Measles, Mumps, and Rubella - Centers for Disease Control and ...

12 MMWR May 22, 1998administration of all vaccinations should be documented in the patient’s permanentmedical record.Serologic screening for measles, rubella, or mumps immunity generally is neithernecessary nor recommended if a person has other acceptable evidence of immunityto the disease (Table 1). Serologic screening can be a barrier to vaccination. With theexception of women who are known to be pregnant (see Women of ChildbearingAge), persons who lack acceptable evidence of immunity generally should be vaccinatedwithout serologic testing. Serologic screening is appropriate only when personsidentified as susceptible are subsequently vaccinated in a timely manner. Screening ismost applicable when the return and vaccination of those tested can be ensured (e.g.,hiring of new health-care workers). If these conditions are not met, serologic screeningis inappropriate (91 ). Likewise, during an outbreak of measles, rubella, or mumps,serologic screening before vaccination generally is not recommended because waitingfor results, contacting, and then vaccinating persons identified as susceptible canimpede the rapid vaccination needed to curb the outbreak.Serologic screening for antibodies to measles, rubella, or mumps alone will notidentify persons who are susceptible to the other diseases for which screening is notdone. Post-vaccination serologic testing to verify an immune response to MMR or itscomponent vaccines is not recommended.The criteria for acceptable evidence of immunity to measles, rubella, and mumps(Table 1) provide presumptive rather than absolute evidence of immunity. Occasionally,a person who meets the criteria for presumptive immunity can contract andtransmit disease. Specific criteria for documentation of immunity have been establishedfor certain persons (e.g., health-care workers, international travelers, andstudents at post-high school educational institutions) who are at increased risk forexposure to measles, rubella, and mumps (Table 1). Criteria accepted as evidence ofimmunity for the purpose of meeting school or college entry requirements or othergovernment regulations may vary among state and local jurisdictions.MeaslesPersons generally can be presumed immune to measles (Table 1) if they have documentationof adequate vaccination, laboratory evidence of immunity to measles,documentation of physician-diagnosed measles, or were born before 1957. Criteria foradequate vaccination currently vary depending on state and local vaccination policybecause of differences in the way states have implemented the two-dose measles vaccinationschedule. All states are strongly encouraged to take immediate steps toimplement the two-dose MMR vaccination schedule so that, by 2001, adequate vaccinationof children will be defined in all 50 states as follows:• For preschool-aged children: documentation of at least one dose of MMR vaccineadministered on or after the first birthday.• For children in kindergarten through grade 12: documentation of two dosesof MMR vaccine separated by at least 28 days (i.e., 1 month), with the firstdose administered no earlier than the first birthday.Doses of MMR and other measles-containing vaccines administered before the firstbirthday should not be counted when determining adequacy of measles vaccination.