This is because maternal antibodies to measles persist in many infants until approximately 11 months of age. These may interfere with active immunisation before 12 months of age. This means that doses given in this time frame may not need to be repeated in all cases. See also Table. Minimum acceptable age for the 1st dose of scheduled vaccines in infants in special circumstances in Catch-up vaccination. Children as young as 6 months of age can receive MMR vaccine in certain circumstances, including travel to highly endemic areas and during outbreaks.
See Travellers. This is due to a small but increased risk of fever and febrile seizures when MMRV vaccine is given as the 1st dose of measles-containing vaccine in this age group. See Adverse events. The scheduled month dose of MMRV should still be given at the usual time. See Table. Advise parents and carers about the small but increased risk of fever and febrile seizures compared with that expected after MMR vaccine.
See Catch-up vaccination for more details, including minimum intervals between doses. Adolescents and adults who have been incompletely vaccinated or do not have evidence of immunity to measles are recommended to receive measles-containing vaccine.
People born before do not need to receive measles-containing vaccine unless serological evidence indicates that they are not immune. This is because circulating measles virus and disease were prevalent before , so most people would have acquired immunity from natural infection. However, confirmed cases of measles have occurred in people born before See Serological testing for immunity to measles.
See Epidemiology. No data are available on safety, immunogenicity or efficacy in this age group. Healthcare workers are strongly recommended to have received 2 doses of measles- containing vaccine. Measles can be transmitted in healthcare settings and infect staff and patients. See Serological testing for immunity to measles , and Recommended vaccines for people at increased risk of certain occupationally acquired vaccine-preventable diseases in Vaccinations for people at occupational risk. Childhood educators and carers are strongly recommended to have received 2 doses of measles-containing vaccine given at least 4 weeks apart.
People who work in childhood education and care do not need to receive measles-containing vaccine if they have either:.
People who work in long-term care facilities are strongly recommended to have received 2 doses of measles-containing vaccine given at least 4 weeks apart. People who work in long-term care facilities do not need to receive measles-containing vaccine if they have either:.
People who work in correctional facilities are strongly recommended to have received 2 doses of measles-containing vaccine given at least 4 weeks apart. Measles can be transmitted in correctional facilities and cause outbreaks. People who work in correctional facilities do not need to receive measles-containing vaccine if they have either:. Travellers born during or since are strongly recommended to have received 2 doses of measles-containing vaccine.
Measles importation after international travel is the most significant source of measles cases in Australia. Infants travelling to countries where measles is endemic , or where measles outbreaks are occurring, may receive MMR vaccine from as young as 6 months of age, after an individual risk assessment.
However, this dose needs to be repeated, meaning that these infants need 2 further doses of measles-containing vaccine. They should receive the next dose of MMR vaccine at 12 months of age or 4 weeks after the 1st dose, whichever is later. They should receive their final dose of measles-containing vaccine as MMRV vaccine at 18 months of age. Serological testing for immunity to measles and mumps, rubella and varicella is not recommended before or after routine administration of the 2-dose childhood schedule of these vaccines.
However, serological testing for measles immunity can be done:. Alternatively, these people can receive MMR vaccine without serological testing. There is no known increase in adverse events from vaccinating people with pre-existing immunity to one or more of the vaccine antigens. Serological tests for immunity to measles can detect antibody produced by both previous natural infection and vaccination. Sensitivity varies by assay and clinical setting including time since vaccination.
When interpreting serological testing results, it may be useful to discuss the results with the laboratory that performed the test, to ensure that decisions are based on all relevant clinical information. The Therapeutic Goods Administration website provides product information for each vaccine. See also Vaccine information and Variations from product information for more details.
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MMR — measles-mumps-rubella combination vaccine. MMRV — measles-mumps-rubella-varicella combination vaccine. Measles, mumps and rubella vaccines are not available separately as an alternative to MMR vaccine. However, a monovalent varicella vaccine is available see Varicella. If a person receives MMR vaccine at the same time as monovalent varicella vaccine, use separate syringes and injection sites.
Do not mix MMR vaccine and monovalent varicella vaccine together before injection. The 2 brands of MMR vaccine are interchangeable, so the 2nd MMR vaccine dose does not have to be the same brand as the 1st. The same principle applies to the 2 MMRV vaccines, 15 although they are not routinely recommended in a 2-dose schedule. See Anaphylaxis in Adverse events for more details about MMR vaccination for people with a known egg allergy. MMR -containing vaccines are contraindicated in pregnant women.
There is no risk to pregnant women from contact with people who have recently been vaccinated. The vaccine virus is not transmitted from vaccinated people to susceptible contacts. See also Rubella , Varicella , Vaccination for women who are planning pregnancy, pregnant or breastfeeding and Table. Vaccines contraindicated in pregnancy: live attenuated vaccines for more details.
Breastfeeding women can receive MMR vaccines. See also Rubella. MMR -containing vaccines comprise live attenuated viruses and are contraindicated in people who are immunocompromised. This means that MMR -containing vaccines are contraindicated in:. See Vaccination for people who are immunocompromised for more details. For more details on using live attenuated vaccines in people receiving corticosteroid therapy, see Table.
Recommended timing of live attenuated vaccine doses in adults and children taking corticosteroids in Vaccination for people who are immunocompromised. People who have received an immunoglobulin -containing blood product should wait 3—11 months before receiving a measles-containing vaccine. This is because the immunoglobulin may impair the expected immune response to the vaccine. The interval between receiving the blood product and the vaccine depends on the amount of immunoglobulin in each product. Recommended intervals between immunoglobulins or blood products, and measles-mumps-rubella, measles-mumps-rubella-varicella or varicella vaccination and Vaccination for people who have recently received normal human immunoglobulin and other blood products.
People may receive MMR vaccine at the same time as anti-D immunoglobulin , but at different injection sites. They can also receive MMR vaccine at any time before or after anti-D immunoglobulin. Anti-D immunoglobulin does not interfere with the antibody response to the vaccine. People who have received a measles-containing vaccine should not receive immunoglobulin -containing products for 3 weeks after vaccination, unless the benefits of receiving the blood product outweigh the benefits of vaccination.
If the person receives an immunoglobulin -containing product within 3 weeks after a measles-containing vaccine, the vaccinated person should be either:. People may receive anti-D immunoglobulin at any time after receiving MMR vaccine. Therefore, it is recommended that these groups receive only MMR vaccine and monovalent varicella vaccine — see Varicella. People on low-dose systemic corticosteroids can receive MMR -containing vaccines.
Low-dose systemic corticosteroid therapy includes:.
People receiving high-dose corticosteroids can receive MMR -containing vaccines after they have stopped corticosteroid therapy for at least 1 month see Contraindications. Some experts suggest temporarily stopping lower doses of steroids 2—3 weeks before vaccination with live viral vaccines, if possible. See also Vaccination for people who are immunocompromised. Household contacts of people who are immunocompromised should ensure that they are age-appropriately vaccinated against, or are immune to, measles, mumps, rubella and varicella. Household contacts of people who are immunocompromised can safely receive measles-containing vaccines, because the vaccine viruses are not transmissible from vaccinated people to others.
People taking long-term salicylate therapy aspirin can receive MMRV vaccine if needed. The benefit is likely to outweigh any possible risk of Reye syndrome after vaccination with a varicella-containing vaccine see Varicella. Thrombocytopenia is a rare adverse event after MMR vaccination see Adverse events.