Usage
Measles vaccine is prescribed for the prevention of measles. It belongs to the pharmacological classification of vaccines, specifically live attenuated viral vaccines. The vaccine works by prompting the body to produce antibodies against the measles virus, thus providing immunity.
Alternate Names
Measles vaccine is often administered in combination with mumps and rubella vaccines. This combined vaccine is known as MMR (Measles, Mumps, and Rubella) vaccine. Another variation includes varicella (chickenpox) and is called MMRV vaccine. Measles vaccine is also referred to as the measles-containing vaccine and is available internationally under various brand names such as M-M-R II and Priorix.
How It Works
Pharmacodynamics: The measles vaccine contains live attenuated (weakened) measles virus. Upon administration, the virus replicates, triggering an immune response without causing the actual disease in immunocompetent individuals. This leads to the production of measles-specific antibodies, which provide long-lasting immunity.
Pharmacokinetics: The vaccine is administered subcutaneously (SC) or intramuscularly (IM). The attenuated virus replicates locally at the injection site and in regional lymph nodes. It is not known to be significantly metabolized or distributed systemically in high amounts. Elimination pathways for the attenuated virus and its components are not specifically characterized, as the vaccine primarily works by stimulating the immune system, which then handles the weakened virus.
Mode of Action: The measles vaccine virus interacts with the immune system, specifically B cells and T cells. This interaction leads to the development of immunological memory, involving both humoral (antibody-mediated) and cell-mediated immunity.
Receptor Binding, Enzyme Inhibition, or Neurotransmitter Modulation: This information is not applicable for vaccines in the same way it is for drugs that target specific receptors, enzymes, or neurotransmitters.
Dosage
Standard Dosage
Adults:
For adults born in or after 1970 without evidence of immunity, two doses of MMR vaccine are recommended, separated by at least 28 days. Adults born before 1957 are generally considered immune.
Children:
- Routine Vaccination: Two doses of MMR are recommended, the first at 12-15 months and the second at 4-6 years.
- Early Exposure Risk: For infants 6-11 months traveling to areas with high measles risk or during outbreaks, one dose can be given. However, this dose does not count toward the routine two-dose series. Two further doses are required according to the standard schedule.
Special Cases:
- Elderly Patients: Standard adult dosing applies.
- Patients with Renal Impairment: No dose adjustment is generally required.
- Patients with Hepatic Dysfunction: No dose adjustment is generally required.
- Patients with Comorbid Conditions: Patients with HIV infection should receive MMR unless severely immunocompromised (CD4 count <200 cells/µL or CD4+ T-lymphocyte count <15%). Severely immunocompromised patients, including those with leukemia, lymphoma, or receiving immunosuppressive therapy, should not receive MMR.
Clinical Use Cases
The measles vaccine is for preventive immunization, not for use in acute clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
No specific dosage adjustments are required based on renal/hepatic dysfunction, metabolic disorders, or genetic polymorphisms. However, the vaccine is contraindicated in severely immunocompromised individuals.
Side Effects
Common Side Effects:
- Pain, redness, or swelling at the injection site
- Fever
- Mild rash
- Swollen glands in the cheeks or neck
Rare but Serious Side Effects:
- Febrile seizures
- Allergic reactions (anaphylaxis)
- Temporary joint pain (more common in teenagers and adult women)
Long-Term Effects: Serious long-term side effects are extremely rare.
Contraindications
- Severe allergic reaction to a previous dose of MMR or its components (gelatin, neomycin)
- Pregnancy
- Severe immunodeficiency
Drug Interactions
- Immunosuppressants: Concurrent use can decrease vaccine effectiveness and potentially lead to disseminated disease.
- Immune Globulin/Blood Products: Should not be administered concurrently as they can interfere with vaccine response.
- Corticosteroids: High-dose corticosteroids are a contraindication to MMR.
Pregnancy and Breastfeeding
Measles vaccine is contraindicated in pregnancy. Pregnancy should be avoided for 4 weeks after MMR vaccination. The vaccine can be given to breastfeeding mothers.
Drug Profile Summary
- Mechanism of Action: Live attenuated vaccine inducing immunity against measles.
- Side Effects: Commonly injection site reactions, fever, rash. Rarely febrile seizures, allergic reactions.
- Contraindications: Pregnancy, severe immunodeficiency, prior severe allergic reaction to MMR or its components.
- Drug Interactions: Immunosuppressants, corticosteroids, IG/blood products.
- Pregnancy & Breastfeeding: Contraindicated in pregnancy; safe during breastfeeding.
- Dosage: Two doses for children (12-15 months, 4-6 years) and adults lacking immunity.
- Monitoring Parameters: Observe for common side effects and signs of allergic reaction.
Popular Combinations
MMR is a popular combination, providing protection against measles, mumps, and rubella. MMRV adds protection against varicella.
Precautions
- General Precautions: Screen for contraindications and previous allergic reactions.
- Pregnant Women: Contraindicated.
- Breastfeeding Mothers: Safe to administer.
- Children & Elderly: Adhere to age-specific dosing schedules.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Measles Vaccine?
A: Two doses are recommended for children (first dose at 12-15 months, second dose at 4-6 years) and adults without evidence of immunity.
Q2: Can pregnant women receive the measles vaccine?
A: No, measles vaccine is contraindicated during pregnancy.
Q3: What are the common side effects of the measles vaccine?
A: Common side effects include pain, redness, or swelling at the injection site, fever, mild rash, and swollen glands.
Q4: Is the measles vaccine safe for breastfeeding mothers?
A: Yes, it is safe for breastfeeding mothers to receive the MMR vaccine.
Q5: What should be done if a child has a fever after receiving the MMR vaccine?
A: Fever is a common side effect. Administer antipyretics as needed and monitor the child’s condition. Contact a healthcare provider if the fever is high or persistent.
Q6: Can a child receive the MMR vaccine if they have a cold?
A: Minor illnesses are not contraindications. However, if the child has a moderate or severe illness with fever, it’s generally advisable to postpone the vaccination until they have recovered.
Q7: What are the signs of a severe allergic reaction to the MMR vaccine?
A: Signs of a severe allergic reaction (anaphylaxis) include difficulty breathing, swelling of the face or throat, hives, dizziness, and weakness. This requires immediate medical attention.
Q8: How effective is the measles vaccine?
A: Two doses of the measles vaccine are about 97% effective in preventing measles.
Q9: Can the measles vaccine cause autism?
A: No, multiple studies have shown no link between the measles vaccine and autism.
Q10: Is there a treatment for measles if someone gets infected despite vaccination?
A: There’s no specific antiviral treatment for measles. Supportive care, such as managing fever and dehydration, is typically provided.
Please note that this information is current as of February 16, 2025, and is intended for use by qualified medical professionals. Always consult the latest medical guidelines and resources for the most up-to-date information.
