Measles, Mumps, Rubella & Varicella (MMR & MMRV) Vaccines

Measles

The measles virus causes a fever, rash, cough, red eyes and a runny nose. The red rash starts on the face and spreads to the rest of the body. Measles complications include ear infections, pneumonia, miscarriage, an infection of the brain causing brain damage, and death. It is easily spread when an infected person coughs or sneezes. Measles continues to spread in Canada and North America due to travel.

Mumps

The mumps virus causes a fever, headache and salivary gland swelling in the cheeks and jaw (parotitis). Complications include meningitis (infection in the lining of the brain), painful swelling of the testicles or the ovaries, deafness, or miscarriage. It is spread by contact with saliva of an infected person (e.g., sharing drinks, food or kissing) or their infected droplets through coughing, sneezing or even talking. Outbreaks have occurred in schools, universities and among sports teams.

Rubella

The rubella virus causes a fever, sore throat, swollen lymph glands in the neck and a rash on the face and neck. The symptoms can be absent or mild in children. Adults may have a headache, weakness, runny nose, red eyes and, rarely, swelling of the joints. Rubella can also cause encephalitis (swelling of the brain). Rubella is most dangerous in early pregnancy as it can cause miscarriage, stillbirth or severe birth defects such as cataracts, deafness, heart defects, and developmental delay known as congenital rubella syndrome. Rubella is spread through coughing or sneezing or from contact with the saliva of an infected person.

Varicella (Chickenpox)

Varicella, also called chickenpox, is very contagious. It often starts with fever, cough, sore throat and general aches and pains. Itchy red rashes appear and can spread to almost anywhere on the body. The rashes will gradually form into blisters and then scab over. In rare cases, chickenpox can lead to pneumonia, blood and skin infections or swelling to the brain.

Vaccine Recommendations

• Children: MMR is given routinely on or after the first birthday. A second dose of MMRV is given at 4 to 6 years of age.
• Born in 1970 or later: Receive two doses of measles-containing vaccine
• Born in 1969 or earlier: May have had measles infection. Can get vaccinated if unsure.
• Travellers to areas where measles is spreading: Ensure you have been vaccinated or have immunity from a previous infection before travelling. Infants 6 to 11 months of age can receive one dose of MMR vaccine before travel (they will still be required to get two doses after the first birthday).
• Preventing an infection when exposed to someone contagious with measles and not immune (Post-exposure prophylaxis):
  • Measles vaccine given within 72 hours of exposure may prevent infection.
  • Human immune globulin (Ig) may be used if given within 6 days of exposure and if at high risk for getting very sick from a measles infection.
• Health care workers, post-secondary students and military personnel should ensure they are protected.
• The MMR vaccine is safe when breastfeeding.

People Who Should Not Get the MMR or MMRV Vaccine

MMR & MMRV vaccines are not recommended if you have:

• A history of anaphylaxis after previous administration of a dose of these vaccines
• Allergies to any component of these vaccines (Note: people with egg allergies can still receive these vaccines)
• Known IgA deficiency (unless the benefit outweighs the risk, speak with a health care provider for details)
• A weakened immune system
• Active, untreated tuberculosis (people with tuberculosis should consult an infectious disease specialist to learn if or how they can receive these vaccines)
• On long-term salicylate therapy, since it is recommended to avoid the use of salicylates for 6 weeks after immunization
• Are pregnant

People Who Should Delay Vaccination with MMR or MMRV

• if you have received a live vaccine in the past 28 days
• received a blood product in the past 12 months
• have an illness more serious than a cold
• you think you may be pregnant or are trying to become pregnant. Women should not get pregnant for one month after receiving the MMR vaccine

School Requirements

Students in Ontario must be vaccinated against Measles, Mumps, Rubella, and Varicella or have a valid exemption on file with Toronto Public Health in order to attend school under the Immunization of School Pupils Act. Parents have to update their child’s immunization record with Toronto Public Health or provide a valid exemption form. Students without updated records may be suspended from school. Learn more about reporting vaccines required for school.

Vaccine Side Effects & Risks

MMR and MMRV vaccines are safe, effective and well tolerated. Common side effects include redness, swelling and pain where the needle was given, fever, temporary swelling of the glands in the neck, joint pain or muscle aches. Rarely, a rash that looks like chickenpox or measles can occur. Reactions are usually mild and go away in a few days.

In rare cases, some children may get high fever or an allergic reaction that can cause trouble breathing, rash, swelling in the throat and face. It is treated immediately and does not last long.

For the MMR vaccine: On rare occasions, immune thrombocytopenic purpura (ITP) can occur within six weeks after vaccination. Most children recover completely in three months without serious complications. Encephalitis has been reported in approximately one per million doses, much lower than that observed with natural measles disease (one per 1,000 cases).

For the MMRV vaccine: Salicylates (such as aspirin) should not be given to children after MMRV vaccination for at least 6 weeks.

Report any severe reactions to the MMR or MMRV vaccine to your health care provider.