Measles vaccination: when is it given?
The measles vaccination is very important: namely, the disease can cause serious complications such as middle ear, lung or brain inflammation. Although such complications are rare, they can be serious and even fatal. Children under the age of five and adults over the age of 20 are particularly susceptible to measles complications.
- Infants and young children (basic immunization within the first two years of life).
- Adults born after 1970 if they were not vaccinated against measles or were vaccinated only once during childhood or have an unclear vaccination status
Regulations according to the Measles Protection Act
The vaccination recommendations of the STIKO have been supplemented by the Measles Protection Act since March 1, 2020. It prescribes mandatory measles vaccination in certain cases:
Adolescents who attend a school, educational institution or other community facility where minors are predominantly cared for are also subject to the Measles Protection Act. As with children, it must be proven that they have been vaccinated twice against measles or that they have sufficient immunity as a result of having lived through measles.
All children or adolescents and adults born after 1970 who were already being cared for or working in a community facility as of the cutoff date of March 1, 2020, must submit proof of measles vaccination or immunity by July 31, 2021, at the latest.
In addition, under the Measles Protection Act, asylum seekers and refugees are required to provide proof of measles vaccination protection four weeks after admission to a community shelter.
What does compulsory vaccination aim to achieve?
Compulsory vaccination is intended to prevent measles outbreaks as far as possible in the future. This protects babies in particular, who are not usually vaccinated until they are one year old, but who comparatively often develop fatal complications. In addition, people whose immune systems do not build up sufficient protection.
Measles vaccination: when must not be given?
In general, measles vaccination must not be administered in the following cases:
- During pregnancy (see also notes below)
- In case of acute fever (> 38.5 degrees Celsius) or another severe, acute illness
- In case of hypersensitivity to one of the components of the vaccine
The measles vaccine
The measles vaccine is a so-called live vaccine. It contains attenuated pathogens that are no longer capable of reproducing (attenuated measles viruses). Nevertheless, the immune system reacts to it by producing specific antibodies. This makes the measles vaccination a so-called active vaccination (in contrast to a passive vaccination, in which ready-made antibodies are injected, e.g. against tetanus).
No more single measles vaccine
Since 2018, no single vaccine (single vaccine) against measles is available in the EU. Only combination vaccines are available – either the MMR vaccine (combined vaccine against measles, mumps and rubella) or the MMRV vaccine (additionally protects against varicella, i.e. chickenpox pathogens).
In addition, the combination vaccines have proven to be just as effective and tolerable as the respective single vaccines.
Even if someone already has immunity to one of the measles, mumps, rubella or varicella (MMRV) diseases (e.g. due to having lived through the disease), the combination vaccine can be administered – there is no increased risk of side effects.
Measles vaccination: pregnancy and lactation
After a measles vaccination pregnancy should be avoided for four weeks!
If a pregnancy does occur or if the doctor has vaccinated because the pregnancy was not yet known, no abortion is necessary. Many hundreds of recorded vaccinations during or shortly before pregnancy showed no increased risk of malformations of the child.
Measles vaccination: how often is vaccinated?
The general vaccination recommendation for adults born after 1970 who do not have sufficient immunity against measles is a single measles vaccination.
Adults born after 1970 who work in medical or community settings must have been vaccinated against measles at least twice, according to the Measles Protection Act, or provide evidence of existing immune protection, for example, due to an illness they have had!
Measles vaccination: How is it carried out?
Children and adolescents who received only one vaccination dose or none at all as infants should receive the measles vaccination as soon as possible: The missing second vaccination dose is administered or the complete basic immunization with two vaccination doses is carried out at least four weeks apart.
- Two measles vaccinations are required when working in a medical or community setting if there is no evidence of having lived through measles disease.
- For all other adults born after 1970 with inadequate immunity to measles, a single measles vaccination is recommended.
Where is the vaccine injected?
Measles vaccination: side effects
Like any vaccination and any other medication, the measles vaccination – or more precisely, the MMR or MMRV vaccination – can cause side effects, even if it is considered to be well tolerated overall. Few vaccinated individuals develop local reactions at the injection site such as redness, pain, and swelling in the days following vaccination. Occasionally, swelling of the lymph nodes near the injection site is observed.
Occasionally, mild swelling of the parotid gland develops. Rarely, mild testicular swelling or joint discomfort occurs (the latter is preferred in adolescents and adults).
Very rare side effects of measles vaccination (or MMR or MMRV vaccination) are allergic reactions and prolonged joint inflammation.
Infants and young children may rarely have febrile convulsions as part of the temperature increase. These usually have no consequences. The risk of febrile seizure is slightly higher if physicians use the MMRV vaccine instead of the MMR vaccine for the first vaccination. Therefore, doctors often choose the MMR vaccine for the first shot and administer the varicella vaccine at a different body site. The next vaccination can then be given with the MMRV vaccine without any problems.
Two to five out of 100 vaccinated persons develop the so-called vaccination measles one to four weeks after the measles vaccination: In appearance, these resemble the real measles, that is: The affected develop a weak measles-like rash, often accompanied by fever.
No autism due to the MMR vaccination!
A study published in 1998 with twelve participants unsettled the population for a long time – and partly still does today: The study assumed a possible connection between the MMR vaccination and autism.
In the meantime, however, it is known that at that time deliberately false and fictitious results were published – the responsible physician lost his medical license in Great Britain and the published study was completely revoked.
How long does the measles vaccination last?
Experts assume that the effect of the complete basic immunization – i.e. the measles vaccination twice – lasts for life. It is possible that the amount of certain antibodies (immunoglobulin G, or IgG for short) against measles viruses in the blood of the vaccinated person decreases over time. According to current knowledge, however, this does not affect the vaccination protection.
Do I need a measles booster vaccination?
So far, however, there is nothing to suggest that this will affect measles immunization in the population. According to current knowledge, it is therefore not necessary to have the measles vaccination refreshed.
Measles despite vaccination
In addition to the above-mentioned vaccine measles, people can also get the “real” measles in rare cases after receiving the measles vaccine twice. With regard to the cause of this, physicians distinguish between primary and secondary vaccination failure.
In primary vaccination failure, the measles vaccination does not develop the intended protective effect from the outset. In about one to two percent of those vaccinated, the double measles vaccination does not work. This means that the affected persons do not produce sufficient antibodies against measles viruses.
In infants, it may also be due to maternal antibodies. These circulate in the child’s blood and can thus interact with the measles vaccine. As a result, in rare cases, vaccine protection cannot be established.
Incorrect storage or administration of the vaccine can also lead to primary vaccine failure.
Secondary vaccination failure
Post-exposure measles vaccination
Experts recommend this postexposure active vaccination to all affected persons older than nine months. In individual cases, earlier vaccination is also possible “off-label” outside the approval range – at the age of six to eight months. Affected children should still receive the usual two measles vaccinations afterwards. This is the only way that vaccine protection is usually safely achieved.
Measles lock vaccination
Post-exposure passive vaccination
Pregnant women and babies under six months of age can also receive passive immunization as a precaution after a possible measles infection. This is because active measles vaccination is not permitted during pregnancy (no live vaccines!) and is not approved for children under six months of age.
After passive immunization (immunoglobulin administration), subsequent MMR or MMRV vaccination is not safely effective for about eight months!
