When is the second dose of mmr given

Is this extra dose safe? Is it effective? Does an early dose of the measles vaccine replace the routine, first-birthday dose? Does an early, third dose of the measles vaccine affect the recommended timing of the two-standard doses in any way? Can my child get the second dose of the MMR vaccine early, too?

What if my child didn't get the routine MMR vaccines on time? What about the MMRV vaccine? Remember: If all of this seems confusing, don't worry. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Follow Us. Back to Top. Ask the Pediatrician. KidsDoc Symptom Checker. HealthyChildren Magazine. Children who receive measles vaccine at 6 through 11 months of age because of travel outside the U. The second dose of MMR is recommended to produce immunity in those who fail to respond to the first dose. The second dose should be administered routinely at age years, before a child enters kindergarten or first grade.

The recommended visit at age 11 or 12 years serves as a catch-up opportunity to verify vaccination status and administer MMR vaccine to children who have not yet received two doses. If desired, the second dose of MMR may be administered as soon as four weeks 28 days after the first dose. Children who already have received two doses of MMR vaccine at least four weeks apart, with the first dose administered no earlier than the first birthday, do not need an additional dose when they enter school unless required by state law.

Administration of a routine second dose at least 28 days after the first dose rather than at years is appropriate for children who may be exposed to measles in the U. Children without documentation of adequate vaccination against measles, mumps and rubella or other acceptable evidence of immunity to these diseases can be re-admitted to school after receipt of the first dose of MMR.

A second dose should be administered as soon as possible, but no less than four weeks after the first dose. Only doses of vaccine with written documentation of the date of receipt should be accepted as valid. Self-reported doses or a parental report of vaccination is not considered adequate documentation.

A health care professional should not provide an immunization record for a patient unless the provider has administered the vaccine or has seen a record that documents vaccination. People who lack adequate documentation of vaccination or other acceptable evidence of immunity should be vaccinated. Advertising Disclaimer ». Unlike with measles, MMR has not been shown to be effective at preventing mumps or rubella in people already infected with the virus i.

During outbreaks of measles or mumps, everyone without presumptive evidence of immunity should be brought up to date on their MMR vaccination. And some people who are already up to date on their MMR vaccination may be recommended to get an additional dose of MMR for added protection against disease. All 50 states and the District of Columbia DC have state laws that require children entering childcare or public schools to have certain vaccinations. There is no federal law that requires this. The Advisory Committee on Immunization Practices recommends that all states require children entering childcare, and students starting school, college, and other postsecondary educational institutions to be up to date on MMR vaccination:.

For more information, see State Vaccination Requirements. Most health insurance plans cover the cost of vaccines. But you may want to check with your health insurance provider before going to the doctor. Learn how to pay for vaccines. This program helps families of eligible children who might not otherwise have access to vaccines. You can also contact your state VFC coordinator. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Vaccines and Preventable Diseases.

Section Navigation. Facebook Twitter LinkedIn Syndicate. Minus Related Pages. Children CDC recommends all children get two doses of MMR measles-mumps-rubella vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age.

Students at post-high school educational institutions Students at post-high school educational institutions who do not have presumptive evidence of immunity need two doses of MMR vaccine, separated by at least 28 days.

Adults Adults who do not have presumptive evidence of immunity should get at least one dose of MMR vaccine. These adults include students at post-high school education institutions healthcare personnel international travelers International travelers People 6 months of age and older who will be traveling internationally should be protected against measles.

Before any international travel— Infants 6 through 11 months of age should receive one dose of MMR vaccine. Infants who get one dose of MMR vaccine before their first birthday should get two more doses one dose at 12 through 15 months of age and another dose separated by at least 28 days. Children 12 months of age and older should receive two doses of MMR vaccine, separated by at least 28 days.

Teenagers and adults who do not have presumptive evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days. See also, Travel Information Measles Mumps Rubella Healthcare personnel Healthcare personnel should have documented presumptive evidence of immunity , according to the recommendations of the Advisory Committee on Immunization Practices pdf icon [48 pages]. On This Page. Women of Childbearing Age Women of childbearing age should check with their doctor to make sure they are vaccinated before they get pregnant.

Groups at increased risk for mumps because of a mumps outbreak During a mumps outbreak, public health authorities might recommend an additional dose of MMR vaccine for people who belong to groups at increased risk for getting mumps. Those who received more than two doses of measles-containing vaccines were also excluded from the study.

The relative risk RR of measles was estimated from odds ratio OR. Both matched and unmatched analyses were done. However, because these analyses provided similar results, only unmatched results are presented below. Of the 11, cases included in RDIS during the study period, occurred among children born between 1 October and 30 September who received their first dose of measles vaccine between 11 and 23 months of age.

Of the 22, controls initially selected, 16, were used in the analysis. The final case:control ratio was Protection against measles improved incrementally with age at vaccination up to 14—15 months table 1.

After that age, the risk of measles stabilized. The changes in point estimates after 15 months are likely due to random variation rather than to real changes in protection. Odds ratio OR of measles, comparing children who received a single dose of vaccine given at different ages months with those who received two doses after their first birthday. Among children who received two doses, those who received their first dose before the first birthday were at significantly greater risk of measles than those who had their first dose after their first birthday RR, 3.

In children who received their first dose between age 12 and 14 months, the risk of measles was not significantly greater in univariate analysis if the second dose was given before rather than after 24 months of age OR, 4. In multivariate logistic regression analysis, the age at first dose, but not the delay from the first to second dose, significantly changed the risk of measles.

Distribution of cases and controls who received two doses of measles vaccine, according to age at first and second dose. The risk of measles with a first vaccination given at 11 months was greater than that with one given at 12—14 months RR, 3. The analysis of this data set from a very large number of measles cases and matched controls supports the assertion that a second dose of measles vaccine confers protection among those who experienced vaccine failure after the first dose of vaccine and is consistent with results from serologic studies [ 1 ].

As expected, the protection induced by a single dose of vaccine increased with older age at vaccination but reached a plateau at age 15 months.

Delaying the administration of the first dose to later than 15 months of age did not improve protection to a level similar to that afforded by two doses delivered after age 12 months. If interference of maternal antibody with measles vaccine and immaturity of humoral immune response [ 4 ] were the only explanations of primary vaccine failure, protection should improve continuously with older age at vaccination. In fact, protection given by a single dose is maximal when the vaccine is administered at age 15 months.

This strongly suggests that other mechanisms are involved in primary vaccine failures. All of the cases reported to the RDIS met the national measles surveillance case definition.

Although reporting may not be complete, it is unlikely that the completion rates varied significantly by whether the case received one or two doses of measles vaccine in the past. Controls were matched for age and residence, to increase the likelihood of comparable exposures to measles infection. In addition, matching for residence would to some extent control for regional differences between epidemic and nonepidemic areas or from year to year.

The results obtained from the matched and unmatched analyses were similar, suggesting that these factors did not induce confounding. Children who received their first dose of measles vaccine at 11 months of age and their second dose after age 12 months had a significantly greater risk of measles than those who received both doses after their first birthday OR, 3. This finding supports the recommendation that children who receive a first dose of measles vaccine prior to their first birthday should be given two additional doses after that birthday [ 5 , 6 ].