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revised January 30, 2012

Arrow BulletCommunicable Diseases - Measles, Mumps, Rubella Vaccine (MMR)

The MMR vaccine is a three-in-one vaccine that protects against measles, mumps and rubella. Children are required to have two doses of MMR vaccine as part of the routine immunization schedule. The first dose of MMR must be given on or after the first birthday. The second dose of MMR is routinely given in combination with the second recommended dose of varicella (chicken pox). This is given as a four-in-one vaccine called MMRV and is given at 4 to 6 years of age (preferably prior to school entry). Children may be immunized with MMR and varicella as separate vaccines if there are existing medical reasons or if the child will be travelling outside Canada prior to his/her fourth birthday.

Vaccination against measles, mumps and rubella is required by law for all children attending licensed child-care centres in Peel. These vaccines are also required for all children attending school in Ontario (unless exempted).

Two doses of the MMR vaccine should be given to adults who are not protected against measles, mumps or rubella. A second dose of MMR is recommended for the following individuals who may have only received one dose in adolescence: young adults (18-25 years), post secondary students, individuals who received killed measles vaccine (1967-1970), health care workers or those who plan to travel internationally.

What is measles?

  • Measles (red measles) is a serious childhood disease caused by a virus. It is easily spread by coughing, sneezing or even talking to an infected person.
  • Measles begins with a fever, runny nose and cough. Several days later, a rash appears first on the face and then spreads to the chest and limbs. The eyes may be very sensitive to light. Measles can last for one to two weeks.
  • Measles can cause serious and sometimes permanent health problems. The disease often causes an ear infection or pneumonia. One in every 1,000 children with measles has an inflammation of the brain, called encephalitis. Encephalitis can lead to convulsions, deafness or mental retardation. One in every 1,000 children with measles may die of complications.
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What is mumps?

  • Mumps is a disease caused by a virus; it usually occurs in childhood. Mumps spreads by contact with an infected person through sneezing, coughing or even talking. Mumps causes fever, headache and infection of the salivary glands causing the cheeks to swell painfully.
  • Sometimes mumps is more serious. It can cause inflammation of the brain or its protective surface (encephalitis or meningitis). One in 200 children with mumps develops encephalitis. The inflammation usually goes away without leaving permanent damage. Mumps can also cause deafness.
  • About one out of every four men with mumps develops a painful inflammation and swelling of the testicles. One out of every 20 women develops inflammation of the ovaries. Both of these conditions are temporary and rarely result in permanent damage or sterility.
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What is rubella (German measles)?

  • Rubella is usually a mild illness in children, but it can be more severe in older children and adults, especially women. Rubella may cause fever, sore throat, swollen glands in the neck and a rash on the face and neck. Rubella spreads by contact with an infected person through coughing, sneezing or even talking.
  • As many as three in five teenage girls and women with rubella get aches, pains and swelling of the joints. Rubella can be followed by chronic arthritis. It can also cause temporary blood clotting problems.
  • Rubella is very dangerous in pregnant women. If a woman gets rubella in the early part of a pregnancy, it is very likely that her baby will die or be severely handicapped. The most common handicaps are blindness, deafness, mental retardation and heart defects.
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How well does the MMR vaccine protect against measles, mumps and rubella?

  • When given in the recommended number of doses, the vaccine protects:
    • about 99 per cent of people against measles
    • 95 per cent of people against mumps
    • about 98 per cent of people against rubella.
  • The MMR vaccine provides lifelong protection from measles, mumps and rubella. If a vaccinated child or adult still contracted these diseases, the symptoms would be much less severe.
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Is the MMR vaccine safe?

  • Yes, the MMR vaccine is safe. Most children will have no side effects. The MMR vaccine can cause a rash or fever in some children five to 12 days after it is given. These symptoms may last up to three days.
  • There is no risk of a pregnant women or anyone else catching measles, mumps or rubella from a child who has been recently vaccinated. It is safe to give this vaccine to women who are breastfeeding.
  • Occasionally, a high fever can cause a convulsion or seizure. The convulsion comes from the high fever caused by the vaccine rather than the vaccine itself. The convulsion does not put the child at risk of getting epilepsy, brain damage or any other nerve problems. Convulsions caused by high fever are more likely to occur in children who have had convulsions before or whose parents, brothers or sisters have had convulsions. Overall, the benefits of the vaccine are much greater than the risks.
  • The mumps part of the vaccine may cause fever and swelling of the glands in the neck. Meningitis, which is an infection of the fluid and lining covering the brain and spinal cord, may occur very rarely in one in 800,000 people who get the vaccine. The meningitis caused by mumps vaccine is mild, and permanent brain damage does not occur.
  • The rubella part of the vaccine may cause a mild fever, rash or swelling of the glands in the neck in one out of seven children. These symptoms usually happen six to 10 days after getting the vaccine and last for one to two days. Less than one in 200 children may develop swelling and pain in some joints after receiving the vaccine.
  • The four-in-one MMRV vaccine is safe. The rate of febrile seizures (seizures caused by high fever) has not been reported to be higher than if MMR and varicella vaccines are given separately.
  • Up to one in four teenage girls and adult women may get painful swelling of some joints within one to three weeks after vaccination. The joint pain and swelling usually lasts for only a few days. Very rarely, chronic arthritis may occur.
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When should I see a health professional after vaccination?

  • Vaccine recipients should see a doctor, a nurse practitioner or go to the nearest hospital emergency department if they develop any of the following symptoms within three days of getting the vaccine:

    • high fever (over 40°C or 104°F).
    • hives (itchy rash)
    • swelling of the face or mouth
    • trouble breathing, hoarseness or wheezing
    • convulsions or seizures
    • other serious problems
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Who should not get the MMR vaccine?

  • The doctor may decide not to give the MMR vaccine to anyone who has:
    • a fever or infection worse than a cold
    • severe allergic reaction to this vaccine in the past
    • a disease or is taking a medication that lower the body's ability to fight infections
    • severe allergy to any component of the vaccine: neomycin, sorbitol, gelatin
    • religious or philosophical objections to any components (see above) of the vaccine
    • recently received a blood transfusion or immune globulin
  • Pregnant women should not get the MMR vaccine. If a woman gets the MMR vaccine and then discovers she is pregnant, she should call her doctor right away. Women should wait for at least one month following MMR immunization before becoming pregnant.
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Where can I learn more about the MMR vaccine?

  • Talk to your doctor or nurse practitioner. For more information on immunization, the Day Nurseries Act or the Immunization of School Pupil's Act, call Peel Health at 905-799-7700. Caledon residents call free of charge at 905-584-2216.
  • Information on immunization is also available at www.ImmunizePeel.ca
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Personal Immunization Record (yellow card)

  • After you or your child receive any vaccine:
    • make sure the doctor updates the personal Immunization Record
    • notify Peel Health at 905-799-7700 or www.ImmunizePeel.ca
  • Keep your Immunization Record in a safe place with your other important documents.
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Revised: January 30, 2012


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