Measles, Mumps, and Rubella (MMR)

Select any of the links below to jump to a specific topic.

Measles Overview

What is measles?

Measles is a highly contagious disease caused by the measles virus. Symptoms include high fever, cough, watery eyes, and full body rash. Infected people spread measles by coughing or sneezing. Measles virus may remain in the air for 2 hours after an infected person has left.

Read more about measles and how it affects people on the Centers for Disease Control and Prevention (CDC) website.

What are the symptoms of measles?

Measles has the following symptoms:

High fever
Cough
Runny nose
Red, watery eyes
Rash

Three to five days after symptoms start, a rash breaks out from the face and spreads downward across the body down to the feet. The rash appears as flat red spots and may join together as they spread.

Who is at risk?

Babies and young children are at higher risk for severe complications from measles.

Limit the spread of measles

Measles is incredibly contagious. The best protection against measles is the measles, mumps, and rubella (MMR) vaccine. MMR vaccine provides long-lasting protection against all strains of measles.

Mumps Overview

What is mumps?

Mumps is a highly contagious disease caused by the mumps virus. Symptoms include puffy cheeks, a tender swollen jaw, fever, headache, and muscle aches. The disease is spread by direct contact with saliva or respiratory droplets. An infected person can spread the virus by:

Coughing, sneezing, or talking.
Sharing items with saliva on them, such as water bottles or cups.
Close-contact activities like sports, dancing, or kissing.

Read more about mumps and how it affects people on the Centers for Disease Control and Prevention (CDC) website.

What are the symptoms of mumps?

Mumps causes salivary glands to swell under the ears (parotitis), which leads to the following symptoms:

Puffy cheeks and tender, swollen jaw
Fever
Headache
Muscle aches
Tiredness
Loss of appetite

Who is at risk?

Adults are more at risk for severe complications from mumps. Complications can include:

Inflammation of the testicles (orchitis) or ovaries (oophoritis)
Inflammation of breast tissue (mastitis)
Inflammation of the pancreas
Inflammation of the brain (encephalitis) or tissue covering the brain and spinal cord (meningitis)
Deafness

Limit the spread of mumps

The best way to protect from mumps is to get vaccinated with the MMR vaccine. Vaccination prevents most cases and complications from mumps.

An infected person can spread mumps a few days before symptoms. Those with mumps should avoid contact with others by staying home and avoiding social events.

If someone needs to interact with an infected person, they should:

Be vaccinated to reduce chance of infection.
Avoid close contact.
Avoid touching their face.
Wear a mask.
Keep the space ventilated.

If handling used dishware, clothing or items from a sick person, wash your hands with soap and warm water for at least 20 seconds afterwards.

Rubella Overview

What is rubella?

Rubella, also called German measles, is a highly contagious disease caused by a virus. Symptoms include a red rash that starts on the face and moves to the rest of the body, fever, and headache. The disease is spread when an infected person coughs or sneezes. Rubella was eliminated in the United States in 2004 but infected travelers can cause rubella cases in the states.

Read more about rubella and how it affects people on the Centers for Disease Control and Prevention (CDC) website.

What are the symptoms of rubella?

Rubella has the following symptoms:

Red rash that starts on the face and spreads to the rest of the body
Low-grade fever
Headache
Redness or swelling of the white of the eye (pink eye)
General discomfort
Swollen and enlarged lymph nodes
Cough
Runny nose

A quarter to half of people infected with rubella will not have symptoms.

Who is at risk?

Pregnant people are at increased risk for rubella. Pregnant people who get rubella may cause a miscarriage, birth defects, or infant death.

Up to 70% of women who get rubella may experience arthritis.

Limit the spread of rubella

People infected with rubella can spread the disease to others up to one week before symptoms appear. This is why MMR vaccination is the most effective way to prevent rubella infection.

People infected with rubella should stay at home and avoid social events. Inform friends, family, work, and school or daycare providers if you have rubella.

If someone needs to interact with a person with measles, they should:

Be vaccinated to reduce chance of infection.
Avoid close contact.
Avoid touching their face.
Wear a mask.
Keep the space ventilated.

MMR Vaccine

When do people get the measles, mumps, rubella (MMR) vaccine?

Children should receive 2 doses of MMR vaccine.

The first dose is given between 12 to 15 months of age.
The second dose is given between 4 to 6 years of age.

Adults who have never been vaccinated should get at least one dose of the MMR vaccine.

Health care staff without MMR immunity should get two doses of MMR vaccine, separated by at least 28 days.

Any person aged 6 months or older travelling internationally should be protected against measles. Talk to your doctor if this situation applies to you or your family.

Some people should not get MMR vaccine:

Those with weakened immune systems should not get MMR vaccine.
Those with tuberculosis should not get MMR vaccine.
Those with a condition that makes them bruise or bleed easily should not get MMR vaccine.

Some people should wait to get MMR vaccine:

Pregnant people should wait to get MMR vaccine until they are no longer pregnant.
Those who have received other vaccines within the last 4 weeks should wait to get MMR vaccine.
Those who have given a blood transfusion or received blood products should wait at least 3 months for MMR vaccine.

What are the side effects of MMR vaccine?

Most people experience minor or no side effects. The most common side effects of MMR vaccine include:

Sore arm or redness where the vaccine is given
Fever
Mild rash
Temporary pain and stiffness in the joints

This vaccine is continually monitored for safety. The benefits and side effects of this vaccine outweigh the risk of getting measles, mumps, or rubella.

Why is MMR vaccine important?

Getting two doses of the MMR vaccine is 97% effective at preventing measles and rubella, and 88% effective against mumps. Vaccinated people who do get sick from the disease have milder symptoms.

Getting vaccinated protects yourself, your family, and others in the community. This protects people who can’t get vaccinated, such as those with weakened immune systems, infants, and pregnant people.

Before vaccination was available, 3 to 4 million people got measles each year in the United States. This lead to 48,000 hospitalizations, 1,000 cases of brain swelling (encephalitis), and 400 to 500 deaths a year.

Since the introduction of measles vaccine in 1963, measles cases have reduced by 99%.

Even with fewer cases, vaccines are still important because the United States still has outbreaks of disease in unvaccinated populations, high-risk groups, and international travelers.

Vaccine Information Statement and Resources

The Vaccine Information Statement (VIS) is given to parents/guardians at the time of vaccination. It explains the benefits and risks of the specific vaccination.

Read the current MMR Vaccine VIS from the Centers of Disease Control and Prevention (CDC).

Additional resources for the public

Childhood Vaccine Program

The Washington State Childhood Vaccination Program provides vaccines to children 18 years of age and younger at no cost. MMR vaccine is included in this program.

View participating health care providers on the Department of Health’s Vaccine Provider Map.

MMR Vaccine Requirement for Schools

MMR vaccine is required for child care and school entry in the state of Washington. Learn more about school and child care immunization requirements by visiting the family friendly school immunization requirements web page.

MMR Vaccine FAQ

What are the measles vaccine requirements?

Washington state requires children entering childcare, kindergarten, or grade school to be vaccinated against measles. You can read more about this requirement on our school and childcare immunizations information web page.

Staff and volunteers at a childcare center, Early Childhood Education and Assistance Program (ECEAP), or head start preschool are required to provide documentation showing they have received the MMR vaccine or have immunity from measles. You can read more about this requirement on our MMR Requirement FAQ.

How can I find out my vaccination status?

You can check to make sure you have been vaccinated with the MMR vaccine by obtaining vaccination records from your doctor’s office, pharmacy, or the provider that vaccinated you. You can also try checking with a school to see if they have your immunization record that you submitted when registering for school. Finally, you can sign up for MyIR to obtain an electronic immunization record from the Washington State immunization registry or contact the Department of Health.

What kind of vaccine is the MMR?

The measles, mumps, and rubella (MMR) vaccine contains live but weakened strains of the measles, mumps, and rubella viruses. After vaccination, the immune system makes virus-fighting antibodies against the weakened vaccine virus. Measles vaccine protects against measles because if you have been vaccinated and then are exposed to someone with measles, your body remembers how to fight off the virus. That’s because the vaccine trained your immune system. The vaccine does not cause disease but works to produce a strong and long-lasting immune response.

Why are vaccines so important to prevent measles?

The MMR vaccine is highly effective in preventing measles. If we have high rates of MMR vaccinations in a community, we can prevent outbreaks that require us to take time away from work and school. We can protect those who are not able to be vaccinated, such as those with weakened immune systems or infants too young to be vaccinated.

Who recommends the MMR Vaccine?

The Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the American College of Obstetricians and Gynecologists, the American College of Physicians (ACP), and the Washington State Department of Health all recommend this vaccine.

How effective is the MMR vaccine?

The MMR vaccine is very effective. One dose of the MMR vaccine is 93% effective in preventing measles. A second dose increases effectiveness to 97%.

Who should receive the MMR vaccine?

All children should receive 2 doses of the MMR vaccine at 12-15 months of age, and again at 4-6 years of age.

Adults born after 1957 who have never been vaccinated should get at least 1 dose of the MMR vaccine, unless they are at high risk.

High risk people include healthcare workers, school-age children, international travelers, and students attending college or vocational programs. If they have never been vaccinated or are not immune, they should get 2 doses of the MMR vaccine, given at least 28 days apart.

How long does it take for someone to be protected from measles after vaccination?

The body needs time to produce protective antibodies for the measles vaccine to work. It takes about 2-3 weeks for people to be fully protected. If you travel outside of the US, you should plan to be fully vaccinated at least 2 weeks before leaving.

Is there anyone who should not receive the MMR vaccine?

Pregnant women, anyone with a severe allergy to any component of the MMR vaccine, people with active tuberculosis, and anyone with a weakened immune system, should not receive the MMR vaccine.

What are the side effects of the MMR vaccine?

Common side effects include redness or soreness at the vaccination site, temporary joint or muscle pain, mild rash, or fever. These symptoms are usually mild and last 24 to 48 hours.

Can people who are fully vaccinated still get measles?

The vaccine is 97% effective after 2 doses, so that leaves 3 out of 100 people who may not have made antibodies to the vaccine who can get measles. Vaccines, like medications, are not 100% effective. Some people’s immune system may not have responded well to the vaccine. But fully vaccinated people who get measles are more likely to have a milder illness and less likely to spread the disease to other people, especially those who can’t get vaccinated.

What should I do if I’m not sure whether I’m immune to measles?

If you’re unsure about your immunity to measles, start by checking your vaccination records to see if you received the MMR (measles, mumps, and rubella) vaccine. If you were tested for measles in the past, try to locate the lab results. If you don’t have records of either vaccination or a blood test confirming immunity, its recommended that you get vaccinated with the MMR vaccine. There is no harm in receiving another dose, even if you were previously vaccinated but don’t have documentation.

I was not vaccinated with MMR but was exposed to somebody with measles. Should I receive a vaccine?

Yes. An MMR vaccine can be effective if given within 3 days of being exposed.

If I'm exposed to someone with measles and I can't get the MMR vaccine, is it possible to get immune globulin?

Yes, measles immune globulin can be given to pregnant people and people who have a weakened immune system who can't get the MMR vaccine. Talk to your provider about this option.

What is an MMR titer?

A titer is a blood test that checks for antibodies (immunity) against specific diseases. An MMR titer checks for immunity to measles, mumps, and rubella.

Should I get a blood test to check for measles immunity?

The CDC does not recommend measles antibody testing before or after MMR vaccination to assess immune response. 97% of people are protected against measles when they get 2 MMR vaccines, so antibody testing is not needed. Patients who haven’t been vaccinated or have no documented immunity should receive 1 or more doses of the MMR vaccine.

Does the MMR vaccine cause autism?

No. There is no scientific evidence that any vaccine causes autism. There have been many studies and research conducted and all of them have found no association between vaccines and autism.

The MMR vaccine prevents dangerous measles infection and saves lives. It continues to be monitored for safety and it remains our best defense against measles, mumps, and rubella.

For more information, see Vaccines and Autism, Children's Hospital of Philadelphia.

My family is unsure if vaccines are safe. What can I tell them to make them change their mind about getting the MMR vaccine?

Talking to family members who are unsure about vaccines requires time to listen and hear about their specific concerns. You can provide information to family members about why you vaccinate and reasons to get vaccinated. For example, you can tell them that measles is highly contagious and can cause children to be very sick, such as getting pneumonia, swelling of the brain, deafness and even death. About 1 in 5 people who are not vaccinated will need to be hospitalized.

The MMR vaccine has been licensed since the 1970s. It’s been monitored for safety for many years with minor side effects.
Many large studies show no connection between MMR vaccine and autism. The causes of autism spectrum disorder are not known, but genetics plays a strong role. Autism develops before birth or early in life.
MMR vaccine is the best way to be protected against measles, mumps, and rubella. One dose is 93% effective, and 2 doses are 97% effective to prevent measles infection.
Vaccination is the best defense to maintain your immune system's strength and protect against these serious health risks.
A helpful resource: check out our Plain Talk About Immunizations booklet.

MMR Vaccine for Children

When should my child get the MMR vaccine?

Children should get 2 doses to develop life-long immunity. The first dose should be given at 12-15 months of age and the second dose at 4-6 years of age.

Can my baby get the MMR vaccine before 12 months?

Yes, in special situations – infants 6-11 months old may receive 1 dose during a measles outbreak, prior to international travel, or travel to an area of the United States that is experiencing an outbreak. If your baby gets the MMR vaccine before 12 months, make sure the baby gets 2 more vaccines to make sure they are fully protected against measles.

There is a measles outbreak in my community. Can my child be vaccinated if s/he is younger than 12 months?

Children as young as 6 months can safely receive the MMR vaccine. Ask your provider to see if they recommend the MMR vaccine before 12 months if there’s an outbreak in your area. These children will still need to receive 2 additional MMR vaccines starting at the age of 12 months to be considered immune to measles.

How soon after my child gets the first MMR vaccine can they receive the second vaccine?

The second dose of the MMR vaccine is usually given at age 4-6 years old. However, it is safe to receive the second dose after at least 28 days have passed since receiving the first dose if you are travelling outside of the US or if your child is exposed to someone with measles.

Is it better for my child to get the disease rather than the vaccine?

The MMR vaccine is our best defense against measles, mumps and rubella. It is constantly monitored for safety and effectiveness, and the benefits outweigh any potential risks. Hundreds of millions of doses of the MMR vaccine have been given in the U.S. since it was developed, with an excellent record of safety.

Measles can be a serious disease, with 1 in 3 people experiencing 1 or more complications. Complications from measles are more common among very young children (younger than 5 years), people over age 20, pregnant people, or those with weakened immune systems. Death from measles occurs in 1 to 3 per 1,000 people with measles in the United States.

The most common complication of measles include ear infections (1 in 10 children) and diarrhea (fewer than 1 in 10 people). Pneumonia (1 in 20 children) is the most common cause of measles-related death. About 1 out of 1,000 infected people will develop acute encephalitis, an inflammation of the brain that can lead to permanent brain damage.

My child has an egg allergy: is it safe to give the MMR vaccine?

Yes, it is safe to give the MMR vaccine to children with egg allergies. Several studies show that the MMR vaccine is safe in children who are severely allergic to eggs. Both the American Academy of Pediatrics and the federal Advisory Committee on Immunization Practices (ACIP) recommend giving the MMR vaccine to children, regardless of egg allergy.

My child received the MMR vaccine and developed a rash. Did the vaccine give my child measles?

About 5 percent of people who receive the MMR vaccine develop a mild rash. When it occurs, the rash usually appears 7 to 12 days after vaccination. This rash is not an infection and cannot be spread to others. The vaccine viruses are not spread from a vaccinated person, even if they develop a rash. No special precautions, such as exclusion from school, are needed.

MMR Vaccine for Adults

Do adults who already received the MMR vaccine need a booster?

Most vaccinated adults are immune to measles and do not need a booster. Check for the MMR vaccine on your immunization record. If you were born before 1957, you likely had measles disease and developed life-long immunity and do not need MMR vaccines. If you are not sure of your immunity or vaccination status, it is safe to get an MMR vaccine.

Who is considered a “high risk” adult who needs 2 MMR vaccines?

People attending college or other post-high school educational institutions, healthcare workers, and international travelers.

I’m a college student without vaccination records. My titer results show I’m immune to rubella and mumps, but not measles. What type of vaccine should I receive?

Individuals vaccines for measles, for mumps, or for rubella are no longer available in the U.S. You will need get the combined MMR vaccine. You should receive 2 doses of MMR since you are at higher risk of measles infection as a college student.

I was born before 1957, do I still need an MMR vaccine?

No. If you were born before 1957, you are considered immune to measles. This is because you lived through many years of epidemic measles before the first vaccines were developed and are very likely to have had the disease.

I was born before 1957 and my blood test is negative for measles. Should I get the MMR vaccine now?

People born before 1957 are considered immune to measles. However, if your blood test shows you are not immune to measles, you can receive 1 or more MMR vaccines.

I’m a healthcare worker and I was born before 1957. How many MMR vaccines do I need?

Although people born before 1957 are considered to have measles immunity, healthcare workers are in a high-risk category. If there is no measles outbreak in your area, you may consider getting 2 doses of the MMR vaccine. During an outbreak, it is recommended that all healthcare workers, including those born before 1957, receive 2 doses of the MMR vaccine.

I was told that I had measles in my childhood. Am I immune or do I need to get vaccinated?

If you have a lab result that shows that you had measles infection, you don’t need to get vaccinated. If you don’t have documentation of measles infection, measles antibodies through a blood test, or MMR vaccination, you should receive the MMR vaccine.

I do not have my immunization record but think I have received the MMR vaccine in the past. How many MMR vaccines do I need?

If you don’t have documentation of previous MMR vaccination or documentation of immunity, follow the recommendations below.

Adults born in 1957 or later who are at low risk (not international travelers, healthcare workers, or attending college/vocational program) should get 1 dose of MMR vaccine.

High-risk adults such as healthcare personnel, international travelers born in 1957 or later, and people attending college/vocational program, should receive 2 doses of MMR vaccine.

I received my measles vaccine between 1963-1967, but am not sure which type of vaccine I received. Do I need to get a blood test to check for immunity?

No, you don’t need a blood test to check for immunity. Two types of measles vaccines were used in the 1960s: live virus, and inactivated (killed) virus. The inactivated version was later found to be not as effective in promoting immunity. If you do not know which type you received, or you do not have any records, you should receive at least 1 dose of the MMR vaccine. If you are at higher risk, 2 doses are recommended.

I had my blood tested for measles immunity and it was negative. What should I do?

If you have an immunization record showing that you received 2 MMR doses, you are considered immune even with a negative titer and do not need an additional vaccine. If you don’t have an immunization record showing that you received the MMR vaccine, you can get vaccinated. There is no harm in getting additional MMR vaccines even if you were vaccinated in the past but just don’t have your records.

Which people don’t need additional MMR vaccine doses?

Preschool-aged children with at least 1 MMR dose given on or after their first birthday.

Low-risk adults with at least 1 MMR vaccine.

School-aged children, adolescents, and high-risk adults, with 2 MMR doses.

People born before 1957.

Am I a “high risk” adult who needs 2 MMR vaccines?

If you are a college student, healthcare worker, or international traveler you are considered high risk and should receive 2 MMR vaccines.

I have HIV. Can I get the MMR vaccine?

Yes. The MMR vaccine can be safely given to people with HIV who are not severely immunocompromised, as demonstrated by their labs.

I received 2 doses of the MMR vaccine as a child. During pregnancy, my labs showed I wasn’t immune to rubella. Should I get another vaccine?

If your labs showed you’re not immune to rubella despite receiving 2 MMR vaccines, you should get another dose after pregnancy. The MMR vaccine isn’t recommended during pregnancy since it is a live vaccine.

Standalone rubella vaccines are not available in the U.S., but it is safe and effective to receive a third MMR dose in this case. Rubella is very dangerous during pregnancy and puts the pregnant person at risk for miscarriage or stillbirth. The developing baby is at risk for severe birth defects with devastating, lifelong consequences.

I’m breastfeeding. Is the MMR vaccine safe to take?

Yes. Breastfeeding does not interfere with the MMR vaccine’s effectiveness and does not affect the health of the baby. It is safe to continue breastfeeding after receiving the vaccine.

MMR Vaccine and Travel

I was born before 1957, am not a healthcare worker, and want to get the MMR vaccine before international travel. Can I still get the MMR vaccine?: It is not necessary, as individuals born before 1957 are generally considered immune. However, the MMR vaccine may be given to anyone born before 1957 if desired. Blood work is not required before MMR vaccination.
I am planning to travel abroad and have already received 2 MMR vaccines after the age of 12 months. Do I need a booster?: No. If you have received 2 MMR doses at age 12 months or later, you are considered immune and do not need another dose before traveling.
I’m planning to travel within the U.S. What are the recommendations for MMR vaccination?: Everyone should follow the CDC’s recommended MMR vaccination schedule. Talk with your healthcare provider or check the state health department’s website for specific recommendations if there is a community-wide outbreak in the area that you’re travelling. If you haven’t received any MMR vaccine and you’re traveling to an area with a measles outbreak, get the MMR vaccine at least 2 weeks before travel.
We're traveling internationally, and our baby is under 12 months old. Should they receive the MMR vaccine early?: Yes. Children 6-11 months old should receive 1 dose of the MMR vaccine before traveling internationally. Your child should get 2 more doses at 12 months of age and at 4 years of age.
I’m traveling abroad, and my trip is less than 2 weeks away. Should I get the MMR vaccine?: Yes. MMR vaccination is recommended at least 2 weeks before international travel. However, even if your trip is sooner, getting vaccinated before travel is still advised.