflammation of the joints. Occasionally the number of blood platelets falls, but only temporarily (platelets = thrombocytes are important for blood clotting).

In a few individual cases worldwide, brain inflammation after an MMR vaccination has been reported. So far, however, no connection between the inflammation and the MMR vaccination has been proven.

MMR vaccination and autism

In 1998 a British doctor published an article alleging a possible link between MMR vaccination and the occurrence of autism - to the concern of many parents. However, during his examination, the doctor referred to the data from only 12 children. In addition, methodical errors and even manipulations were later proven. The article was then completely revoked and the doctor lost his medical license.

In addition, subsequent, extensive and high-quality studies (e.g. a Danish study with more than 530,000 children) could show that there is no connection between the MMR vaccination and autistic disorders.

MMR vaccination: who shouldn't get it?

Doctors advise against the MMR vaccination in the following cases:

If you have an acute fever (> 38.5 degrees Celsius) or an acute, serious illness
If you have a known allergy to one of the components of the MMR vaccine
During pregnancy (see below)

If the immune system is severely restricted (e.g. certain congenital immunodeficiencies, HIV infection), those affected should speak to the doctor treating them to determine whether an MMR vaccination makes sense. In particular, vaccination failure could occur because the immune system is too weak to develop protection against the vaccine.

If you are allergic to egg white, an MMR vaccination is generally possible. Researchers produce the vaccine with chicken cells. However, the vaccine itself usually contains little or no trace of chicken protein. However, allergy sufferers should discuss the MMR vaccination with their doctor in advance. In the case of a known, very severe chicken protein allergy, doctors recommend monitoring those affected after an MMR vaccination, for example in hospital.

MMR vaccination: pregnancy and breastfeeding

The MMR vaccination consists of live vaccines. It is therefore contraindicated in pregnancy. Pregnant women are generally not allowed to receive live vaccines. The weakened pathogens may be dangerous for the unborn child, even if they do not harm the mother.

Pregnancy should be avoided for at least four weeks after an MMR vaccination!

If the vaccine is inadvertently given, it is usually not necessary to terminate the pregnancy. There are numerous, described vaccinations during or shortly before pregnancy that did not result in an increased risk of malformations in the child.

A measles, mumps and rubella vaccination during breastfeeding is possible in principle. Studies have shown, however, that mothers after an MMR vaccination can transmit the weakened vaccine virus with their breast milk. There is a possible risk, although so far no indications of a measles disease in the child have been found. The recommendation is anyway: the earlier vaccinated, the sooner protected. This also and especially applies to women of childbearing age, provided that they were not given a basic immunization in childhood.

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