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Vaccinations - MMR and Measles

Professor David Salisbury, Director of Immunisation at the Department of Health, answers questions about the MMR and Measles jabs.

He explains why vaccinations are important and what the symptoms of measles are. He also talks about single vaccines and the possible side effects of the MMR jab.

Why should my child have the MMR vaccine?

It is important to vaccinate your children against illnesses, particularly against measles, mumps and rubella with the MMR jab. People think measles is a mild disease, but that's simply not true. It is one of the most infectious viruses in the UK. It is spread most readily by people being in close contact with each other, for example, small children because they play so closely together.

There have been two deaths due to measles in the UK since 2006. Measles is one of the most infectious diseases known, so if you don't have your child vaccinated they are pretty likely to catch it.

What are the symptoms of measles?

Almost everyone who catches measles will have a high fever and a rash. They will almost certainly have to spend a week or two in resting in bed. About one in every 15 children that catch measles will have further complications. Measles can cause pneumonia, fits, swelling of the brain and even brain damage. In some cases, it can kill. The risk of infection is greatest in children who have received no MMR vaccine. Children who have only received one dose of MMR vaccine need a second dose of the vaccine to ensure they are protected.

I have heard bad things about the MMR jab in the past, should I be worried?

Some parents have found the decision about whether to give their child the MMR vaccine difficult, probably because of the media stories in recent years. There is no credible evidence to support the link between MMR vaccine and autism.

The MMR vaccine has been used widely and safely around the world for more than 30 years. Over 500 million doses have been given in over 100 countries. The MMR vaccine has been given to hundreds of millions of children around the world to protect them from measles, mumps and rubella, and in the UK about nine out of every 10 children have had the vaccination by their fifth birthday. The scientific evidence is also clear – there is plenty of evidence on the benefits and safety of the vaccine, and no credible evidence suggesting the vaccine is dangerous. It is the best way to prevent measles. Two doses of the MMR vaccine gives about 99 per cent protection against measles and also protects you against mumps and rubella.

When should my child have the MMR jab?

Children will ideally have the vaccination just after their first birthday and the second dose when they are over three years old and certainly before they start school and start to mingle with other children who might have the infection. The vaccination is free on the NHS – you can just call to make an appointment for your child with your GP or practice nurse.

Are there any adverse reactions that should I expect once my child has had the MMR vaccination?

Any vaccination can cause mild side effects, such as soreness at the site of injection. Injection site reactions do not happen often after MMR. The reactions that do happen occur when the viruses in the vaccine start to act and this happens at different times.

The following side effects can come after the first dose:

Bullet Six to ten days after the immunisation, about one in ten children may develop a mild fever and some develop a measles-like rash and go off their food for two or three days. This can happen when the measles part of the vaccine starts to work, and is normal. Your child doesn't have real measles and isn't infectious.

Bullet About one in every 1000 immunised children may have a fit caused by a fever. This is called a ‘febrile convulsion', and can be caused by any fever. If you know this could be a side effect, you can look out for the fever and treat it with infant paracetamol or ibuprofen. If a child who has not been immunised gets measles, they are five times more likely to develop a fever and have a fit.

Bullet Rarely, children may get mumps-like symptoms (fever and swollen glands) about two to three weeks after their immunisation as the mumps part of the vaccine starts to work – again this is not actually mumps and is not infectious.

Bullet Very rarely, children may get a rash of small bruise-like spots in the six weeks after the vaccination. This is usually caused by the measles or rubella parts of the vaccine. If you see spots like these, take your child to the doctor to be checked. They will tell you how to deal with the rash.

Bullet Less than one child in a million develops encephalitis (inflammation of the brain) after MMR vaccine, but other infections can also cause encephalitis. However, if a child catches measles, the chance of developing encephalitis is about one in 1000. Your doctor or practice nurse will be able to discuss these issues in more detail.

If my child has a reaction to the vaccine, how should I treat it?

Give your child infant paracetamol/ibuprofen and if symptoms persist take your child to the doctor or call NHS Direct on 0845 4647. If your child does suffer from a rash of small bruise-like spots, take your child to the doctor to be checked in the first instance.

How can I be sure the MMR jab will work to protect my child?

The MMR jab has a proven record of success- since the vaccine was introduced in 1988, it has almost wiped out measles, mumps and rubella in young children. The MMR vaccine is given in two doses. With two doses of the MMR vaccine, a child has an extremely high chance of being protected against measles, mumps and rubella.

By vaccinating our children, we also protect other children who are unable to have the vaccine for medical reasons.

Some of my friends have given their children single injections, would you recommend this?

It may be possible to have single vaccines if you pay privately, but it certainly isn't ideal. The NHS does not recommend single measles, mumps or rubella vaccines because there is no evidence to support the use of single vaccines or to suggest that they are in any way "safer" than MMR.

Having single vaccines leaves your child at risk of catching measles, mumps or rubella in the gaps between the vaccines. And the single vaccines may not all be available so your child may have started on a course that cannot be completed. Single vaccines are not currently licensed for use in the UK.

Is there an effective alternative to vaccination?

No, vaccination is the only effective way to protect your child.

Finally and most importantly, would you give your own precious child the MMR vaccination?

Yes. I would not risk my children's health by not protecting them.

"When I started working as a paediatrician, I remember very clearly the tragic case of a twelve year old boy who had come into hospital to die. He had caught measles when he was young and the virus had destroyed his brain. I also saw the terrible damage that rubella can do when it is caught by a pregnant woman. I have no wish to see or hear about such cases again when they can be so simply avoided by a safe and effective vaccine – MMR"

January 2010
Professor David Salisbury
Director of Immunisation at the Department of Health
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