Home > Expert Insights, In the News, Preventable Diseases > Giving MMR Vaccine Early To Protect Children Against Measles

Giving MMR Vaccine Early To Protect Children Against Measles

MeaslesAs the number of measles cases tied to the Disneyland outbreak continues to rise, parents are growing concerned about possible measles exposure in children who are not yet old enough to receive their first dose of MMR (measles, mumps rubella) vaccine.  The CDC recommendation is to administer the first dose of MMR between the ages of 12-15 months.  However, this recommendation leaves children under one year of age at risk, and so Abigail, like many other parents with young children, raised her concerns on our Vaccinate Your Baby Facebook page by asking

Does anyone have information on giving the MMR vaccine early? My child is just 6 months old. We live in Southern California, a hotbed of the latest measles outbreak. We’re right in it…even our local grocery store was exposed. 

I’m a stay at home mom and he has no siblings, and at this point, we are not taking him to public areas often. But this outbreak is incredibly worrisome. I read that children who travel can be offered the MMR vaccine at 6 months. At what point should we consider it for our child? Any studies on early vaccination — risks, effectiveness, etc?

mary_beth_koslap_petracob

Every Child By Two Scientific Advisory Board Member, Mary Beth Koslap-Petraco, DNP, PNP-BC, CPNP, FAANP responds to Abigail’s question as follows:

MMR vaccine is very safe for babies. I have given it numerous times to children less than 12 months old who are traveling outside the U.S. The reason we usually don’t administer the vaccine until babies are 12 months old is because there is evidence that the baby still has some passive immunity from the mom. This can prevent the baby from mounting a robust immune response to the vaccine. Once the baby is 6 months old that immune response does start to wane. So for babies traveling outside the country we don’t like to take any chances. Especially since measles is endemic in many places outside of the U.S., to include countries in Europe, Asia, the Pacific, and Africa.  In fact, of the 288 cases of measles that occurred in the U.S. during the first half of 2014, 280 cases (97%) were associated with importations from at least 18 countries.

If you live or are traveling to an area that has a known measles outbreak, then it would definitely be advisable to talk to your child’s doctor about administering an MMR vaccine prior to 12 months of age.  However, it is important to realize that those babies will need to get another MMR when they are 12 months old because by then we can be more certain that the passive immunity from the mother is gone.

Because studies have shown that about 5% of individuals don’t mount an immune response after one shot, we then give a second MMR at 4-6 years of age.  Unfortunately, about 1% of the population will never develop immunity even after the recommended two shots.  That is one reason we must make sure everyone who can be vaccinated is. This way we keep the possibility of disease transmission low, which in turn protects both the people who could not mount immunity through the vaccine, as well as those who can’t be vaccinated because they’re not old enough or have certain medical condition that prevent them from being vaccinated.

This is a concept we refer to as herd immunity and in the case of measles, which is highly contagious, we need as much as 94% of the population to be immune in order to maintain a threshold that will prevent outbreaks such as the one we’re seeing as a result of exposure in Disneyland.   All it takes is for a single case of measles to arrive in this country to spark an outbreak.  In the past, this has typically occurred as a result of an unvaccinated American who traveled outside the country who then unknowingly returned home with a measles infection.   And since measles is contagious for up to four days before symptoms appear, it’s likely that contagious individuals would be out in public places without even knowing they are infected.

It is understandable for parents to be concerned about measles outbreaks. Measles can be extremely dangerous, especially to young children.  That is why I would suggest you contact your doctor or local health department to inquire about the possibility of giving your child the MMR vaccine if they are between 6-11 months of age.  The health department should be our go-to resource for assessing the risk of disease in our local communities and for helping us determine if the MMR vaccine is appropriate for a specific population.

If you have questions regarding measles vaccination, send them to shotofprevention@gmail.com and we will ask the Scientific Advisory Board to address them.

Dr. Mary Beth Koslap-Petraco is coordinator for child health at Suffolk County Department of Health Service in New York, a primary care provider and preceptor for graduate and undergraduate students, and an assistant professor at Long Island University Post in Greenvale, New York. She is a nationally known expert in immunization practice and is an advisor for the Centers for Disease Control and Prevention and served on the Advisory Board of the Immunization Action Coalition and National Vaccine Advisory Committee. Dr. Koslap-Petraco has advised local and state health departments on immunization public policies using her expertise as a public health nurse to influence system level changes. Dr. Koslap-Petraco  currently serves on the Executive Board and Scientific Advisory Board of Every Child by Two.
  1. reissd
    January 27, 2015 at 9:55 am

    Thank you, this is really, really helpful. Several moms in my area are – justifiably – very worried.

    Like

  2. January 27, 2015 at 10:37 am

    Reblogged this on The Polk County Immunization Coalition and commented:
    This is an excellent post, especially for anyone concerned about the measles outbreak in California. The bottom line is seeking information from your local, trusted health providers.

    Like

  3. johnfryer
    January 27, 2015 at 11:24 am

    Hi Thanks for your comprehensive answer.

    When I was younger we looked at the infections in other places and took the vaccines/immunoglobins to cover them.

    I had one for typhoid for example and that was going to another country in modern Europe.

    Why isnt it compulsory for travellers going to places with measles just to get a shot before leaving?

    And the same for people going to the USA who might bring the illness with them if not vaccinated.

    Like

  4. Lawrence
    January 27, 2015 at 3:29 pm

    It probably should be – but difficult to enforce.

    Like

  5. Greg Stern MD
    January 28, 2015 at 4:41 am

    Thanks for mentioning “The health department should be our go-to resource for assessing the risk of disease in our local communities and for helping us determine if the MMR vaccine is appropriate for a specific population.” I work at a county health department and we had an outbreak of 6 cases last year. We spent a lot of time identifying and monitoring contacts and consulting with our state Department of Health regarding control measures. If vaccination is indicated outside of the usual schedule, the health departments would be contacting clinicians and notifying the public.

    Like

  6. Irene
    January 29, 2015 at 8:18 am

    What about if you are traveling to an area with measles and your child is 5 months old?

    Like

  7. January 29, 2015 at 9:10 am

    Irene – consult your pediatrician.

    Like

  8. Mc
    January 31, 2015 at 12:22 am

    Hi. I have two little ones. My youngest has recently gotten her first dose. My oldest is almost four. I have been searching for information about how covered they are, but can’t find it anywhere. I don’t really understand how a two dose vaccine works, though this article has clarified some for me. Obviously, my three year old will be getting her second dose in a couple of months, but should I be concerned since we’re in an area where there’s an outbreak? Thanks!

    Like

  9. jgc56
    January 31, 2015 at 1:14 am

    Around 95% of children receiving one dose of measles vaccine before their first birthday develop protective antibody titers, so even after just one dose it’s likely your child is protected. About 99% of people who receive a second dose after 12 months are seen to have developed protective titers, and that’s a highly significant improvement given that measles’ threshold for herd immunity also hovers right around 95%.

    Like

  10. ar28
    February 3, 2015 at 1:34 pm

    Thank you for this article. I just gave my daughter her second MMR at 3 1/2 years old simply because we are headed to Southern California and DisneyLand in about a month. My Pediatrician didn’t even offer the titer. After hearing where we were going, he didn’t hesitate and gave her the shot now (before the scheduled 4-6 yrs old). Even if her antibodies were good after the 1st shot, I did not want to take any chances.

    Like

  11. February 5, 2015 at 2:59 am

    Is there anyway someone can expand on this article? i have a two months old, and live in Orange county, southern California. I want to know if my baby can receive a vaccination as early as possible, if so I how early, without increasing any medical safety risk.

    Like

  12. Chris
    February 5, 2015 at 3:42 am

    marcus lee, have you talked to your baby’s doctor?

    Like

  13. February 8, 2015 at 12:22 am

    One of the brilliant pieces i have seen in the week.

    Like

  14. February 8, 2015 at 1:05 pm

    I’ve just bookmarked this page, great website!

    Like

  15. Christine Vara
    February 17, 2015 at 12:17 pm

    marcus lee, please send your specific questions to shotofprevention@gmail.com if you haven’t already. We have been receiving dozens of inquiries and have asked our scientific advisory board to assist in responding.

    Like

  16. February 17, 2015 at 3:09 pm

    Yes I have. Just talked to the pediatrician last week, and at this point, she states that the current recommendation is still MMR vaccination at 1 year, and not at 6 months.

    Like

  17. heather
    February 27, 2015 at 12:12 pm

    My daughter is 15. She’s had two mmr shots. Her school nurse called me and told me she needs another one because her first mmr vaccine was given the day before she turned one so it doesn’t count. This sounds completely ridiculous to me, but I would love your professional opinion

    Like

  18. jgc56
    February 27, 2015 at 12:22 pm

    well, her immune system thinks it still counts: if she’s had two shots in total she’s as protected as she’s going to get (but just try explaining that to a bureacracy…)

    Your physician should be able to write a note explaining that it is not medically indicated for her to receive a third MMR shot

    Like

  19. Lawrence
    February 27, 2015 at 1:46 pm

    @heather – sounds a bit ridiculous to me as well. I agree with JGC, speak with your pediatrician & I’m sure he’ll be happy to write that note for you.

    Like

  20. Shonda Mahmoud
    March 5, 2015 at 6:50 am

    However Dusty

    Like

  21. Claudia
    March 12, 2015 at 2:56 pm

    As an adult, should we be getting a 3rd MMR during this time? I know when I was pregnant with my first child in 2011 I was tested to see if I was still immune to some diseases, since at 28 my mom had long lost my immunization record and I wasn’t sure. I do remember my doctor telling me I was still immune to Rubella so I didn’t need any additional shots. That was almost 4 years ago. When should an adult think about getting a booster?

    Like

  22. jgc56
    March 12, 2015 at 3:50 pm

    With respect to measles the CDC recommends that adults who received either an inactivated (killed) measles vaccine or a measles vaccine of an unknown type during the period from 1963 through 1967 be revaccinated with 2 doses of MMR vaccine.

    With respect to mumps it recommends adults vaccinated before 1979 with either killed mumps vaccine or mumps vaccine of unknown type and who are also at high risk for mumps infection (e.g., health care workers) be revaccinated with 2 doses of MMR vaccine. and that .

    With respect to rubella, it recommends that women of childbearing age–regardless of birth year–have their immune status determined (i.e., rubella antibody titer measured). If this indicates they are not protected those who are not pregnant should be vaccinated, while those who are pregnant should receive MMR vaccine upon completion or termination of pregnancy and before discharge from the health care facility.

    Like

  23. Lawrence
    March 12, 2015 at 3:53 pm

    If you are concerned, then you can have your titers tested – the components of the MMR offer very long-lasting immunity (decades at minimum)….but a very small percentage of people may either not get immunity to begin with or have it wane.

    Like

  24. Deepak shetty
    February 8, 2017 at 10:29 am

    We have given two MMR vacination dose to our child. Is it compulsory to give the MR vacination now.

    Like

  25. Merry Grace Barite
    September 19, 2017 at 3:28 am

    I just want to ask,what will happen if the MMR will be given to less than 6months old?

    Like

  26. Lawrence
    September 19, 2017 at 8:11 am

    A decent chance that the baby won’t get measles…..

    Like

  1. February 17, 2015 at 11:35 am
  2. February 28, 2015 at 1:51 pm
  3. March 3, 2015 at 8:08 am

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