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Who Should Not Get Measles Vaccine?


Who should not get measles vaccine?

Contraindications to receiving the MMRII vaccine documented in Merck’s product insert include1:

  • Persons who have experienced a severe allergic reaction or anaphylaxis to any MMR vaccine component, including gelatin and neomycin, should not be vaccinated with MMR.
  • Pregnant women should not receive this vaccine, as well as women seeking to become pregnant should avoid become pregnant for 3 months following MMR vaccination.
  • Individuals receiving immunosuppressive therapy. Vaccination with MMR should be delayed for 3 months following the administration of human immune globulin, blood, or plasma.
  • Persons with leukemia, lymphoma, blood dyscrasias and other malignant neoplasms affecting the lymphatic systems or bone marrow.
  • Individuals with febrile respiratory illness or other active febrile infection should avoid MMR vaccine.
  • MMR and other measles-containing vaccines are not recommended for HIV-infected persons with evidence of severe immunosuppression.
  • Persons with a family history of hereditary or congenital immunodeficiency should not be vaccinated with MMR until the immune competence of the recipient has been determined.
  • Individuals with untreated tuberculosis should not be vaccinated with MMR vaccine.

Merck’s MMRII product insert also warns that caution should be taken when administering the vaccine to individuals with a history of cerebral injury, family or personal history of convulsions, or any other condition where stress related to fever should be avoided. As well, a person with thrombocytopenia may exacerbate their condition by receiving the MMR vaccine.

Both live measles and mumps vaccine are manufactured in chick embryo cell culture. Extreme caution should be taken when vaccinating individuals with a history of anaphylaxis or immediate hypersensitivity to eggs and Merck advises careful evaluation of the risks and benefits when considering vaccination in this population.

Rubella vaccine virus has been found in the breast milk of nursing mothers with documentation of its ability to be transferred to infants. Serological evidence of rubella infection and a case of mild clinical illness typical with an acquired rubella infection has also been documented in a nursing infant. As a result of these findings, Merck cautions the use of MMR vaccine in nursing women.

IMPORTANT NOTE: Even though the CDC’s Advisory Committee on Immunization Practices (ACIP) states that Merck’s MMRII vaccine can be administer at the same time as other viral and bacterial vaccines, Merck’s MMRII product information insert states that other live virus vaccines—such as varicella2 should NOT be given at the same time as MMR vaccine but rather should be administered one month prior or one month after MMR vaccination.3

Additionally, Merck’s product insert does not recommend giving MMRII at the same time as DTP (diphtheria, tetanus, and pertussis) and/or OPV (oral poliovirus vaccine) even though the Advisory Committee on Immunization Practices (ACIP) has stated that simultaneous administration of the entire recommended vaccine series is acceptable.4

MMRII vaccine is approved for use in persons 12 months of age and older. Despite recommendations by the CDC’s Advisory Committee on Immunization (ACIP) that children between 6 and 12 months who will be traveling or residing abroad be vaccinated with MMR prior to international travel,5 Merck’s MMRII product insert states that effectiveness and safety have not been established in this population.6 Studies have determined that early vaccination of an infant often results in vaccine failure due to both the infant’s immature immune system response as well as the presence of maternal antibodies that interfere with vaccination. Early vaccination can result in reduced antibodies that persist, despite revaccination. 7

Contraindications to receiving MMR-V (ProQuad) vaccine documented in Merck’s product insert include:8

  • Persons who have experienced a severe allergic reaction or anaphylaxis to any MMR-V vaccine component, including gelatin and neomycin, should not be vaccinated with MMR-V.
  • Febrile illness or active untreated tuberculosis
  • Persons with acquired or primary immunodeficiency status and individuals receiving immunosuppressive therapy. Vaccination with MMR-V should be delayed for 3 months following the administration of human immune globulin, blood, or plasma.
  • Individuals with a family history of hereditary or congenital immunodeficiency.
  • Pregnant women.
  • Persons with leukemia, lymphoma, blood dyscrasias and other malignant neoplasms affecting the lymphatic systems or bone marrow.

Merck’s MMR-V (ProQuad) product insert warns of a higher incidence of fever and febrile seizures in children between the ages of 12 and 23 months following administration of MMR-V in comparison with children who receive separate doses of MMR and varicella vaccines. Caution is advised when administering MMR-V in children with a history of seizures, cerebral injury, or any other medical condition where stress from fever should be avoided.

Both live measles and mumps vaccine are manufactured in chick embryo cell culture. Extreme caution should be taken when vaccinating individuals with a history of anaphylaxis or immediate hypersensitivity to eggs and Merck advises careful evaluation of the risks and benefits when considering vaccination in this population.

Merck’s MMR-V vaccine product insert reports that transmission of varicella vaccine virus may occur between vaccine recipients and susceptible contacts, including high risk individuals, resulting in both the development or non-development of varicella-like rash. As a result, Merck cautions that vaccine recipients should attempt to avoid close contact with high risk individuals. This population includes pregnant women who lack a positive history of illness or vaccination and their newborn infants, any infants born prior to 28 weeks gestation, and any immunocompromised individuals.

Merck also advises careful evaluation of the risk and benefits of vaccination with MMR-V in children with thrombocytopenia or history of the blood disorder as no clinical data on the development or exacerbation of this condition exists. Thrombocytopenia has been reported following vaccination with MMRII, measles vaccine, varicella vaccine and again following an addition dose of both measles and MMRII vaccines.

The safety or efficiency of MMR-V has not been determined in children who are infected with human immunodeficiency virus (HIV).

Children between 12 months and 12 years of age who receive MMR-V vaccine should avoid the use of salicylate (aspirin) or salicylate-containing products for 6 weeks following vaccination due to the risk of Reye Syndrome with aspirin and wild-type varicella disease.

MMR-V is approved for use in children 12 months to 12 years of age. Children under the age of 1 year or older than 12 years of age should not receive MMR-V vaccine.

IMPORTANT NOTE: NVIC encourages you to become fully informed about Measles and the Measles vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

« Return to Vaccines & Diseases Table of Contents

References

1 FDA Measles, Mumps and Rubella Virus Vaccine, Live  May 16, 2017

2 FDA Varivax Feb. 17, 2017

3 FDA Measles, Mumps and Rubella Virus Vaccine, Live  May 16, 2017

4 Ibid

5 CDC Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. June 14, 2013; 62(RR04);1-34

6 FDA Measles, Mumps and Rubella Virus Vaccine, Live  May 16, 2017

7 Niewiesk S Maternal Antibodies: Clinical Significance, Mechanism of Interference with Immune Responses, and Possible Vaccination Strategies Front Immunol. 2014; 5: 446.

8 FDA Measles, Mumps, Rubella and Varicella Virus Vaccine Live. Oct 23, 2018


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