Infectious Diseases - MMR Frequently Asked Questions
What are Measles, mumps and rubella?
Measles is a viral infection, which is spread from
person to person. Symptoms of measles include fever, cough, a typical rash, swollen glands, red eyes
and loss of appetite. Symptoms can last for up to 10 days in children and longer in adults. Serious
complications can occur.
Mumps is caused by a virus and causes you to feel
generally unwell as well as, in many people (70%), causing symptoms such as painful swollen glands in
the face and neck. Symptoms last for up to 10 days and complications can occur.
Rubella (also known as ‘German measles’) is a mild
viral disease which causes a transient rash, swollen glands behind the ear and the back of the neck
and occasionally, in adults, painful joints. The infection is particularly serious in pregnancy.
Why is it important to protect children against these
Measles, mumps and rubella can all have serious complications.
Measles can cause ear infections (1 in 20), respiratory
problems (1in 25), convulsions (1in 200) and meningitis/ encephalitis (inflammation of the brain) (1/1000).
It has a 1 in 2,500 — 5,000 chance of causing death. In children who acquire measles when aged less
than 2 years, 1 in 8000 will develop a fatal degenerative brain condition within 8 years of infection.
Mumps can cause deafness usually with partial or complete
recovery (1 in 25) and swollen, painful testicles in older boys and men (1in 5). Prior to the introduction
of MMR vaccine mumps was the biggest cause of viral meningitis in children. Mumps during pregnancy is
a cause of spontaneous abortion (miscarriage).
Rubella can also cause inflammation of the brain (1
in 6,000) and can affect blood clotting (1 in 3,000). In pregnant women it can cause miscarriage or
major health problems for their babies such as blindness, deafness, heart problems or brain damage.
It is important to remember that without the MMR vaccine
nearly every child will get all three diseases.
MMR vaccine protects your child against measles, mumps and rubella (German
measles). It is given to children at 15 months and again as a booster before they go to school. Since
MMR was introduced here in 1988 the number of children catching these diseases has
fallen to an all time low. MMR uptake rates in Northern Ireland are the highest in
the British Isles – 9 out 10 parents here choose to have their child immunised with MMR.
MMR has been extensively used all over the world and has an excellent
There is no evidence that MMR causes autism. Speculation about a link
between the 2 arose following the publication of a paper by Dr Wakefield in the Lancet in 1998. Many
national and international experts and agencies, including those with no links to government, have reviewed
Dr Wakefield’s theories and papers and can find no evidence whatsoever to support a link between MMR
and autism. Many other well-conducted studies have also failed to establish a link between the two.
The most recent study involved over half a million children in Denmark, 82% of whom had received MMR
vaccine. This study collected detailed information on all the children, including their autism status.
No association was found between MMR and autism in this very well conducted and large study.
There is some demand among the general public to give separate mumps,
measles and rubella vaccines, spaced by at least 1 year. Dr Wakefield suggested this at a press conference
following the publication of his paper in 1998. The suggestion is not supported by his 12 co-authors
and there is no scientific evidence to support his view.
- No country in the world recommends giving these vaccines separately.
- Separating vaccines puts children at risk while they wait unnecessarily
between each vaccine.
- Giving vaccine separately means that children are subject to
unnecessary repeat injections and more risk of adverse reactions – even if mild – at the injection site.
- In addition, using separate vaccines would decrease the uptake
of vaccination and thus increase the risk that these diseases will return. Experience of separating
out the pertussis component of DTP vaccine in the 1970s showed that uptake of pertussis immunisation
decreased to around 30%. As a result there were large increases in the rates of pertussis infection,
including many deaths.
Currently none of the single component vaccines for mumps or measles
which are licensed in the UK are manufactured for, or marketed in, the UK. The Medicines Control Agency
(MCA) has restricted the importation of unlicensed single component vaccines on the ground that under
law, unlicensed medicines should not be imported when a safe and effective licensed alternative, i.e.
MMR vaccine, is available and meets the patients clinical needs. There are concerns that these unlicensed
vaccines may be ineffective or less safe than MMR as they have not been subjected to the same rigorous
trials and controls. At the end of 2002 safety and efficacy concerns arose about a single mumps vaccine
imported from the Czech Republic.