VIDEOS
MMR Vaccine Product Insert
Measles Vaccine Product Insert
The live virus measles vaccine is no longer available in the U.S.
Rubella Vaccine Product Insert
Mumps Vaccine Product Insert
Media Reports About MMR Vaccine Debate
Measles, also called rubeola, is a highly contagious disease caused by a virus and is spread by coughing, sneezing or simply breathing near another person. Measles usually is most common in the late winter and early spring. Up until the past two decades, measles was one of the most common childhood diseases in America, occurring primarily in children aged two to six years, and almost every child had measles by the age of 15.
Historically, the majority of children in technologically advanced countries recovered from measles without major complications. However, measles in teenagers and adults or in very young infants can be much more severe with serious complications and increased mortality. In 1941, there were 894,134 cases of measles reported, the highest number of cases ever reported in one year. A record low of 44 cases was reported in 2002.
Some researchers believe that measles as a childhood disease in years past helped the human immune system to mature, priming it to be more effective in dealing with challenges from viruses and bacteria later in life. Recovery from natural measles infection confers lifelong immunity and a woman who has recovered from measles as a child passes maternal antibodies to her fetus, which often protects her newborn from measles for the first year of life. Young mothers today, who were vaccinated as children and never had measles do not have natural maternal measles antibodies to pass on to their babies and, so, most American babies born today are vulnerable to measles from the moment of birth.
Measles is a cyclical disease and there are increases around the world every two to three years. Measles is dangerous in Third World countries or in underprivileged communities in technologically advanced countries with poor living conditions, sanitation, nutrition and substandard health care.
The incubation period for measles is usually 10 to 20 days and the course of the disease lasts several weeks. Most cases of measles are mild and symptoms begin with a light, hacking cough, low fever, runny eyes and nose and general signs of a cold. For four or five days before the outbreak of measles spots, the cough can become more severe and hacking with swelling and redness of the eyes and sensitivity to light. Fevers can be high (104-105 F.). The symptoms of high fever and cold do not respond to antibiotics, aspirin or cough medicine.
The symptoms worsen before the rash appears and 24-49 hours before the rash appears, the inside of the mouth is covered with grayish-white dots surrounded by reddening that are about the size of a grain of salt. The rash is faint at the beginning and first appears behind the ears and then becomes darker and spreads rapidly to the face, neck and arms within 24 hours. By the time the rash reaches the legs and feet - in two to three days - it begins to fade on the face and gradually fades from the rest of the body in the next few days. As soon as the rash appears, the child appears to be much better.
Treatment includes soothing applications to relieve the itchy rash and fluids, cool sponge baths and other therapy to help reduce fever and prevent dehydration. Other health care therapies including homeopathy, naturopathy, Traditional Chinese Medicine, and chiropractic have been used to modify the symptoms of measles and enhance the natural ability of the immune system to heal the body. Recovery from measles in a previously healthy child is usually complete without complications.
However, a severe case of measles can include secondary infections such as otitis media (inner ear infections), strep, bronchitis, pneumonia, hepatitis and Haemophilus influenza. Occasionally, extremely high fevers, brain inflammation and convulsions can be followed by permanent brain damage, transverse myelitis, subacute sclerosing panencephalitis, deafness, blindness, paralysis, and death. Complications are more common in adults, in immune compromised or chronically ill children and in babies under one year old.
An atypical, severe form of measles has been seen in some persons who have been vaccinated with inactivated measles vaccine (not currently used in the U.S.). Symptoms begin with a fever, headache and stomach pain for several days and then a rash appears on the hands and feet and progresses towards the head - just the opposite progression that is seen in natural measles. The rash is especially noticeable on the legs and in body creases. Severe pneumonia is a common complication. Live virus measles vaccine, which is licensed for use in the U.S. today, can sometimes cause vaccine strain measles virus infection, which is very severe and can end in death.
Mumps is a viral disease that can be spread through coughing, sneezing of simply breathing near another person. It used to be a very common childhood disease in the U.S. among children under age ten. In 1968, there were 152,209 cases reported, the highest number of cases ever reported in one year. In 2002 there were 270 reported cases. A usually mild disease in children, it can be much more severe in older teenagers and adults.
Mumps can cause fever, headache and inflammation of the salivary glands, which makes the cheeks swell. Incubation is generally 14 to 21 days. Symptoms may begin with low grade fever, headache, vomiting and earache. Swelling first appears in front of the ear above the jaw line but the glands under the chin can also be involved. Eating is painful because the saliva irritates swollen glands. Just one side or both sides of the face may swell. Swelling usually goes away in a week and recovery is usually complete without complications.
Rarely, mumps can be more severe and cause an inflammation of the lining of the brain and spinal cord (meningitis). Symptoms include severe headache, vomiting, irritability, lethargy. Rarely, it can cause inflammation of the brain itself and can cause permanent brain damage, deafness or death (one death was reported in 1991). Adolescent or adult males who get mumps can develop painful inflammation and swelling of the testicles (orchitis) and, in rare cases, become sterile.
Treatment for mumps infection includes bed rest, bland diet and plenty of fluids. Other health care therapies such as homeopathic, naturopathic, Traditional Chinese Medicine and chiropractic have been used to modify the symptoms of mumps and enhance the functioning of the immune system. Recovery from mumps infection confers lifelong immunity.
Also known as German Measles or the "three day measles," rubella is usually a mild childhood disease and used to be common in American children five to nine years old. However, today in the U.S., rubella is most frequently seen among teenagers and young adults when it can be more serious.
In 1969, there were 57,686 cases of rubella reported in the U.S., the highest number of cases reported In one year. In 1992, there were 160 cases of rubella reported in the U.S. with one death reported to have resulted from disease complications. In 2002, there were only 18 reported cases.
Rubella is a cyclical disease and increases are seen around the world every six to nine years. It occurs most often in the winter and spring and is spread through coughing, sneezing or simply breathing near another person. The virus can be found in an infected person's blood and throat.
Incubation period is 14 to 21 days. Symptoms begin with signs of a mild cold, low-grade fever and swelling of the glands in the back of the neck and under the chin. Sometimes the glands behind the ears become enlarged. A pink rash first appears on the face and then spreads to the arms, head, chest and sometimes the legs. The rash is not as red or blotchy as measles and generally fades by the third to fifth day. Recovery from rubella usually confers lifelong immunity, although repeat cases do occur rarely.
If a woman gets rubella in the first trimester of pregnancy, she has a 20 to 25 percent greater chance of giving birth to a deformed baby and is at risk of suffering a miscarriage. Birth defects can include blindness, damage to the heart and major arteries, deafness, abnormally small brain and mental retardation.
Young adults, especially young women, who get rubella may have swollen glands in the back of the neck and some pain, swelling and stiffness in the joints (arthritis) that persists for several weeks. Recovery from rubella is usually quick but occasionally brain inflammation and chronic arthritis can cause permanent damage.
The most frequent reactions reported to occur following MMR vaccine include brief burning and stinging at the injection site; fatigue, sore throat, cough, runny nose, headache, dizziness, fever, rash, nausea, vomiting or diarrhea, and sore lymph glands. Other reported reactions include anaphylaxis, convulsions, encephalopathy, otitis media, conjunctivitis, nerve deafness, thrombocytopenia purpura, optic neuritis, retinitis, arthritis, Guillain-Barre syndrome, and subacute sclerosing panencephalitis.
In 1981, the British National Childhood Encephalopathy Study concluded that there was a statistically significant association between measles vaccination and the onset of a serious neurological disorder within 14 days of receiving measles vaccine. The risk for previously normal children was estimated to be 1 in 87,000 measles vaccinations.
In 1991, the Institute of Medicine concluded that there is compelling scientific evidence that the rubella vaccine portion of the MMR shot can cause acute arthritis, with the highest incidence occurring in adult women who receive rubella vaccine (up to 15 percent) and that some individuals go on to develop chronic arthritis. Because either no studies or too few scientific studies have ever been conducted to investigate rubella vaccine reactions, a determination could not be made as to whether rubella vaccine causes other serious health problems which have been reported following rubella vaccination including thrombocytopenia purpura, radiculoneuritis (spinal nerve pain) or other neuropathies such as carpal tunnel syndrome.
In 1994, the Institute of Medicine concluded that there is compelling scientific evidence that the measles vaccine can cause anaphylaxis that can end in death and that the MMR vaccine can cause thrombocytopenia (a decrease in the number of platelets, the cells involved in blood clotting) that can end in death. The incidence of thrombocytopenia was estimated to be 1 case per 30,000 to 40,000 vaccinated children. The IOM also concluded that the measles vaccine portion of the MMR vaccine can cause vaccine-strain measles virus infection that can end in death.
Because either no studies or too few studies have ever been conducted to investigate MMR vaccine reactions, a determination could not be made as to whether measles or mumps vaccine causes encephalitis or encephalopathy (brain disease); sensorineural deafness, or insulin dependent diabetes mellitus; whether the mumps vaccine causes aseptic meningitis, orchitis (inflammation of the testis) or sterility; or whether the measles vaccine causes subacute sclerosing panencephalitis, residual seizure disorders, optic neuritis, transverse myelitis, or Guillain-Barre syndrome.
In 1995, a British study concluded that adults who were vaccinated with measles vaccine as children were at much higher risk of developing inflammatory bowel disease such as Crohn's disease and ulcerative colitis, as adults. Several researchers are looking into the possible link between inflammatory bowel disease and measles vaccine as well as other vaccines.
The vaccine manufacturer's product insert for MMR vaccine states "It is also not known whether [the vaccine] can cause fetal harm when administered to pregnant women or can affect reproduction capacity" and "it is not known whether measles or mumps vaccine virus is secreted in human milk. Recent studies have shown that lactating postpartum women immunized with live attenuated rubella vaccine may secrete the virus in breast milk and transmit it to breast-fed infants."
An MMR vaccine manufacturer states that in a study of 279 children 11 months to 7 years of age, MMR vaccine was shown to be 95 to 99 percent effective. Protection is estimated to persist for up to 11 years. In a measles outbreak in the U.S. in the late 1980's and early 1990's, it was found that there were a significant number of vaccine failures in older children, teenagers and adults, when the disease can be more severe. The government proceeded to recommend that a second MMR shot be given to boost immunity either before entrance to kindergarten or before entrance to junior high school.
In the national outbreak of measles during the late 1980's and early 1990's, it also became apparent that children who had been vaccinated before 15 months of age were also at risk for vaccine failure, especially if their mothers had recovered naturally from measles disease as children. An MMR vaccine manufacturer states "Infants who are less than 15 months of age may fail to respond to the measles component of the vaccine due to presence in the circulation of residual measles antibody of maternal origin, the younger the infant, the lower the likelihood of seroconversion." The manufacturer goes on to advise that infants vaccinated at less than 12 months of age will have to be revaccinated after 15 months of age even though "there is some evidence to suggest that infants immunized at less than one year of age may not develop sustained antibody levels when later immunized."
The measles outbreaks in the late 1980's and early 1990's in the U.S. also demonstrated that babies, whose young vaccinated mothers had never naturally recovered from measles infection as children, were vulnerable to measles infection from birth. The young vaccinated mothers did not have natural maternal antibodies to transfer to their newborns to protect them from measles in the first year of life. In the 1989-91 measles outbreak in the U.S., the largest increase in measles cases was in infants under one year old.
In 1995, there were 309 cases of measles reported in the U.S. Out of 219 cases where vaccination status was known, 123 (56 percent) had been vaccinated with at least one dose. Of 285 measles cases where age was known, 38 percent were under 5 years old and 39% were more than 20 years old.
In the mid-1990's, reports of an association between autism and vaccination (specifically suggesting a possible link with MMR vaccine) were published. Although the U.S. Institute of Medicine (IOM) acknowledged the hypothesis was biologically plausible, IOM concluded there was not enough evidence establishing a causal relationship. Nevertheless, in light of persistent reports by parents that their children are regressing into autism after MMR vaccination, there is an on-going scientific investigation by independent scientific researchers, such as British gastroenterologist Andrew Wakefield, M.D., into clinical and laboratory evidence that MMR vaccination may cause autism in biologically vulnerable children.
Information on Autism and MMR can be found on this website.