Why is rubella vaccine given postpartum

A dose of MMR vaccine administered up to 4 days before the first birthday may be counted as valid. However, school entry requirements in some states may mandate administration on or after the first birthday. The 4-day "grace period" should not be applied to the day minimum interval between two doses of a live parenteral vaccine.

Can MMR be given on the same day as other live virus vaccines? If you can give the second dose of MMR as early as 28 days after the first dose, why do we routinely wait until kindergarten entry to give the second dose?

The second dose of MMR may be given as early as 4 weeks after the first dose, and be counted as a valid dose if both doses were given after the first birthday. The second dose is not a booster, but rather it is intended to produce immunity in the small number of people who fail to respond to the first dose.

The risk of measles is higher in school-age children than those of preschool age, so it is important to receive the second dose by school entry.

It is also convenient to give the second dose at this age, since the child will have an immunization visit for other school entry vaccines. What is the earliest age at which I can give MMR to an infant who will be traveling internationally?

Also, which countries pose a high risk to children for contracting measles? ACIP recommends that children who travel or live abroad should be vaccinated at an earlier age than that recommended for children who reside in the United States.

Before their departure from the United States, children age 6 through 11 months should receive 1 dose of MMR. The risk for measles exposure can be high in high-, middle- and low-income countries. Consequently, CDC encourages all international travelers to be up to date on their immunizations regardless of their travel destination and to keep a copy of their immunization records with them as they travel.

For additional information on the worldwide measles situation, and on CDC's measles vaccination information for travelers, go to wwwnc. If we give a child a dose of MMR vaccine at 6 months of age because they are in a community with cases of measles, when should we give the next dose? The next dose should be given at 12 months of age. The child will also need another dose at least 28 days later.

For the child to be fully vaccinated, they need to have 2 doses of MMR vaccine given when the child is 12 months of age and older.

A dose given at less than 12 months of age does not count as part of the MMR vaccine two-dose series. I have an 8-month-old patient who is traveling internationally. The infant needs to be protected from hepatitis A as well as measles, mumps, and rubella. The family is leaving in 11 days. IG may contain antibodies to measles, mumps, and rubella that could reduce the effectiveness of MMR vaccine.

For this reason, in February ACIP voted to recommend that hepatitis A vaccine should be administered to infants age 6 through 11 months traveling outside the United States when protection against hepatitis A is recommended. MMR and hepatitis A vaccine may be safely co-administered to children in this age group.

Neither vaccine is counted as part of the child's routine vaccination series. Can I give the second dose of MMR earlier than age 4 through 6 years the kindergarten entry dose to young children traveling to areas of the world where there are measles cases?

The second dose of MMR can be given a minimum of 28 days after the first dose if necessary. If I give MMR to an infant traveler younger than age 1 year, will that dose be considered valid for the U. A measles-containing vaccine administered more than 4 days before the first birthday should not be counted as part of the series. MMR should be repeated when the child is age 12 through 15 months 12 months if the child remains in an area where disease risk is high. The second dose should be administered at least 28 days after the first dose.

Live measles vaccine given prior to the application of a TST can reduce the reactivity of the skin test because of mild suppression of the immune system. An year-old college student says he had both measles and mumps diseases as a preschooler, but never had MMR vaccine.

Is rubella vaccine recommended in such a situation? This student should receive two doses of MMR, separated by at least 28 days. A personal history of measles and mumps is not acceptable as proof of immunity. Acceptable evidence of measles and mumps immunity includes a positive serologic test for antibody, birth before , or written documentation of vaccination.

For rubella, only serologic evidence or documented vaccination should be accepted as proof of immunity. Additionally, people born prior to may be considered immune to rubella unless they are women who have the potential to become pregnant. When not given on the same day, is the interval between yellow fever and MMR vaccines 4 weeks 28 days or 30 days? I have seen the yellow fever and live virus vaccine recommendations published both ways.

The CDC travel health website recommends that yellow fever vaccine and other parenteral or nasal live vaccines should be separated by at least 30 days if possible.

Either interval is acceptable. What is the recommendation for MMR vaccine for healthcare personnel? ACIP recommends that all HCP born during or after have adequate presumptive evidence of immunity to measles, mumps, and rubella, defined as documentation of two doses of measles and mumps vaccine and at least one dose of rubella vaccine, laboratory evidence of immunity, or laboratory confirmation of disease.

During an outbreak of measles or mumps, healthcare facilities should recommend 2 doses of MMR separated by at least 4 weeks for unvaccinated healthcare personnel regardless of birth year who lack laboratory evidence of measles or mumps immunity or laboratory confirmation of disease.

During outbreaks of rubella, healthcare facilities should recommend 1 dose of MMR for unvaccinated personnel regardless of birth year who lack laboratory evidence of rubella immunity or laboratory confirmation of infection or disease.

Would you consider healthcare personnel with 2 documented doses of MMR vaccine to be immune even if their serology for 1 or more of the antigens comes back negative? Healthcare personnel HCP with 2 documented doses of MMR vaccine are considered to be immune regardless of the results of a subsequent serologic test for measles, mumps, or rubella. Documented age-appropriate vaccination supersedes the results of subsequent serologic testing.

In contrast, HCP who do not have documentation of MMR vaccination and whose serologic test is interpreted as "indeterminate" or "equivocal" should be considered not immune and should receive 2 doses of MMR vaccine minimum interval 28 days. ACIP does not recommend serologic testing after vaccination. However, the person is not infectious, and no special precautions such as exclusion from work need to be taken.

A year-old female is going to pharmacy school and the school wants her to have a second dose of MMR vaccine. She had the first dose as a child and developed measles within 24 hours of receiving the vaccine. Recent serologic testing showed she is immune to mumps and measles but not immune to rubella. Can I give her a second dose of the MMR with her having measles after the first dose? Yes, as a healthcare professional, this person should get a second dose of MMR to ensure she is immune to rubella.

There is no harm in providing MMR to a person who is already immune to one or more of the components. If she developed measles only one day after getting her first MMR, she must have been exposed to the disease prior to vaccination.

What are the contraindications and precautions for MMR vaccine? See www. We have many patients who are immunocompromised and cannot get the MMR vaccine. How should we advise our patients? People with medical conditions that contraindicate measles immunization depend on high MMR vaccination coverage among those around them.

To help prevent the spread of measles virus, make sure all your staff and patients who can be vaccinated are fully vaccinated according to the U. Also, encourage patients to remind their family members and other close contacts to get vaccinated if they are not immune. If patients who cannot get MMR vaccine are exposed to measles, CDC has guidelines for immune globulin for post-exposure prophylaxis which can be found at www.

We have a patient who has selective IgA deficiency. We also have patients with selective IgM deficiency. Can MMR or varicella vaccine be administered to these patients? It is possible that the immune response may be weaker, but the vaccines are likely effective.

I have a patient who is traveling internationally and needs MMR vaccine. He recently received an injectable steroid. How long should he wait before receiving MMR vaccine?

There is no need to wait a specific interval before giving MMR. Injectable steroids are not considered immunosuppressive for the purpose of vaccination decisions, and so there is no concern about safety or efficacy of MMR. Can I give MMR to a child whose sibling is receiving chemotherapy for leukemia?

MMR and varicella vaccines should be given to the healthy household contacts of immunosuppressed children. We have a 40 lb six-year-old patient who has been taking 15 mg of methotrexate weekly for arthritis for 12 months. Can we give the child MMR and varicella vaccine based on this methotrexate dosage? Administration of both varicella and MMR vaccines are contraindicated until such time as the methotrexate dosage can be reduced.

The IDSA definition of low-level immunosuppression for methotrexate is a dosage of less than 0. Is it true that egg allergy is not considered a contraindication to MMR vaccine?

Several studies have documented the safety of measles and mumps vaccine which are grown in chick embryo tissue culture in children with severe egg allergy. ACIP recommends routine vaccination of egg-allergic children without the use of special protocols or desensitization procedures. Can I give MMR to a breastfeeding mother or to a breastfed infant? Breastfeeding does not interfere with the response to MMR vaccine.

Vaccination of a woman who is breastfeeding poses no risk to the infant being breastfed. Although it is believed that rubella vaccine virus, in rare instances, may be transmitted via breast milk, the infection in the infant is asymptomatic. If a patient recently received a blood product, can he or she receive MMR vaccine? Yes, but there should be sufficient time between the blood product and the MMR to reduce the chance of interference.

The interval depends on the blood product received. Is it acceptable practice to administer MMR, Tdap, and influenza vaccines to a postpartum mom at the same time as administering RhoGam?

Receipt of RhoGam is not a reason to delay vaccination. The current recommendations are as follows:. Administer 2 doses of MMR vaccine to all HIV-infected people age 12 months and older who do not have evidence of current severe immunosuppression or current evidence of measles, rubella, and mumps immunity. If laboratory results state only one type of parameter percentage or counts this is sufficient for vaccine decision-making.

Administer the first dose at 12 through 15 months and the second dose to children age 4 through 6 years, or as early as 28 days after the first dose. Unless they have acceptable current evidence of measles, mumps, and rubella immunity, people with perinatal HIV infection who were vaccinated prior to establishment of effective antiretroviral therapy ART should receive 2 appropriately spaced doses of MMR vaccine after effective ART has been established.

If laboratory results state only one type of parameter percentages or counts this is sufficient for vaccine decision-making. What is the recommended length of time a woman should wait after receiving rubella MMR vaccine before becoming pregnant? How should teenage girls and women of child-bearing age be screened for pregnancy before MMR vaccination?

ACIP recommends that women of childbearing age be asked if they are currently pregnant or attempting to become pregnant. Vaccination should be deferred for those who answer "yes. Pregnancy testing is not necessary. If a pregnant woman inadvertently receives MMR vaccine, how should she be advised? No specific action needs to be taken other than to reassure the woman that no adverse outcomes are expected as a result of this vaccination.

MMR vaccination during pregnancy is not a reason to terminate the pregnancy. You should consult with others in your healthcare setting to identify ways to prevent such vaccination errors in the future.

We require a pregnancy test for all our 7th graders before giving an MMR. Is this necessary? Can we give an MMR to a month-old whose mother is 2 months pregnant? Measles, mumps, and rubella vaccine viruses are not transmitted from the vaccinated person, so MMR vaccination of a household contact does not pose a risk to a pregnant household member.

If a woman's rubella test result shows she is "not immune" during a prenatal visit, but she has 2 documented doses of MMR vaccine, does she need a third dose of MMR vaccine postpartum?

In , ACIP changed its recommendation for this situation see www. It is recommended that women of childbearing age who have received 1 or 2 doses of rubella-containing vaccine and have rubella serum 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.

I have a female patient who has a non-immune rubella titer two months after her second MMR vaccination. This complication is rare in men or children who get rubella. In rare cases, rubella can cause serious problems, including brain infections and bleeding problems. Rubella is caused by a virus a tiny organism that can make you sick. It is not caused by the same virus that causes measles. It spreads through the air when an infected person coughs or sneezes, or by sharing food or drinks with someone who is infected.

It also can be passed to a baby from a pregnant person who is infected. A person with rubella may spread the disease to other people up to 1 week before they notice a rash. Infected people can continue to spread the disease up to 7 days after getting a rash. People infected with rubella should tell their friends, family, and the people they work with if they have rubella.

Telling others helps prevent the spread of rubella to even more people. Rubella can be serious for the baby, especially during the first 3 months. Having rubella during pregnancy increases the risk of:. Immune means being protected from an infection.

You are probably immune to rubella because you were vaccinated as a child or you had the illness during childhood. If you were not born in the United States or came as an adult you may not be vaccinated against rubella.

Ask your health care provider to do a blood test to see if you are immune to rubella. Before pregnancy. Get the measles, mumps and rubella MMR vaccine. Wait 1 month before trying to get pregnant after getting the shot.

During pregnancy. But there are things you can do to help prevent getting infected with rubella:. After pregnancy. Get the MMR vaccination after you give birth. It is safe to get the MMR vaccine while nursing. It also prevents you from passing rubella to your baby during a future pregnancy. For example:. Women who are planning to become pregnant should check with their doctor to make sure they are vaccinated before they get pregnant.

Because MMR vaccine is an attenuated weakened live virus vaccine, pregnant women who are not vaccinated should wait to get MMR vaccine until after they have given birth. Adult women of childbearing age should avoid getting pregnant for at least four weeks after receiving MMR vaccine.

Skip directly to site content Skip directly to page options Skip directly to A-Z link. Section Navigation. Facebook Twitter LinkedIn Syndicate. Having measles, mumps, or rubella during pregnancy might increase the chance of stillbirth fetal death after 20 weeks. A measles or mumps infection near the time of delivery might also increase the chance of a baby being born with the infection, although this is thought to be rare.

Does having measles, mumps, or rubella in pregnancy cause long-term problems in behavior or learning for the baby? Having a rubella infection in pregnancy has been shown to cause intellectual disabilities in some children. There is not enough information to know if measles or mumps can cause long-term problems in behavior or learning for the baby. If you have measles, mumps, or rubella, talk to your healthcare provider about the best ways to prevent the spread of the illness to your breastfed baby.

Can having measles, mumps, or rubella make it harder for me to get my partner pregnant or increase the chance of birth defects? Measles and rubella have not been studied for effects on male fertility. A mumps infection may temporarily decrease testicular size, but this is not likely to cause infertility difficulty getting a partner pregnant. Infected partners can pass these viruses to a pregnant person through close contact.

In general, exposures that fathers or sperm donors have are unlikely to increase the risk to a pregnancy. The MMR vaccine is a mixture of live but weakened measles, mumps, and rubella viruses.

The vaccine causes a person to develop antibodies to these viruses and provides protection should they encounter these viruses in the future. These antibodies usually last for life. The vaccine may cause mild side effects including rash or joint aches. In the U. I am not sure if I ever received the MMR vaccine. Should I get the vaccine before becoming pregnant? It is recommended that all individuals of childbearing age who do not have immunity to MMR receive the vaccine at least one month before getting pregnant.

If you were born outside the U. There is no evidence that getting the MMR vaccine during pregnancy would increase the chance of birth defects. The MMR vaccine is not recommended during pregnancy because of a very small chance of developing the disease from the weakened virus in the vaccine itself.