Measles Vaccination Recommendations

Information on measles vaccination recommendations for health professionals.

On this page:
Measles vaccination and effectiveness
Vaccine recommendations
MMR vaccine contraindications and precautions

Measles vaccination and effectiveness

Vaccination is the best way to prevent measles. Measles vaccine is available combined with mumps and rubella vaccines as MMR, or MMR combined with varicella vaccine as MMRV. The MMR vaccine is a live-attenuated (weakened) vaccine that produces a mild, non-infectious response.

The Advisory Committee on Immunization Practices (ACIP) recommends that MMR be used when any of the individual components is indicated. Single-antigen measles vaccine is not available in the United States.

Vaccine recommendations

• Infants: If traveling internationally, infants 6 through 11 months old should receive one dose of MMR vaccine before departure.
  • Infants who receive a dose of MMR vaccine before their first birthday should receive two more doses of MMR vaccine at the recommended ages and at least 28 days apart.
• Children: Children should receive two doses of MMR vaccine. The first dose at 12 through 15 months of age and the second dose at 4 through 6 years of age.
  • Giving the second dose of the vaccine earlier is allowed as long as it is at least 28 days after the first dose.
• Adults:
  • Adults born before 1957 are considered immune from measles.
  • All other adults born in or after 1957 should have documentation of at least one dose of MMR or other evidence of measles immunity.
  • Most adults in the U.S. are at low risk for measles. In general, providers do not need to actively screen low-risk adult patients for measles immunity in non-outbreak areas in the U.S.
• High-risk adults: Certain adults are considered to be at high risk for either acquiring measles and/or transmitting disease to vulnerable persons. High-risk adults need written documentation of two doses of MMR vaccine (each dose separated by at least 28 days) or other presumptive evidence of immunity. High-risk adults include:
  • Students at post-high school educational institutions.
  • Household or close, personal contacts of immunocompromised people with no evidence of immunity to measles.
  • Health care personnel.
  • International travelers to any country outside the United States.
• Domestic travelers: People 6 months of age and older who are living in/visiting domestic measles outbreak areas should follow state and local guidance in areas with ongoing community-wide transmission of measles. For more information visit CDC: Measles Cases and Outbreaks.

MMR vaccine contraindications and precautions

Contraindications

• Anyone who has a known severe immunodeficiency from:
  • Hematologic and solid tumors.
  • Receipt of chemotherapy
  • Congenital immunodeficiency.
  • Long-term immunosuppressive therapy or patients with human immunodeficiency virus (HIV) infection who are severely immunocompromised.
• Persons known to be pregnant should not receive measles vaccine. Pregnancy should be avoided for 28 days following MMR vaccine.
• Severe allergic reaction (anaphylactic)to a previous dose of a vaccine component.

Precautions

• Moderate or severe acute illness with or without fever.
• Recent (within 11 months) receipt of antibody-containing blood product (specific interval depends on product).
• History of thrombocytopenia or thrombocytopenic purpura.
• Need for tuberculin skin testing or interferon gamma release assay (IGRA) testing.
• Personal or family history of seizures.

Additional information

• Close contact with a pregnant woman is not a contraindication to MMR vaccination of the contact.
• Breastfeeding is not a contraindication to vaccination of either the woman or the breastfeeding child.
• Persons receiving low dose or short course (less than 14 days) corticosteroid therapy, alternate-day treatment, maintenance physiologic doses, or topical, aerosol, intra-articular, bursal, or tendon injections may be vaccinated.
• Patients with leukemia in remission who have not received chemotherapy for at least three months may receive MMR or its component vaccines.