The MMR vaccine is a combined vaccine against measles, mumps and rubella.
It is given in two doses to children at around 13 months, although teenagers and adults can also have the vaccine.
What is the MMR vaccine?
MMR is a combination vaccine which offers protection against three diseases:
-measles
-mumps
-rubella (german measles)
It is first given by injection, to children at around 13 months, with a second dose given as a pre-school booster at around three to five years
The MMR vaccine can also be given to younger children, including babies from five months, who have been exposed to someone with a measles infection. This can prevent them from becoming ill themselves and helps to control the outbreak.
Pregnant women who are not immune to rubella can also receive the MMR vaccine.
The Diseases
Although children usually recover from measles, mumps or rubella, each one can be unpleasant and have serious consequences.
Measles can cause pneumonia, fits, encephalitis (infection of the brain) and a brain abnormality that can lead to mental deterioration, coma and eventually death.
Mumps can cause meningitis/encephalitis, deafness and, in boys damage the testicles causing sterility.
Rubella is usually a minor illness. However, if a pregnant woman is infected during the first part of her pregnancy, it can cause problems in the unborn child including heart damage, blindness, deafness and brain damage.
Is the MMR vaccine effective?
The combined MMR vaccine is the most effective and safe way of protecting your child against measles, mumps and rubella.
The first dose of the vaccine gives 90% protection against measles and mumps and 95% against rubella. This means that out of 100 people given the vaccine, 90 will then be immune to measles and mumps, and 95 to rubella. Adding a second dose increases the protection to over 99 percent for all three illnesses.
Since the MMR vaccine was introduced in the UK in 1988, the number of children catching measles, mumps and rubella has fallen to an all-time low. No children have died from acute measles since 1992.
Who shouldn't have the MMR vaccine?
Some children aren't able to have the MMR vaccine.
Children who have an illness such as cancer, or who are taking drugs that suppress the immune system, should not take the vaccine.
If your child has a fever, you should delay vaccination. If he or she has recently received another live vaccine, you should delay vaccination for at least three weeks. You should also delay vaccination if your child has received an immunoglobulin injection within the last three months.
If your child has a fever then vaccination should be delayed until he or she is better. The vaccine would not make their illness worse, but could make it difficult to identify side-effects.
Your doctor or nurse will be able to advise you on whether your child should be immunised.
If you are worried about how your child will react to the vaccine, or if he or she has had previous reactions, talk to your GP, practice nurse or health visitor.
Egg allergy and the MMR vaccine
The MMR vaccine is made using a protein related to egg.
Recent evidence shows that it is safe to give the MMR vaccine to nearly all children, even to those who have a very severe reaction to eggs.
If your child has a severe allergy to eggs, your GP or nurse can make special arrangements to give your child the MMR vaccine safely, such as in a hospital.
Side-effects and safety
It is not possible to say that MMR, or any vaccine, is absolutely safe. Some children do get side-effects to the MMR vaccine, especially after the first injection.
The three different viruses in the vaccine act at different times and may produce the following side-effects.
-Six to 10 days after the immunisation, some children may become feverish (this happens to about 1 in 10 children). Some develop a measles-like rash and go off their food.
-About one in every 1000 immunised children may have a fit caused by the fever. This is called a "febrile convulsion".
-Rarely, children may get mumps-like symptoms (fever and swollen glands) about three weeks after their immunisation.
-Children may get a rash of small bruise-like spots in the six weeks after the vaccination, but this is very rare. If you see spots like these, take your child to your GP to be checked.
-Fewer than one child in a million develops encephalitis (infection of the brain) after the MMR vaccine - although there is very little evidence that it is the vaccine that causes it. If a child catches measles however, the chance of developing encephalitis is between one in 200 and one in 5000.7
Side-effects of the vaccine are usually mild and, crucially, they are milder than the potentially serious effects of having measles, mumps or rubella.
Autism and Bowel Disease
The speculation over a link between the MMR vaccine and autism started in 1998 when a paper was published in a medical journal about 12 autistic children who also had bowel problems. Although the research stated that they did not prove a link between autism and the MMR vaccine, the resulting publicity gave the impression that there was a link.
If a child has autism, parents typically start to notice the signs when their child is one to two years. As the MMR injection is given at around 13 months of age, it is easy to understand why some people think they may be linked.
However, there is now a large body of scientific literature available, based on the records of millions of MMR vaccinations, that shows this is not the case. Based on this evidence, independent experts agree that there is no proven link between MMR and autism.
Although the number of cases of autism appears to have risen significantly in the last 20 years, this is probably due to better diagnosis of the condition, and a change in the way that doctors classify disorders so that autism is used more frequently than terms such as developmental delay.
Single Vaccines
There are a number of reasons why the vaccines for measles, mumps and rubella are not given separately:
-using separate vaccines could mean that fewer children would receive all the necessary vaccinations, increasing the risk of measles, mumps and rubella returning
-having separate vaccines would lead to delays between the three vaccinations - leaving children at risk of infection from measles, mumps and rubella
-three times as many injections (six in total) would be unpleasant for the child due to the pain from each jab and six episodes of side-effects
-the single vaccines are not licensed for use in the UK, and have therefore not passed the UK's tough safety and effectiveness requirements - so they may be less, not more, safe than the well-proven MMR vaccine
MMR around the World
When making your decision about whether to vaccinate your child with the MMR vaccine it is useful to consider the evidence for MMR in different countries around the world.
MMR has been around for nearly 30 years (it was introduced in the US in the 1970s for example), is used in over 100 countries, and more than 500 million doses have been given.
Studies from around the world have shown MMR to be a highly effective vaccine, with an excellent safety record.
No country recommends single rather than combined vaccines.
A website has been put together to answer any questions you might have about MMR.
NHS Immunisation Information: MMR-THE FACTS
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