Measles, Mumps, and Rubella - Centers for Disease Control and ...
Measles, Mumps, and Rubella - Centers for Disease Control and ...
Measles, Mumps, and Rubella - Centers for Disease Control and ...
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Vol. 47 / No. RR-8 MMWR 1<strong>Measles</strong>, <strong>Mumps</strong>, <strong>and</strong> <strong>Rubella</strong>—Vaccine Use <strong>and</strong> Strategies <strong>for</strong> Elimination of<strong>Measles</strong>, <strong>Rubella</strong>, <strong>and</strong> Congenital <strong>Rubella</strong> Syndrome<strong>and</strong> <strong>Control</strong> of <strong>Mumps</strong>:Recommendations of the Advisory Committee onImmunization Practices (ACIP)SUMMARYThese revised recommendations of the Advisory Committee on ImmunizationPractices (ACIP) on measles, mumps, <strong>and</strong> rubella prevention supersederecommendations published in 1989 <strong>and</strong> 1990. This statement summarizesthe goals <strong>and</strong> current strategies <strong>for</strong> measles, rubella, <strong>and</strong> congenital rubella syndrome(CRS) elimination <strong>and</strong> <strong>for</strong> mumps reduction in the United States.Changes from previous recommendations include• Emphasis on the use of combined MMR vaccine <strong>for</strong> most indications;• A change in the recommended age <strong>for</strong> routine vaccination to 12–15 months <strong>for</strong>the first dose of MMR, <strong>and</strong> to 4–6 years <strong>for</strong> the second dose of MMR;• A recommendation that all states take immediate steps to implement a two doseMMR requirement <strong>for</strong> school entry <strong>and</strong> any additional measures needed to ensurethat all school-aged children are vaccinated with two doses of MMR by 2001;• A clarification of the role of serologic screening to determine immunity;• A change in the criteria <strong>for</strong> determining acceptable evidence of rubella immunity;• A recommendation that all persons who work in health-care facilities have acceptableevidence of measles <strong>and</strong> rubella immunity;• Changes in the recommended interval between administration of immune globulin<strong>and</strong> measles vaccination; <strong>and</strong>• Updated in<strong>for</strong>mation on adverse events <strong>and</strong> contraindications, particularly <strong>for</strong>persons with severe HIV infection, persons with a history of egg allergy or gelatinallergy, persons with a history of thrombocytopenia, <strong>and</strong> persons receiving steroidtherapy.INTRODUCTIONSince monovalent vaccines containing measles, rubella, <strong>and</strong> mumps vaccineviruses—<strong>and</strong> subsequently combined measles-mumps-rubella (MMR) vaccine—werelicensed, the numbers of reported cases of measles, mumps, rubella, <strong>and</strong> congenitalrubella syndrome (CRS) have decreased by more than 99%. In 1993, the ChildhoodImmunization Initiative established goals of eliminating indigenous transmissionof measles <strong>and</strong> rubella in the United States by 1996. Subsequently, the goals of the
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