Getting it right on terminations
MMR after single vaccine
Q A patient had single measles and rubella vaccines given to her child. She is now due a pre-school booster and is aware that she is not immunised against mumps. She has been advised to have two MMRs but is concerned that three lots of MR may increase the risk of adverse events. What advice should be given? Are the single vaccines as effective as MMR in protecting against measles and rubella?
A We do not know how effective single antigen vaccines are against measles and/or rubella as these are not licensed in the UK.
The advice given to this child's parents is correct. In order for this child to have a good chance of being fully immunised against measles, mumps, and rubella, two doses of MMR should be given. The three doses of MR should not increase the risk of adverse effects.
The two doses of the MMR vaccine should be separated by three months. If there is any community risk involving any of these infectious diseases, the interval can be reduced to four weeks.
Incidentally, the advice of a gap of three months between the two MMR doses will apply to all ages except children under 18 months. Because of the possibility of residual maternal antibodies, the second dose in these children is given after they reach 18 months in situations where there are no local outbreaks.
Dr George Kassianos
RCGP spokesperson on immunisation and a GP in Bracknell, Berkshire