Submitted by Public Health Nurse Darlynn Williams Recent measles activity and press reports have resulted in questions regarding MMR vaccination and the possible need for additional doses for certain populations. The information below is intended to help clarify MMR vaccine recommendations for adults.

Please note, the recommendations to protect adults against measles has not changed from the ACIP MMR Recommendations statement was published in 2013. The current recommendations can be found at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htm.

Recommendations: One dose of MMR or measles containing vaccine received on or after the first birthday, or other presumptive immunity, is sufficient for most* U.S. adults born on or after 1957.

Other presumptive evidence of measles immunity includes: Birth before 1957†, laboratory evidence of immunity, laboratory confirmation of disease.

Certain adults are considered to be high risk and need two doses of MMR or measles containing vaccine, each dose separated by at least 28 days, unless they have other presumptive evidence of measles immunity, as listed above. These adults include: students at post-high school education institutions, healthcare personnel, international travelers.

*Some adults may have received a killed measles vaccine during the 1960’s. The killed measles vaccine was available from 1963 through 1967 and administered to less than 5% of adults. The ACIP recommends that persons who were vaccinated before 1968 with the inactivated (killed) measles vaccine or measles vaccine of unknown type, should receive at least one dose of MMR or measles containing vaccine.

† The majority of persons born before 1957 are likely to have been infected naturally and may be presumed immune. For unvaccinated healthcare personnel born before 1957 who lack laboratory evidence of measles immunity or laboratory confirmation of disease, health care facilities should consider vaccinating personnel with 2 doses of MMR vaccine at the appropriate interval.

If there is an outbreak in your community, additional MMR vaccine recommendations may be issued. The at-risk and/or target populations for vaccine will be defined by public health authorities and will depend on the populations impacted by the outbreak.

Clarification of recommendations: There is no recommendation for an adult catch-up program for persons born before 1989. Those born since 1989 likely would have been required to have 2 doses of a measles containing vaccine for school attendance. There is no current recommendation for vaccination campaigns among adults or individuals in non-affected areas to prevent measles outbreaks.

If you have any additional questions about MMR vaccine recommendations contact the Montana Immunization Program at (406) 444-5580 or visit https://www.cdc.gov/measles/vaccination.html.