The MMR vaccine (Measles, Mumps, Rubella)

The MMR vaccine (Measles, Mumps, Rubella)


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The MMR vaccine (Measles, Mumps, Rubella)

Pharmacotherapeutic group
 Measles, mumps and rubella vaccine (live).
The composition of the vaccine includes: Measles virus1 Enders Edmonston strain, live, attenuated (not less than 1x103 DICC50) Mumps virus1 Jeryl Lynn ™ strain, vivo, attenuatom (not less than 12.5x103 DICC50), Rubella virus2 Wistar RA strain 27/3, alive, attenuated (not less than 1x103 DICC50).
Produced on embryonic chicken cells and on human diploid fibroblasts WI-38.
The vaccine may contain traces of recombinant human albumin (rHA) and traces of neomycin.

MMR VAXPRO is indicated for simultaneous vaccination against measles, mumps and rubella in individuals from 12 months of age.
MMR VAXPRO can be administered to infants from 9 months of age under special circumstances.
For use in the case of measles outbreaks, or for post-exposure vaccination, or for use in previously unvaccinated 9 months of age who are in contact with susceptible pregnant women, and for people possibly susceptible to mumps and rubella infection

THE DISEASES
Measles, Mumps and Rubella are exanthematous diseases that generally cause a typical rash (called exanthema or rash); this "rash" is accompanied by a series of other manifestations, such as fever, state of malaise and loss of appetite.
Exanthematic diseases can involve many complications, some of which are particularly severe and permanent.
Measles is an infectious disease caused by a virus of the genus morbillivirus (Paramixovidae family). It is a very contagious disease that often affects children between 1 and 3 years, so it is called infantile, such as rubella, chicken pox, pertussis and mumps. It is transmitted only in humans. The patients are isolated during the period of infection. In 2000, out of a total of 1.7 million childhood deaths in the world, caused by vaccine-preventable diseases, about 46% were attributable to measles, an apparently trivial disease that can cause numerous complications, even serious ones, such as encephalitis and subacute sclerosing panencephalitis, leading to death. Complications are relatively rare, but measles are still responsible for between 30 and 100 deaths per 100,000 people affected. The complications are mainly due to bacterial superinfections: average otitis, laryngitis, diarrhea, pneumonia or encephalitis (inflammation of the brain). They are more often found in newborns, malnourished children or immunocompromised persons.
Usually the diagnosis is made only for clinical observation. Eventually, specific antibodies against the measles virus can be found in the serum, 3 or 4 days after the eruption.Rubella is an infectious disease caused by a virus of the genus rubivirus, belonging to the Togaviridae family. Externally, it manifests itself with a rash similar to those of measles or scarlet fever. Rubella is usually a benign disease that rarely presents complications (mostly arthralgias and transient arthritis). It becomes dangerous, however, during pregnancy especially if the mother contracts the disease in the first trimester: the earlier the infection is the greater the risk of embryo-fetal damage. Rubella in these cases may be responsible for serious consequences in the product of conception, such as miscarriage, intrauterine death of the fetus, severe fetal malformations and, in the child, delay in acquiring the stages of development.

Mumps is an infectious disease caused by a virus belonging to the Paramyxovirus group, the most evident sign of which is the swelling of the salivary glands. In particular, the enlargement of the parotid glands, placed under the auricles, behind the angle of the jaw, gives the face the characteristic appearance from which the popular name of "orecchioni". In children the disease resolves in a few days in most cases. Among the complications described there are encephalitis (0.02-0.3%), meningitis (0.5-15%), pancreatitis (4%) and hearing damage. In children, in 5 cases every 100,000 of the disease, mumps cause hearing loss: this infection is in fact the main cause of acquired sensorineural sensorineural deafness. Encephalitis rarely leads to death, but it can have permanent consequences such as paralysis, epilepsy, facial nerve paralysis, aqueduct stenosis, and hydrocephalus. Complications are more common in adults. In 20-30% of males after puberty, there is the onset of orchitis, a very painful inflammatory disease, characterized by the swelling of one or both testes. This, though rarely, can result in a testicular atrophy resulting in infertility. Otophoritis and mastitis are relatively rare and usually do not have lasting consequences. Infection during the first 12 weeks of pregnancy is associated with a high percentage of spontaneous abortions (25%), but does not involve the risk of malformations of the fetus.

Risks related to infectious diseases preventable with vaccination

MEASLES
Average otitis 7-9%
Pneumonia 1-6%
Diarrhea 6%
Encephalitis 0.05-1% (of these, 15% die and 25% have permanent brain sequelae)
Sub-acute sclerosing panencephalitis (SSPE) 0.001%
Lethality 0.01 - 0.1%
MUMPS
Aseptic meningitis 10%
Pancreatitis 4%
Encephalitis 0.06 0.3%
Deafness (sensory unilateral) 0.007%
orchitis in males (after puberty) Up to 38%
Oophoritis in females (after puberty) 5%
Lethality 0.02%
Miscarriage in the first trimester of pregnancy Increased incidence
RUBELLA
Encephalitis 0.02%
Neonatal lethality 0.02%
Other death 0.0005%
Abortion 0.005%
Congenital rubella syndrome (CRS) 0.16%
Deafness of the child 0.06%
Deafness and blindness of the child 0.03%
Mental retardation of the child 0.014%


THE VACCINE
The vaccine belongs to live attenuated vaccines. In Italy only a few months has been introduced mandatory in children, always mandatory for recruits at the time of enrollment. The vaccine exists in the form of a vaccine complex against measles, mumps and rubella (Mpr).

• When to vaccinate
- Persons aged 12 months or more
- Persons aged 12 months or more must receive a dose on a fixed date. A second dose should be administered at least 4 weeks after the first dose according to official recommendations. A third reference to the sixth year of age is indicated in children vaccinated by the second year of age, as per the new ministerial vaccination calendar. Pregnant women should not be vaccinated
As with all live attenuated vaccines, vaccination is not performed in individuals with immune deficiency or under immunosuppressive therapy (corticoids, antineoplastic, anti-rejection), nor, as a precaution, in pregnant women or wishing to be pregnant in the following month. Instead, it is recommended for people infected with HIV who have not yet developed AIDS.