mumps vaccine Vaccine "triple" against Measles - Rubella - Mumps (MRP)

Vaccine "triple" against

Measles - Rubella - Mumps (MRP)


photo: Image of the Campaign - archive Usl Bologna - Press Service and Information Giunta Emilia-Romagna RegionThis vaccine is composed of the association, in the same vial, of the three viral strains alive and "attenuated" (ie subjected to appropriate modifications that make them absolutely unable to provoke the disease, but equally able to stimulate the production of antibodies also effective against natural infection) responsible for measles, rubella and mumps.

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The use of this "triple" formulation is recommended for several reasons:

it is an advantage for the child, because it allows to vaccinate simultaneously to all three diseases through a single injection;

it is an advantage for the community, since it reduces the circulation of all three viruses and consequently protects the other older children and adults from these diseases.

The vaccine is administered subcutaneously in the upper and outer part of the arm. To perform this vaccination it is not necessary to keep the baby fasting.

Since this combined vaccine has become available, its use is recommended for all newborns after the 12th month of life; for the recall after at least one year from the previous one (today we recommend after 5 years).

Vaccination with the "triple" vaccine of a person who has overcome the natural disease (perhaps without being aware of it, as is frequently the case with rubella and mumps), or who has already been vaccinated against one of these diseases, is well tolerated and does not expose to any additional side effect, but merely reinforces and prolongs the existing immune protection.

The precautions, contraindications and possible side effects of this vaccine are those reported in the data sheets describing the three individual vaccines. From studies performed only on the trivalent vaccine it was possible, even if exceptionally, a transitory decrease of the platelets (thrombocytopenia) in the 2 months following the vaccination. This complication occurs with much higher frequency during the natural infection of measles and rubella.Vaccination against measles

What is measles?

Measles is a very contagious infectious disease caused by a virus that is transmitted by air.

It manifests with high fever, persistent cough, nasal discharge, conjunctivitis and a typical rash (exanthema).

The child is always very tried by measles that is rightly considered the most serious among the "common" infectious diseases of childhood because of its complications, the more frequent and severe the smaller the child is. They are: otitis media, laryngitis, bronchopneumonia, convulsions, encephalitis. The latter occurs in 1 child every 1000 affected by measles and consists of severe inflammation of the brain (encephalitis) that may have an ominous outcome (15% of cases) or leave permanent outcomes (40% of cases): convulsions, deafness and mental delay. More rarely it is possible that irreversible neurological damage occurs at a distance of 5-15 years from the disease due to a persistent infection related to the morbid virus (subacute sclerosing panencephalitis, PESS).



In recent years, news has spread like wildfire about the possible correlation between measles vaccination and autism. What's true?



The measles vaccine

The measles vaccine is made up of the measles virus that undergoes appropriate modifications that make it incapable of causing the disease, but equally capable of stimulating the production of antibodies also effective against natural infection (live and attenuated vaccine).

Vaccination against measles can not be done individually, because the single vaccine is no longer available, so it is always associated at the same time with that against rubella and mumps through the use of the "triple" combined formulation. The vaccine is administered through a single injection that is carried out subcutaneously.

To carry out this vaccination it is not necessary to keep the child fasting.

Anti-morbid vaccination is recommended for all children during the 2nd year of life, generally at 12-15th month.

In any case, at any age after the 12th month, it is considered useful to undergo this vaccination if the disease has not yet been contracted.

The vaccine is extremely effective because protective antibodies appear in only 7-10 days in 95% of vaccinated children. Because of its rapidity of action it is able to prevent the disease even after infection, provided that the administration takes place within the first 2-3 days from contact with the child.

The protection given by a single dose of vaccine is long lasting in most subjects, but does not seem to be permanent. It is possible, in fact, that the immunity developed after the vaccination carried out at 12-15 months of life, decreases progressively: for this reason a booster dose at the age of 4-6 or at least 12 months after the previous one is recommended.



When should it be postponed?

The circumstances that make it opportune to temporarily postpone this vaccination are few:

· Acute febrile illness in progress;

· Recent administration of immunoglobulins, blood or plasma that may impede a good immune response to the vaccine;

· Recent administration of another live virus-based vaccine (eg antirosolia or antiparotitis or polyosabin, which is now no longer used in Italy).

When should not you be vaccinated?

The single or combined measles vaccine should not be administered in the following circumstances:

§ severe immune system deficiency due to serious illnesses or therapies with immunosuppressive drugs (high-dose cortisone for prolonged periods, radiation therapy);§ solid tumors disseminated or loaded with blood (for example leukemia, lymphomas);

§ serious allergies to the egg or neomycin that have involved for example the appearance of anaphylactic shock;

§ pregnancy: the anti-measles and the anti-mumps vaccine combined with anti-mumps should not be given to pregnant women or thinks of conceiving a child within 3 months; in the case of the single measles vaccine, the woman should not be pregnant and should not conceive in the month following vaccination.



The side effects of the vaccine?

The measles vaccine, both in the simple form and in the one combined with anti-mist and antiparotitis, is well tolerated. Only exceptionally are local reactions (redness, swelling) at the point where the injection is performed. At a distance of 6 - 12 days from vaccination it is possible that the child presents febrile uplift, usually modest and of short duration (1-2 days), which only in 5-15% of the vaccinated can reach 39 ° C.

Most children with fever as a result of immunization vaccination have no other symptoms; sometimes, however, it is possible that signs of a common cold disease may occur or a disease similar to measles very attenuated in the form of faint reddish spots on the skin and redness of the eyes, short-lived and rapid spontaneous resolution.

Like any other foreign substance in the body, this vaccine can cause allergic reactions, albeit with an extremely rare frequency.



Vaccination against rubella

What is rubella?

Rubella is an infectious disease caused by a virus that is transmitted by air. If it is contracted after birth, it appears as a mild disease with a benign course and that manifests itself with a low fever, a generalized enlargement of the lymph nodes (especially those of the neck and those placed behind the nape) and with a rash. short term. Transient joint pain may occur occasionally in children and more frequently in adolescents and female adults. Serious complications, such as encephalitis, are very rare, have a benign pattern and do not leave out results.

The greatest risk that the rubella involves is that of being contracted for the first time in pregnancy by an unprotected woman. In this case, in fact, there is a real probability that the virus reaches the product of conception through the placenta and that causes serious damage such as abortion, congenital malformations of varying severity to the heart, the eyes, the organ of hearing and of the brain. Sometimes the infant with congenital rubella presents stunted growth and signs of suffering from many other organs (skeleton, skin, liver).



The rubella vaccine

The rubella vaccine is constituted by the live rubella virus and subjected to appropriate modifications that make it absolutely incapable of causing the disease but equally capable of stimulating the production of antibodies also effective against natural infection (live and attenuated virus).

Rubella vaccination can not be done individually, because the single vaccine is no longer available, so it is always associated with the one against measles and mumps through the use of the "triple" combined formulation. The vaccine is administered through a single injection that is carried out subcutaneously.

To carry out this vaccination it is not necessary to keep the child fasting.

The anti-MS vaccination is recommended for all children of both sexes in association with the anti-moth and antiparotitis vaccine during the 2nd year of life, generally at 12 - 15 months.

Today it is recommended to also vaccinate the males, not so much to protect them but to further decrease the circulation of the rubella virus and make it even more unlikely that women can become infected during pregnancy.The vaccine is not able to prevent the disease if given to a person who has come into contact with a rubella patient and has been infected.

A single dose of vaccine gives an estimated protection around 90-95% of the vaccinated. The duration of this protection seems to be 7-10 years or more.

Nevertheless, since a vaccination failure during the first years of life or fading over time would expose to very serious consequences (risk of fetal malformations), a second dose of combined anti-ischemic, anti-moth and antiparotite vaccine against 4-5 years.

It is however good that the woman, even if vaccinated, before starting a pregnancy, perform the blood test for the anti-rubella antibody dosage. If these are sufficient, you may feel confident that your child will be protected from congenital rubella; if the antibodies, however, have non-protective values, it is advisable to perform a booster dose of the vaccine.



When must be postponed

This vaccination should be postponed if the child has an acute febrile illness in progress or if they have been recently given immunoglobulin, blood or plasma.



When you should not be vaccinated

The single or combined rubella vaccine should not be administered in the following circumstances:

§ severe deficiency of the immune system due to congenital or acquired immunodeficiencies or to therapies with immunosuppressive drugs, high-dose cortisone for prolonged periods, radiant therapy;

§ solid tumors disseminated or loaded with blood (for example leukemia, lymphomas);

§ pregnancy: anti-rubella vaccination should not be given to pregnant women. If a woman of childbearing age is vaccinated against rubella, she must take all precautions to avoid pregnancy within 3 months of vaccination. This provision is completely precautionary because the administration of the vaccine to pregnant women, when it occurred without the woman being aware of her "state", has never caused any problem. In particular vaccination has never been associated with congenital rubella for which the administration of this vaccine, inadvertently received during pregnancy initiated, is not considered a sufficient reason for the interruption of pregnancy.



Side effects

The rubella vaccine is well tolerated and usually does not cause reactions.

In a small number of vaccinated children (5-15%), it is possible to observe a slight feverish rise, a few spots on the skin and a swollen lymph nodes in the neck 5-12 days after the vaccination.

Very rarely in children, and more frequently in adolescents and in adult women, joint pains may occur after 1 to 3 weeks of vaccination.

Like any other foreign substance in the body, this vaccine can cause allergic reactions, albeit with an extremely rare frequency.Vaccination against mumps

What is mumps?

Epidemic mumps, commonly called "mumps", is an infectious disease caused by a virus that is transmitted by air. It manifests itself by the enlargement, on one or both sides of the face, of the parotid, a voluminous salivary gland placed in front of and under the ear. Other salivary glands can also enlarge and often headache, abdominal pain and more or less high fever occur.

The importance of this disease derives from its possible complications: meningo-encephalitis, damage to the organ of hearing and inflammation of the pancreas which seems to favor the onset of diabetes. If the disease is contracted by a male after puberty, it is not uncommon for it to be complicated by a violent inflammation of one or both of the testicles which can sometimes result in permanent and exceptionally sterile damage. Even if less often the woman can undergo a single or bilateral ovarian inflammation.



The vaccine against mumps

The mumps vaccine is the mumps virus alive and subjected to appropriate changes that make it absolutely incapable of causing the disease but also able to stimulate the production of antibodies also effective against natural infection ("live virus and attenuated ").

Vaccination against mumps can not be done individually, because the single vaccine is no longer available, so it is always associated with the one against measles and rubella through the use of the "triple" combined formulation. The vaccine is administered through a single injection that is carried out subcutaneously.

To carry out this vaccination it is not necessary to keep the child fasting.

Anti-mumps vaccination is recommended for all children of both sexes in combination with the measles and rubella vaccine during the 2nd year of life, typically 12 to 15 months; a second dose of combined vaccine is now recommended for 4-6 years.

Since vaccination against mumps is not effective when carried out to a susceptible individual after infection, pre-pubertal children should be vaccinated as a preventive measure. Even adolescents and male adults who have not been previously vaccinated and who, having failed to perform the specific blood test, do not know if they are protected or not, can be vaccinated. It is important to underline that the anamnestic memory of a swelling under the ear diagnosed as "mumps" is not certain of having contracted the mumps. This is because many other viruses can give parotid localization or because a lymph node enlargement can be easily exchanged with that of the parotid gland.

In any case, the vaccination of a subject already immune (for previous vaccination or for an unrecognized disease) does not involve any damage and simply reinforces its degree of protection.



When must be postponed

This vaccination should be postponed if the child has an acute febrile illness in progress or if they have been recently given immunoglobulin, blood or plasma.



When you should not be vaccinated

The mumps vaccine, single or combined with the antimorbillosis and antirosolia vaccine in the "triple" formulation, should not be administered in the following circumstances:

severe deficiency of the immune system due to serious illness or treatment with immunosuppressive drugs (high-dose cortisone for prolonged periods, radiation therapy);

solid or disseminated blood tumors (e.g. leukemia, lymphomas);

very serious allergies to the egg or neomycin that have involved, for example, anaphylactic shock. This contraindication is valid for mumps vaccines containing traces of neomycin and for vaccines whose viral strain is grown on embryonic chicken cells and which, therefore, may contain egg proteins;

pregnancy: the single or combined anti-mumps and anti-mumps vaccine should not be given to pregnant women; it is not advisable to undertake a pregnancy before 3 months have passed since vaccination.Side effects

The side effects attributed to the vaccine antiparotitis are extremely rare: after a few days it is possible that the child shows a slight transient enlargement of the parotid gland and a short-term fever.

Like any other substance foreign to the body, this vaccine can cause allergic reactions, albeit with an extremely rare frequency.