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Measles, Mumps and Rubella (MMR)

Measles

Measles is caused by a very infectious virus. Nearly everyone who catches it will have a high fever, a rash and generally be unwell.

Children often have to spend about five days in bed and could be off school for ten days. Adults are likely to be ill for longer. It is not possible to tell who will be seriously affected by measles.

The complications of measles affect one in every 15 children. The complications include chest infections, fits, encephalitis (swelling of the brain), and brain damage. In very serious cases, measles kills. In 1987 (the year before the MMR vaccine was introduced in the UK), 86,000 children caught measles and 16 died.

Measles is one of the most infectious diseases known. A cough or a sneeze can spread the measles virus over a wide area. Because it's so infectious, the chances are your child will get measles if he or she is not protected.

Mumps

Mumps is caused by a virus, which can lead to fever, headache and painful, swollen glands in the face, neck and jaw. It can result in permanent deafness, viral meningitis (swelling of the lining of the brain) and encephalitis.

Rarely, it causes painful swelling of the testicles in males and the ovaries in females. Mumps lasts about seven to ten days. Before the MMR vaccine was introduced, about 1,200 people a year in the UK went into hospital because of mumps.

Mumps is spread in the same way as measles. It is about as infectious as flu.

Rubella

Rubella (German measles) is a disease caused by a virus. In children it is usually mild and can go unnoticed. It causes a short-lived rash, swollen glands and a sore throat.

Rubella is very serious for unborn babies. It can seriously damage their sight, hearing, heart and brain. Rubella infection in the first three months of pregnancy causes damage to the unborn baby in nine out of ten cases. This condition is called congenital rubella syndrome (CRS). In many of the cases, pregnant women caught rubella from their own, or their friends’, children.

In the five years before the MMR vaccine was introduced, about 43 babies a year were born in the UK with congenital rubella syndrome.Rubella is spread in the same way as measles and mumps. It is about as infectious as flu.

The MMR vaccine

MMR is the combined vaccine against measles, mumps and rubella. It is the safest way to protect your children against these diseases.

Why are two doses of MMR vaccine needed?
To give better protection. After the first dose, between 5% and 10% of children are not protected against the diseases. After two doses of MMR, less than 1% are left unprotected.

Not all children receive the first dose of MMR. This means that each year the number of children who remain susceptible to measles, mumps and rubella will increase. The second MMR visit is needed to protect those children who did not respond to the first dose, and provides an opportunity to give a first dose to children who didn't receive the vaccine earlier.

Children who did respond to the first dose get a boost to their antibodies with a second dose.For this reason, all countries in the European Union and the US, Canada, Australia and New Zealand recommend two doses of MMR.

Top 10 truths about MMR

1. MMR immunisation is the safest way that parents can protect their children against measles, mumps and rubella - diseases that can be serious for babies, young children and their families
2. Over 500 million doses of MMR have been used in over 90 countries around the world since the early 1970s. The World Health Organization (WHO) states that MMR is a highly effective vaccine with an outstanding safety record (WHO, 2001)
3. No country in the world recommends giving MMR vaccine as three separate injections
4. Children who are not immunised with MMR increase the chance that others will get the diseases. Before MMR, pregnant women would catch rubella from their own children
5. The evidence is that MMR vaccine does not cause autism or inflammatory bowel disease (IBD). There are now numerous studies that do not support a link between autism and IBD and the MMR vaccine (CSM, 1999; Gillberg and Heijbel, 1998; Taylor et al, 1999; Davis et al, 2001; DeWilde et al, 2001)
6. The Wakefield et al study published in the Lancet (a medical journal) in 1998 actually said 'We did not prove an association between MMR vaccine and the syndrome described' and none of the studies since have found a link. Berelowitz, one of the contributors to the Wakefield study, has subsequently said 'I am certainly not aware of any convincing evidence for the hypothesis of a link between MMR and autism...' (Berelowitz, 2001)
7. Single vaccines in place of MMR put children and their families at increased and unnecessary risk. The combined vaccine is safer as it reduces the risk of children catching the diseases while they are waiting for full immunisation cover
8. The normal procedure for licensing was used for MMR and the vaccine was thoroughly tested before being introduced into the UK in 1988
9. Two doses of MMR vaccine are needed to give children the best protection before they go to school. Ninety per cent of those who did not respond to the first dose are protected by the second. Those with low antibodies after the first dose will be boosted
10. There are very few children who have a true contraindication to having the MMR vaccine.

Top 10 myths about MMR

1. Getting protection by catching the diseases is better than having the vaccine.
2. Giving three viruses at the same time is too much for young children's immune system.
3. Other countries around the world give MMR as three separate vaccines.
4. Measles, mumps and rubella are rare in the UK so you don't need to immunise kids against them.
5. MMR causes autism and bowel disease.
6. There was a scientific paper that showed a real link between MMR and autism and bowel disease.
7. Giving the MMR vaccines separately reduces the risk of side effects.
8. The vaccine was not properly tested before it was licensed.
9. My child has already received one dose so there is no need for a second one.
10. My son doesn't need protecting against rubella; my daughter doesn't need protecting against mumps.

MMR and autism

There have been reports in the media that there is a link between MMR and autism. These reports followed a paper that was published in the Lancet in 1998.

Since then there have been many studies on the subject, and parents are understandably concerned that there might be a link.

Why do some parents link MMR with autism in their child?

Autism is a developmental disorder, which usually appears in the second year of life. The first MMR vaccine is given to children in the UK when they are aged between one and two years.Because of this, some parents will see signs of autism in the weeks and months before MMR is given, and others will notice them in the weeks and months after MMR is given.Parents who see changes in their child will often link the change to a particular event.

For example, at one time it was thought that a second child born within two years could affect the development of autism in the first child. Those parents whose children show signs of autism after MMR understandably often link the two events, but there is no evidence to show that there is cause and effect between MMR and autism.

If you are not sure if your child has had one, or both, doses of the MMR vaccine, contact your GP, health visitor or school nurse.

Further information

To find out more about MMR, visit: www.immunisation.nhs.uk/Vaccines/MMR/