Recent increases in measles cases have prompted numerous inquiries from adult patients regarding the necessity of MMR booster vaccinations. This document aims to provide evidence-based guidance on measles immunity and vaccination recommendations for adults, aligning with current clinical practice guidelines.
MMR Vaccine Efficacy and Recommendations:
The measles, mumps, and rubella (MMR) vaccine exhibits high efficacy in preventing measles infection. Specifically, a single dose confers approximately 93% protection, while two doses provide approximately 97% protection. Vaccinated individuals who contract measles generally experience attenuated disease courses, with reduced rates of hospitalization and complications compared to unvaccinated individuals.
The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommends that adults born in or after 1957 without evidence of immunity to measles receive at least one dose of the MMR vaccine.
Evidence of Immunity:
Acceptable evidence of immunity includes:
Documented Vaccination: Written record of one or more doses of a measles-containing vaccine administered on or after the first birthday (for non-high-risk adults).
Laboratory Confirmation: Positive measles IgG antibody titer.
Laboratory Confirmation of Measles Infection: Documented history of laboratory-confirmed measles.
Birth Before 1957: Individuals born before 1957 are generally considered immune due to presumed natural exposure during childhood.
For adults considered at high risk (e.g., healthcare personnel, international travelers, students in post-secondary institutions), two doses of the MMR vaccine, administered at least 28 days apart, are recommended.
Specific Guidance for Adults Born Between 1957 and 1966:
Adults born BETWEEN 1957 and 1966 without documented evidence of immunity should receive at least one dose of the MMR vaccine. High-risk individuals within this age bracket should receive two doses.
Serologic (Blood) Testing for Measles IgG Antibodies:
For adults with uncertain immunity status, serologic testing to detect measles IgG antibodies is recommended. A positive measles IgG titer indicates laboratory evidence of immunity.
In cases where serologic testing yields negative or equivocal results, MMR vaccination is advised. Importantly, the ACIP affirms that administering the MMR vaccine to individuals with pre-existing immunity poses minimal risk of serious adverse events.
Clinical Recommendations:
Adults with concerns regarding their measles immunity can undergo serologic testing for measles IgG antibodies.
Negative or equivocal serologic results necessitate MMR vaccination.
Individuals born after 1957 seeking MMR vaccination or titer testing should contact us, your Primary Doctor or non-physician provider for scheduling.
Published clinical data underscore the severity of measles complications, particularly in unvaccinated populations.
Pneumonia, a common complication, occurs in 1-6% of measles cases in industrialized nations.
Post-infectious encephalitis occurs in approximately 1 per 1000 cases.
Mortality rates are estimated at approximately 1 per 1000 cases.
Recent outbreaks have shown pneumonia rates as high as 41.6% in hospitalized patients, and neurological complications as high as 3.7%.
Hospitalization rates can also be significant.
Achieving and maintaining a vaccination coverage rate of at least 95% with the MMR vaccine is essential for establishing herd immunity and preventing measles outbreaks.
Vaccination for Children:
Given the resurgence of measles due to declining vaccination rates, MMR vaccination is strongly recommended by our physicians for all eligible children. Big Trees MD is a Vaccines for Children (VFC)-certified provider, offering MMR vaccines to eligible children, including those who are uninsured, regardless of Big Trees MD membership status.
The normal vaccination schedule for the Measles, Mumps, and Rubella (MMR) vaccine for a child is as follows:
1. First dose at 12-15 months of age.
2. Second dose at 4-6 years of age.
This schedule is recommended by the ACIP of the CDC.The two-dose regimen ensures high levels of immunity and is crucial for preventing measles outbreaks.
For children traveling internationally, an additional dose may be administered earlier:
• Infants aged 6-11 months should receive one dose before travel. These infants will still need the two routine doses after their first birthday, spaced at least 28 days apart.
Measles poses a significant, highly-contagious public health threat, particularly to unvaccinated individuals. Adherence to current immunization guidelines, including serologic testing and MMR vaccination, is crucial for mitigating the risk of infection and complications.
If we don't maintain our vaccination rate for measles above 95%, we will see the return of widespread measles.
Members who wish to receive an MMR vaccine or titer through their insurance simply need to let us know by sending a portal message. If you have further questions, please also send a portal message.
Non-members who are eligible for vaccination through VFC, please call us at 209.653.2135 to schedule a vaccine appointment today.
Comments