TM Owner Merck & Co.
M-M-R II 0.5mL Injection
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Indications & Clinical Uses
- M-M-R II 0.5 mL is a live attenuated combination vaccine from Merck Sharp & Dohme (Merck & Co.) containing measles, mumps and rubella virus strains, used for active immunisation against all three diseases.
- In the US it is approved for people 12 months of age and older, normally given as a two-dose childhood series (first dose at 12-15 months, second dose at 4-6 years, at least one month apart), and can be used off the routine schedule for outbreak control, international travel or post-exposure protection within 72 hours of measles exposure.
- It is given only by a healthcare provider in a clinic or hospital setting, never self-administered.
- Equivalent combination MMR vaccines are marketed under other brand names by different manufacturers, including Priorix (GSK) and, in the EU, M-M-RVaxPro (MSD); these are licensed as interchangeable for routine immunisation but are not identical products.
Side Effects
- The most common reaction after M-M-R II is pain, redness or swelling at the injection site; fever of 38.0°C or higher was seen in about two-thirds of vaccinated children in clinical trials, and a measles-like rash occurred in roughly 3%.
- Febrile seizures can occur, most often 5-12 days after vaccination, and should prompt medical review if a child develops a high fever.
- Temporary low platelet counts (thrombocytopenia) can appear 4-6 weeks after the dose and usually resolve on their own.
- Rare but serious reactions include encephalitis, Guillain-Barré syndrome and severe allergic reactions such as anaphylaxis, particularly in people with severe egg allergy or gelatin allergy.
- Seek urgent medical care for high fever with seizures, breathing difficulty, facial or throat swelling, or unusual bruising after vaccination.
Precautions & Warnings
- M-M-R II must not be given to anyone who is pregnant, and pregnancy should be avoided for one month after vaccination because it is a live vaccine; it is also contraindicated in people with primary or acquired immunodeficiency, active untreated tuberculosis, moderate or severe febrile illness, or known hypersensitivity to any vaccine component including gelatin or neomycin.
- Use caution in people with a history of severe egg allergy, seizures, or thrombocytopenia, and in those with a family history of congenital immune deficiency.
- Immune globulin or other blood products should not be given at the same time as M-M-R II, as they can blunt the immune response; leave the recommended interval before or after such products.
- If a tuberculin skin test is needed, give it before, at the same time as, or 4-6 weeks after vaccination, since the vaccine can temporarily suppress skin-test reactivity.
- There is no specific driving restriction, but mild fever or feeling unwell after vaccination should be monitored.
Avoid Interactions
- Concurrent use of corticosteroids, chemotherapy, radiation or other immunosuppressive treatment can reduce the vaccine's effectiveness or, rarely, allow disseminated infection with the vaccine virus, so M-M-R II is generally deferred until immunosuppression has resolved.
- Immune globulins, whole blood or plasma given around the time of vaccination can interfere with the immune response; vaccination should be delayed for the recommended interval after such products (often 3 months or more, depending on the dose received).
- Other live vaccines, such as varicella or yellow fever vaccine, should be given on the same day as M-M-R II or spaced at least 4 weeks apart.
- Tell your healthcare provider about all medicines, recent blood products and other vaccines received, so timing can be planned correctly; do not mix M-M-R II with any other vaccine or diluent in the same syringe unless specifically authorised.
References
Frequently Asked Questions
M-M-R II is a live vaccine from Merck that protects against measles, mumps and rubella. It is given to people 12 months and older, usually as a two-dose childhood series. It can also be used after measles exposure or before travel to areas with active outbreaks.
A healthcare provider gives M-M-R II as a single 0.5 mL injection into the muscle or under the skin, usually in the upper arm or thigh. The standard schedule is one dose at 12-15 months and a second at 4-6 years, at least one month apart.
Most children get injection-site soreness or a fever of 38.0°C or higher, and some develop a mild rash. Febrile seizures can occur, usually 5-12 days after the dose. Seek urgent care for high fever with a seizure, breathing trouble or facial swelling.
M-M-R II must not be given during pregnancy, and pregnancy should be avoided for one month afterward, because it contains live virus. It is also avoided in people with weakened immune systems, active tuberculosis, or severe allergy to gelatin, neomycin or egg.
There is no need to restart the series if a dose is late; simply give the missed second dose as soon as possible, keeping at least one month between doses. M-M-R II is given in a clinic, so your provider tracks and reschedules doses for you.
No - M-M-R II is contraindicated in pregnancy and should not be given if pregnancy is possible within the next month. It is approved from 12 months of age, though it can be given as young as 6-12 months during an outbreak, with the routine doses still needed later.
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