For patients receiving subcutaneous immune globulin (IGSC) therapy, administration of at least 200 mg/kg body weight for 2 consecutive weeks before measles exposure should be sufficient. Prevention of measles begins with the measles vaccine (contained in MMR, MR, and measles vaccines). Markowitz LE, Chandler FW, Roldan EO, et al. Ex Officio Members: Vito Caserta, MD, MPH, Health Resources and Services Administration, Rockville, Maryland; Jesse Geibe, MD, Department of Defense, CDC, Atlanta, Georgia; Bruce Gellin, MD, National Vaccine Program Office, District of Columba; Richard Gorman, MD, National Institutes of Health, Bethesda, Maryland; Amy Groom, MPH, Indian Health Service, Albuquerque, New Mexico; Mary Beth Hance, Centers for Medicare and Medicaid Services, Baltimore, Maryland; Linda Kinsinger, MD, Department of Veterans Affairs, Durham, North Carolina; Wellington Sun, MD, Food and Drug Administration, Bethesda, Maryland. Receipt of antibody-containing blood products (e.g., immune globulin, whole blood or packed red blood cells, intravenous immune globulin) may interfere with seroconversion after measles vaccine. However, administration requires a pump and advanced training.
Travelers aged ≥6 months who do not have acceptable evidence of measles, rubella, and mumps immunity should be vaccinated with MMR vaccine. Mumps in pubescent females and its effect on later reproductive function. Click. Clin Vaccine Immunol 2007;14:644–7. Vaccine 1984;2:274–6. Unless the parent or caregiver expresses a preference for MMRV vaccine, CDC recommends that MMR vaccine and varicella vaccine should be administered at separate sites for the first dose in this age group. Measles vaccine is at least 95% effective and seroconversion rates are close 100%.
Kemp A, Van Asperen P, Mukhi A. Measles antibody in vaccinated human immunodeficiency virus type 1-infected children. Prinz W, Taubert HD. The most important cause of the measles resurgence of 1989–1991 was low vaccination coverage. RR-8]; CDC. Persistence of rubella antibodies after 2 doses of measles-mumps-rubella vaccine. The use of concentrated normal human serum gamma globulin (human immune serum globulin) in the prophylaxis and treatment of measles. Most of these reactions are minor and consist of a wheal and flare or urticaria at the injection site. Acute arthralgia or arthritis are rare among children who receive RA 27/3 vaccine (160,303).

Pediatr Infect Dis J 1999;18:620–3. Epidemiology of rubella. Vestergaard M, Hviid A, Madsen KM, et al. A second dose of measles vaccine was recommended for school-aged children in 1989, and all states now require two doses of measles vaccine for school-aged children. Rubella vaccination in pregnancy. The minimum interval between 2 doses of MMRV vaccine is 3 months. Mumps—United States, 1985–1988. 2011.

Providers who are considering administering MMRV vaccine should discuss the benefits of and risks for both vaccination options with the parents or caregivers. Chamot E, Toscani L, Egger P, Germann D, Bourquin C. [Estimation of the efficacy of three strains of mumps vaccines during an epidemic of mumps in the Geneva canton (Switzerland)]. Weibel RE, Carlson AJ Jr, Villarejos VM, et al. Signs and symptoms of SSPE appear an average of 7 years after measles infection, but might appear decades later (27).

Persons with perinatal HIV infection who were vaccinated with measles-, rubella-, or mumps-containing vaccine before establishment of effective ART should receive 2 appropriately spaced doses of MMR vaccine (i.e., 1 dose now and another dose at least 28 days later) once effective ART has been established unless they have other acceptable current evidence of measles, rubella, and mumps immunity (Table 3). Persons who have an equivocal serologic test result should be considered susceptible to mumps unless they have other evidence of mumps immunity (Table 3) or subsequent testing indicates mumps immunity. All MMWR HTML versions of articles are electronic conversions from typeset documents. Usonis V, Bakasenas V, Kaufhold A, Chitour K, Clemens R. Reactogenicity and immunogenicity of a new live attenuated combined measles, mumps and rubella vaccine in healthy children. Seroepidemiological profile of pregnant women after inadvertent rubella vaccination in the state of Rio de Janeiro, Brazil, 2001–2002. All persons who work within medical facilities should have evidence of immunity to measles, mumps, and rubella. Outbreaks of rubella in populations vaccinated with the rubella RA 27/3 vaccine strains are rare. N Engl J Med 1985;313:544–9. Following further viral replication in regional and distal reticuloendothelial sites, a second viremia occurs 5–7 days after initial infection. Schlegel M, Osterwalder JJ, Galeazzi RL, Vernazza PL. Ogbuanu IU, Kutty PK, Hudson JM, et al. Two doses of MMR vaccine are recommended for all persons aged ≥12 months with HIV infection who do not have evidence of measles, rubella, and mumps immunity or evidence of severe immunosuppression. Wharton M, Cochi SL, Hutcheson RH, Bistowish JM, Schaffner W. A large outbreak of mumps in the postvaccine era. Laurence D, McGavin D. The complications of mumps. However, the actual number of cases was estimated at 3–4 million annually. Women of childbearing age who have 1 or 2 documented doses of rubella-containing vaccine and have rubella-specific IgG levels that are not clearly positive should be administered 1 additional dose of MMR vaccine (maximum of 3 doses) and do not need to be retested for serologic evidence of rubella immunity. Arch Dis Child 1987;62:189–91. MMR and MMRV vaccine should not be administered to persons who have experienced severe allergic reactions to a previous dose of measles-, mumps-, rubella-, or varicella (for MMRV vaccine)-containing vaccine or to a vaccine component. Mumps vaccine performance among university students during a mumps outbreak. Fewer opportunities exist for boosting this immunity by exposure to wild type viruses. Hinman AR, Orenstein WA, Papania MJ. To prevent disease and transmission in health-care settings, health-care institutions should ensure that all persons who work in health-care facilities have documentation of adequate vaccination against measles, rubella, and mumps or other acceptable evidence of immunity to these diseases (Table 3) (6). Ann Intern Med 1950;32:1066–74. The inactivated vaccine was withdrawn in 1967 because it did not protect against measles virus infection. Memory B cell counts and function appear to be normal in HIV-infected children who are started on effective ART early (aged <1 year), and responses to measles and rubella vaccination appear to be adequate. Pediatrics 1975;55:392–6. CDC. MMR vaccination might cause febrile seizures.

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