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Measles-mumps-rubella vaccination in high-risk adults

Patricia L Hibberd, MD, PhD
Section Editor
Michael Boeckh, MD
Deputy Editor
Elinor L Baron, MD, DTMH


The national goals of Healthy People 2020 include a continued focus on adult immunization, particularly increasing immunization rates. Despite some progress, approximately 50,000 adults and a few hundred children in the United States die each year from vaccine-preventable diseases. There are also communities with pockets of unvaccinated and under-vaccinated populations that are at increased risk for outbreaks of vaccine-preventable disease [1,2].

The combination MMR vaccine includes the measles, mumps, and rubella live virus vaccines. Single antigen preparations of these vaccines are no longer available in the United States [3].

The rationale and risk-benefit considerations for administration of MMR vaccines will be reviewed here. The principles behind adult immunization and the recommended schedule for healthy adults as well as the rationale and risk-benefits for influenza and pneumococcal vaccine and tetanus-diphtheria toxoid are discussed separately (see "Approach to immunizations in healthy adults" and "Seasonal influenza vaccination in adults" and "Pneumococcal vaccination in adults" and "Tetanus-diphtheria toxoid vaccination in adults").

Immunizations for select groups such as immunocompromised individuals, healthy women who are pregnant or breastfeeding, healthcare workers, and international travelers are also discussed separately. (See appropriate topic reviews.)


Which adults are at risk and is protection important to healthy adults? — The live attenuated measles vaccine was introduced in 1967 and by 1985 had prevented about 52 million cases of measles, 5200 deaths, and 17,400 cases of mental retardation attributable to measles [4]. During the years 1989 to 1991, measles cases started to increase again, and the United States Public Health Service responded by recommending a two-dose immunization schedule [5]. The rationale for the second dose of the measles vaccine was not to serve as a booster but rather to immunize the 5 to 20 percent of people who had not responded to the first dose of the vaccine.


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Literature review current through: Sep 2016. | This topic last updated: Feb 9, 2016.
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