Measles Vaccine

Measles vaccination (Morbilli) is usually given as a combination with measles-mumps–rubella vaccination (MMR vaccination).The vaccine (live vaccine) usually leads to lifelong immunity. The following are the recommendations of the Standing Commission on Vaccination (STIKO) at the Robert Koch Institute on measles vaccination:

Indications (areas of application)

  • S: Individuals born after 1970 ≥ 18 years of age with unclear vaccination status, without vaccination, or with only one childhood vaccination.
  • I: In case of imminent admission or attendance at a community facility (e.g., day care center):
    • Infants from the age of 9 months In the context of an outbreak:

    In the context of an outbreak:

    • Born after 1970 from the age of 9 months with unclear vaccination status, without vaccination or with only one vaccination in childhood.
    • Exceptionally 6-8 month old infants after individual risk-benefit assessment (off-label-use).
  • B: Persons born after 1970 (including trainees, interns, students and volunteers) in the following fields of activity:
      • Medical facilities (according to § 23 (3) sentence 1 IfSG) including facilities of other human medical health professions.
      • Activities with contact to potentially infectious material.
      • Nursing facilities (according to § 71 SGB XI).
      • Community facilities (according to § 33 IfSG)
      • Facilities for the collective accommodation of asylum seekers, persons who are obliged to leave the country, refugees and ethnic German immigrants.
      • Technical, vocational and higher education institutions

Legend

  • S: Standard vaccinations with general application.
  • I: Indication vaccinations for risk groups with individually (not occupationally) increased risk of exposure, disease or complications and for the protection of third parties.
  • B: Vaccinations due to an increased occupational risk, e.g., after risk assessment in accordance with the Occupational Health and Safety Act / Biological Substances Ordinance / Ordinance on Occupational Medical Precautions (ArbMedVV) and / or for the protection of third parties in the context of occupational activities.

Note!Often, adults born before 1970 (before the start of general MMR vaccination) have natural immunity to measles, mumps and rubella.

Contraindications

  • People with very poor immune system, pregnant women and people with allergy to chicken egg white or neomycin – antibiotic (drug against bacterial infections) – should not be vaccinated.

Implementation

  • Basic immunization: the first vaccination should be given between eleven and 14 months of age in all children, and revaccination is then given between 15 and 23 months of age, four to six weeks apart from the previous vaccination. (A total of 2 times vaccination with an MMR vaccine (if necessary, use MMRV combination vaccine if there is a simultaneous indication for varicella vaccination)).
  • Single vaccination, preferably with an MMR vaccine at:
    • Unvaccinated from the age of 9 months or in childhood only once vaccinated persons or persons with unclear vaccination status with contact to measles patients; preferably within 3 days after exposure.
    • In the context of an outbreak Born after 1970 with unclear vaccination status, without vaccination or with only one vaccination in childhood.
  • Vaccinate twice with MMR vaccine (use MMRV combination vaccine if indicated at the same time as varicella vaccination, if necessary).
    • due toVaccinations due to increased occupational risk (B).
      • In women, 2 vaccinations are required for each of the three vaccine components (M-M-R).
      • In men, 2 times of vaccination is required for the measles and mumps vaccine components. For protection against rubella, a single vaccination is sufficient.
  • Repeat vaccination: at the age of 2-17 years.

Efficacy

  • Reliable efficacy
  • Vaccine protection from about 10 days after vaccination
  • Duration of vaccination protection at least 20 years

Side effects / vaccination reactions

  • Local reaction with redness, swelling around the injection site – usually occur 6 to 48 hours after vaccination
  • General reactions with fever (< 39.5 C°), headache/limb pain, malaise – usually occur in the first 72 hours after vaccination
  • If as MMR vaccination:
    • Vaccine sickness – possible up to 4 weeks after MMR vaccination; measles/mumps-like symptoms with increased body temperature (= vaccine measles) occur; mostly mild courses.
    • Parotitis (parotid gland inflammation) (occasionally to rarely).
    • Generalized lymphadenitis (lymphadenitis) (occasional to rare).

Other notes

  • The combined measles, mumps, and rubella (MMR) vaccine is effective and not associated with an increased risk of autism.
  • There is no association between autism and measles-mumps-rubella (MMR) vaccination, even in children with a genetic predisposition (hereditary disposition).

Vaccination status – control of vaccination titers

Morbilli(measles) Measles IgG ELISA <0.15 IU/ml No sufficient vaccination protection detectable → basic immunization required
0.15-0.20 IU/ml Questionable vaccination protection → booster recommended
> 0.20 IU/ml Sufficient vaccination protection