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{{short description|Vaccine used to prevent measles}}
{{expert-subject|Medicine|date=July 2009}}
{{Use dmy dates|date=July 2024}}
{{Drugbox
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{{Infobox drug
| type = vaccine
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| target = <!-- the antigen/bacteria/toxin/virus to protect against --> Measles
| image = File:Providing vaccinations to protect against disease after Typhoon Haiyan (11352296333).jpg
| vaccine_type = <!-- killed/attenuated/live/toxoid/protein subunit/conjugate/recombinant/DNA --> Attenuated
| caption = A child is given a measles vaccine.
| CAS_number =
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| type = vaccine
| ATC_suffix = BD01
| target = ] virus
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| vaccine_type = attenuated
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<!-- Definition and effectiveness -->
'''Measles vaccine''' is a highly effective ] used against ].<ref name="pmid18087048">{{cite journal |author=Ruigrok RW, Gerlier D |title=Structure of the measles virus H glycoprotein sheds light on an efficient vaccine |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=104 |issue=52 |pages=20639–40 |year=2007 |month=December |pmid=18087048 |pmc=2409202 |doi=10.1073/pnas.0709995105 |url=http://www.pnas.org/cgi/pmidlookup?view=long&pmid=18087048}}</ref> The measles-mumps-rubella-varicella combo (]) vaccine has been available since 2005. The most common side effect is a fever, which occurs in about 5%-15% of patients.<ref>http://www.vaccineinformation.org/measles/qandavax.asp</ref>
'''Measles vaccine''' protects against becoming infected with ].<ref name=WHO2017Vac/> Nearly all of those who do not develop immunity after a single dose develop it after a second dose.<ref name=WHO2017Vac /> When the rate of ] within a ] is greater than 92%, ] of measles typically no longer occur; however, they may occur again if the rate of vaccination decreases.<ref name=WHO2017Vac /> The ]'s effectiveness lasts many years.<ref name=WHO2017Vac /> It is unclear if it becomes less effective over time.<ref name=WHO2017Vac /> The vaccine may also protect against measles if given within a couple of days after exposure to measles.<ref>{{Cite web |title=Measles Vaccination and Infection: Questions and Misconceptions |url=https://asm.org/Articles/2019/July/Measles-Vaccination-and-Infection-Questions-and-Mi |access-date=29 April 2022 |website=ASM.org |language=en |archive-date=3 April 2022 |archive-url=https://web.archive.org/web/20220403061045/https://asm.org/Articles/2019/July/Measles-Vaccination-and-Infection-Questions-and-Mi |url-status=live }}</ref><ref name=WHO2017Vac>{{cite journal | vauthors = ((World Health Organization)) | author-link = World Health Organization | title = Measles vaccines: WHO position paper – April 2017 | journal = Weekly Epidemiological Record | volume = 92 | issue = 17 | pages = 205–27 | date = April 2017 | pmid = 28459148 | hdl = 10665/255377 | url = https://apps.who.int/iris/bitstream/handle/10665/255149/WER9217.pdf | access-date = 23 September 2020 | archive-date = 23 January 2023 | archive-url = https://web.archive.org/web/20230123203038/https://apps.who.int/iris/bitstream/handle/10665/255149/WER9217.pdf | url-status = live }}</ref><ref name="who.int 2017">{{cite web | title=Summary of the WHO position on Measles Vaccine- April 2017| website=who.int | date=20 July 2017 | url=https://www.who.int/immunization/policy/position_papers/WHO_PP_measles_vaccine_summary_2017.pdf | archive-url=https://web.archive.org/web/20220308124147/https://www.who.int/immunization/policy/position_papers/WHO_PP_measles_vaccine_summary_2017.pdf | archive-date=8 March 2022 | url-status=dead}}</ref><ref>{{Cite web |title=Measles |url=https://www.who.int/news-room/fact-sheets/detail/measles |access-date=29 April 2022 |website=www.who.int |language=en |archive-date=1 June 2019 |archive-url=https://web.archive.org/web/20190601173915/https://www.who.int/news-room/fact-sheets/detail/measles |url-status=live }}</ref>

<!-- Safety -->
The vaccine is generally safe, even for those infected by ].<ref name=WHO2017Vac/><ref name=CDC2020Me>{{Cite web|title=About Measles Vaccination {{!}} Vaccination and Immunizations {{!}} CDC|url=https://www.cdc.gov/vaccines/vpd/measles/index.html|date=9 January 2020|website=www.cdc.gov|language=en-us|access-date=30 April 2020|archive-date=27 April 2020|archive-url=https://web.archive.org/web/20200427170146/https://www.cdc.gov/vaccines/vpd/measles/index.html|url-status=live}}</ref> Most children do not experience any side effects;<ref name=CDC2020Me2>{{Cite web|title=Measles and the Vaccine (Shot)|url=https://www.cdc.gov/vaccines/parents/diseases/measles.html|last=CDC|date=2 August 2019|website=Centers for Disease Control and Prevention|language=en-us|access-date=30 April 2020|archive-date=29 January 2020|archive-url=https://web.archive.org/web/20200129171152/https://www.cdc.gov/vaccines/parents/diseases/measles.html|url-status=live}}</ref> those that do occur are usually mild, such as fever, rash, pain at the site of injection, and joint stiffness; and are short-lived.<ref name=WHO2017Vac /><ref name=CDC2020Me2/> ] has been documented in about 3.5–10 cases per million doses.<ref name=WHO2017Vac /> Rates of ], ] and ] do not appear to be increased by measles vaccination.<ref name=WHO2017Vac /><ref>{{Cite web |date=5 April 2021 |title=Measles, Mumps, and Rubella (MMR) Vaccination {{!}} CDC |url=https://www.cdc.gov/vaccines/vpd/mmr/public/index.html |access-date=29 April 2022 |website=www.cdc.gov |language=en-us |archive-date=26 April 2020 |archive-url=https://web.archive.org/web/20200426105545/https://www.cdc.gov/vaccines/vpd/mmr/public/index.html |url-status=live }}</ref>

<!-- Formulation -->
The vaccine is available both ] and in combinations such as the ] (a combination with the ] and ])<ref name=WHO2017Vac /> or the ] (a combination of MMR with the ]).<ref>{{cite book | vauthors = Mitchell D |title=The essential guide to children's vaccines |date=2013 |publisher=St. Martin's Press |location=New York |isbn=9781466827509 |page=127 |url=https://books.google.com/books?id=w0C7L9o3m-MC&pg=PA127 |url-status=live |archive-url=https://web.archive.org/web/20170908135232/https://books.google.com/books?id=w0C7L9o3m-MC&pg=PA127 |archive-date=8 September 2017}}</ref><ref name="ProQuad label">{{cite web | title=ProQuad- measles, mumps, rubella and varicella virus vaccine live injection, powder, lyophilized, for suspension | website=DailyMed | date=26 September 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=73eae9fc-507b-4c9c-883d-63eb2e3cc6f6 | access-date=29 January 2020 | archive-date=6 April 2020 | archive-url=https://web.archive.org/web/20200406003810/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=73eae9fc-507b-4c9c-883d-63eb2e3cc6f6 | url-status=live }}</ref><ref name="www.cdc.gov_2019"/> The measles vaccine is equally effective for preventing measles in all formulations, but side effects vary for different combinations.<ref name=WHO2017Vac /><ref>{{cite web |title=Information Sheet Observed Rate of Vaccine Reactions |url=https://www.who.int/vaccine_safety/initiative/tools/MMR_vaccine_rates_information_sheet.pdf?ua=1 |website=] (WHO) |access-date=1 December 2018 |archive-date=19 December 2019 |archive-url=https://web.archive.org/web/20191219183611/https://www.who.int/vaccine_safety/initiative/tools/MMR_vaccine_rates_information_sheet.pdf?ua=1 |url-status=live }}</ref> The ] (WHO) recommends measles vaccine be given at nine months of age in areas of the world where the disease is common, or at twelve months where the disease is not common.<ref>{{Cite web |title=MEASLES VACCINE - Essential drugs |url=https://medicalguidelines.msf.org/viewport/EssDr/english/measles-vaccine-16687745.html |access-date=28 April 2022 |website=medicalguidelines.msf.org |archive-date=5 December 2021 |archive-url=https://web.archive.org/web/20211205110330/https://medicalguidelines.msf.org/viewport/EssDr/english/measles-vaccine-16687745.html |url-status=live }}</ref><ref name=WHO2017Vac /> Measles vaccine is ] of measles.<ref name=WHO2017Vac /> It comes as a dried powder that is mixed with a ] before being injected either just under the skin or into a muscle.<ref name=WHO2017Vac /> Verification that the vaccine was effective can be determined by blood tests.<ref name=WHO2017Vac />

<!-- Usage, history, society and culture -->
The measles vaccine was first introduced in 1963.<ref name="Yellow2014">{{cite book|author=Centers for Disease Control and Prevention|url=https://books.google.com/books?id=nVppAgAAQBAJ&pg=PA250|title=CDC health information for international travel 2014 the yellow book|date=2014|isbn=9780199948505|page=250| publisher=Oxford University Press |archive-url=https://web.archive.org/web/20170908135232/https://books.google.com/books?id=nVppAgAAQBAJ&pg=PA250|archive-date=8 September 2017|url-status=live}}</ref> In that year, the Edmonston-B strain of measles virus was turned into a vaccine by ] and colleagues and licensed in the United States.<ref name="CDC_2020">{{Cite web|last=CDC|date=5 November 2020|title=History of Measles|url=https://www.cdc.gov/measles/about/history.html|access-date=9 February 2021|website=Centers for Disease Control and Prevention|language=en-us|archive-date=6 April 2020|archive-url=https://web.archive.org/web/20200406003814/https://www.cdc.gov/measles/about/history.html|url-status=live}}</ref><ref name=CDC2018Hist/> In 1968, an improved and even weaker measles vaccine was developed by ] and colleagues, and began to be distributed, becoming the only measles vaccine used in the United States since 1968.<ref>{{Cite web |work=The Children's Hospital of Philadelphia |date=20 November 2014 |title=Vaccine History: Developments by Year |url=https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-history/developments-by-year |access-date=28 April 2022 |archive-date=28 April 2022 |archive-url=https://web.archive.org/web/20220428154721/https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-history/developments-by-year |url-status=live }}</ref><ref name="CDC_2020" /><ref name=CDC2018Hist>{{cite web | title=Measles History | website=U.S. ] (CDC) | date=5 February 2018 | url=https://www.cdc.gov/measles/about/history.html | access-date=28 January 2020 | archive-date=6 April 2020 | archive-url=https://web.archive.org/web/20200406003814/https://www.cdc.gov/measles/about/history.html | url-status=live }} {{PD-notice}}</ref> About 86% of children globally had received at least one dose of the vaccine as of 2018.<ref name="WHO-factsheet">{{Cite web |date=20 March 2023 |title=Measles Fact Sheet - WHO |url=https://www.who.int/en/news-room/fact-sheets/detail/measles |access-date=29 May 2023 |website=] (WHO) |archive-date=28 November 2022 |archive-url=https://web.archive.org/web/20221128010546/https://www.who.int/en/news-room/fact-sheets/detail/measles |url-status=live }}</ref> In 2021, at least 183 countries provided two doses in their routine immunization schedule.<ref>{{Cite web |date=14 July 2022 |title=Immunization Coverage - WHO |url=https://www.who.int/en/news-room/fact-sheets/detail/immunization-coverage |access-date=29 May 2023 |website=] (WHO) |archive-date=6 February 2018 |archive-url=https://web.archive.org/web/20180206064744/http://www.who.int/mediacentre/factsheets/fs378/en/ |url-status=live }}</ref> It is on the ].<ref name="WHO23rd">{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }}</ref> As outbreaks easily occur in under-vaccinated populations, non-prevalence of disease is seen as a test of sufficient vaccination within a population.<ref>{{Cite web |title=Measles |url=https://www.who.int/news-room/fact-sheets/detail/measles |access-date=28 April 2022 |website=www.who.int |language=en |archive-date=1 June 2019 |archive-url=https://web.archive.org/web/20190601173915/https://www.who.int/news-room/fact-sheets/detail/measles |url-status=live }}</ref><ref>{{cite book | vauthors = Abramson B |title=Vaccine, vaccination, and immunization law |date=2018 |publisher=Bloomberg Law |isbn=9781682675830 |pages=10–30}}</ref>


==Effectiveness== ==Effectiveness==
]
]
].]]


One dose is about 93% effective while two doses of the vaccine are about 97% effective at preventing measles.<ref name=CDC2020Me/> Before the widespread use of the vaccine, measles was so common that infection was considered "as inevitable as death and taxes."<ref>{{cite journal | vauthors = Babbott FL, Gordon JE | title = Modern measles | journal = The American Journal of the Medical Sciences | volume = 228 | issue = 3 | pages = 334–61 | date = September 1954 | pmid = 13197385 | doi = 10.1097/00000441-195409000-00013 }}</ref> In the United States, reported cases of measles fell from 3 to 4 million with 400 to 500 deaths to tens of thousands per year following introduction of two measles vaccines in 1963 (both an inactivated and a live ] (Edmonston B strain) were licensed for use, see chart at right).<ref name=CDC2020Me /><ref>{{Cite web|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/00041753.htm|title=Measles Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP)|website=www.cdc.gov|access-date=27 April 2020|archive-date=15 May 2012|archive-url=https://web.archive.org/web/20120515055632/http://www.cdc.gov/mmwr/preview/mmwrhtml/00041753.htm|url-status=live}}</ref> Increasing uptake of the vaccine following outbreaks in 1971 and 1977 brought this down to thousands of cases per year in the 1980s. An outbreak of almost 30,000 cases in 1990 led to a renewed push for vaccination and the addition of a second vaccine to the recommended schedule. No more than 220 cases were reported in any year from 1997 to 2013, and the disease was believed no longer ] in the United States.<ref name="pmid9247368">{{cite journal | author = Centers for Disease Control and Prevention (CDC) | title = Summary of notifiable diseases, United States, 1993 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 42 | issue = 53 | pages = i–xvii; 1–73 | date = 1994 | pmid = 9247368 | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/00035381.htm | archive-url = https://web.archive.org/web/20100309075517/http://www.cdc.gov/mmwr/preview/mmwrhtml/00035381.htm | archive-date = 9 March 2010 }}</ref><ref>{{cite journal | author = Centers for Disease Control and Prevention (CDC) | title = Summary of notifiable diseases, United States, 2007 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 56 | issue = 53 | pages = 1–94 | date = July 2007 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5653a1.htm | access-date = 10 September 2017 | archive-date = 13 June 2018 | archive-url = https://web.archive.org/web/20180613234236/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5653a1.htm | url-status = live }}</ref><ref>{{cite book | vauthors = Wallace G, Leroy Z | chapter = Measles | veditors = Hamborsky J, Kroger A, Wolfe S | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | edition = 13th | year = 2015 | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/meas.html | location = Washington D.C. | publisher = Public Health Foundation | access-date = 30 April 2019 | archive-date = 7 February 2015 | archive-url = https://web.archive.org/web/20150207061223/http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html | url-status = live }}</ref> In 2014, 667 cases were reported.<ref>{{cite web |url=https://www.cdc.gov/measles/cases-outbreaks.html |title=Measles Cases and Outbreaks |access-date=30 November 2018 |url-status=live |archive-url=https://web.archive.org/web/20150213145736/http://www.cdc.gov/measles/cases-outbreaks.html |archive-date=13 February 2015}}</ref>
] before and after introduction of the vaccine.]]
Before the widespread use of a vaccine against ], its incidence was so high that infection with measles was felt to be "as inevitable as death and taxes."<ref>{{cite journal |author=Babbott FL Jr, Gordon JE |title=Modern measles |journal=Am J Med Sci |volume=228 |issue=3 |pages=334–61 |year=1954 |pmid=13197385}}</ref> Today, the ] of measles has fallen to less than 1% of people under the age of 30 in countries with routine childhood vaccination.{{Citation needed|date=June 2008}} In the United States, reported cases of measles fell from hundreds of thousands to tens of thousands per year following introduction of the vaccine in 1963 (see chart at right). Increasing uptake of the vaccine following outbreaks in 1971 and 1977 brought this down to thousands of cases per year in the 1980s. An outbreak of almost 30,000 cases in 1990 led to a renewed push for vaccination and the addition of a second vaccine to the recommended schedule. Fewer than 200 cases have been reported each year since 1997, and the disease is no longer considered endemic in the United States.<ref>Centers for Disease Control and Prevention Published October 21, 1994 for Morbidity and Mortality Weekly Report 1993; '''42''' (No. 53)</ref><ref>Centers for Disease Control and Prevention Published July 9, 2009 for Morbidity and Mortality Weekly Report 2007; '''56''' (No. 53)</ref><ref>Centers for Disease Control and Prevention. . Atkinson W, Wolfe S, Hamborsky J, McIntyre L, eds. 11th ed. Washington DC: Public Health Foundation, 2009</ref>


The benefit of measles vaccination in preventing illness, disability, and death has been well documented. The first 20 years of licensed measles vaccination in the U.S. prevented an estimated 52 million cases of the disease, 17,400 cases of ], and 5,200 deaths.<ref>{{cite journal |author=Bloch AB, Orenstein WA, Stetler HC ''et al.'' |title=Health impact of measles vaccination in the United States |journal=Pediatrics |volume=76 |issue=4 |pages=524–32 |year=1985 |pmid=3931045}}</ref> During 1999–2004, a strategy led by the ] and ] led to improvements in measles vaccination coverage that averted an estimated 1.4 million measles deaths worldwide.<ref>{{cite journal |journal= MMWR Morb Mortal Wkly Rep |year=2006 |volume=55 |issue=9 |pages=247–9 |title= Progress in reducing global measles deaths, 1999–2004 |author= Centers for Disease Control and Prevention (CDC) |pmid=16528234 |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5509a8.htm}}</ref> The vaccine for measles has led to the near-complete elimination of the disease in the United States and other developed countries.<ref name=NYTPeebles/> It was introduced in 1963.<ref name="pmid371890">{{cite journal |author=Hayden GF |title=Measles vaccine failure. A survey of causes and means of prevention |journal=Clin Pediatr (Phila) |volume=18 |issue=3 |pages=155–6, 161–3, 167 |year=1979 |month=March |pmid=371890 |doi= 10.1177/000992287901800308|url=http://cpj.sagepub.com/cgi/content/abstract/18/3/155?ijkey=a20de7e74fce454c6392f0fefb1ce9090c881c46&keytype2=tf_ipsecsha}}</ref> These impressive reductions in death and long-range after-effectiveness were initially achieved with a live virus version of the vaccine that itself caused side effects, although these are far fewer and less serious than the sickness and death caused by ] itself. While preventing many deaths and serious illnesses, the live virus version of the vaccine did cause side effects in a small percentage of recipients, ranging from rashes to, rarely, convulsions.<ref name=PI>Collins, Huntly. , copy of article from '']'', August 30, 1999. Accessed August 4, 2010.</ref> The benefits of measles vaccination in preventing illness, disability, and death have been well documented. Within the first 20 years of being licensed in the U.S., measles vaccination prevented an estimated 52 million cases of the disease, 17,400 cases of ], and 5,200 deaths.<ref>{{cite journal | vauthors = Bloch AB, Orenstein WA, Stetler HC, Wassilak SG, Amler RW, Bart KJ, Kirby CD, Hinman AR | title = Health impact of measles vaccination in the United States | journal = Pediatrics | volume = 76 | issue = 4 | pages = 524–32 | date = October 1985 | doi = 10.1542/peds.76.4.524 | pmid = 3931045 | s2cid = 6512947 }}</ref> From 1999 to 2004 a strategy led by the WHO and ] led to improvements in measles vaccination coverage that averted an estimated 1.4 million measles deaths worldwide.<ref>{{cite journal | author = Centers for Disease Control and Prevention (CDC) | title = Progress in reducing global measles deaths, 1999-2004 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 55 | issue = 9 | pages = 247–9 | date = March 2006 | pmid = 16528234 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5509a8.htm | archive-url = https://web.archive.org/web/20071016143014/http://cdc.gov/mmwr/preview/mmwrhtml/mm5509a8.htm | url-status = live | archive-date = 16 October 2007 }}</ref> The vaccine for measles led to the near-complete elimination of the disease in the United States and other developed countries.<ref name=NYTPeebles/> While the vaccine is made with a live virus which can cause side effects, these are far fewer and less serious than the sickness and death caused by measles itself; side effects ranging from rashes to, rarely, ]s, occur in a small percentage of recipients.<ref name=PI>{{cite news | vauthors = Collins H | title = The Man Who Saved Your Life - Maurice R. Hilleman - Developer of Vaccines for Mumps and Pandemic Flu | url=http://www.njabr.org/njsor/science_superstars/maurice_hilleman/ | archive-url=https://web.archive.org/web/20090306224906/http://www.njabr.org/njsor/science_superstars/maurice_hilleman/ | archive-date=6 March 2009 | url-status=dead | work = ] | date = 30 August 1999 | access-date=28 January 2020 }}</ref>


Measles vaccination averted 57 million deaths between 2000 and 2022, as per ] report.<ref>{{Cite web |title=Measles |url=https://www.who.int/news-room/fact-sheets/detail/measles |access-date=2024-08-21 |website=www.who.int |language=en}}</ref>
Measles is ] worldwide. Although it was declared eliminated from the U.S. in 2000, high rates of vaccination and good communication with persons who refuse vaccination are needed to prevent outbreaks and sustain the elimination of measles in the U.S.<ref name=Parker/> Of the 66 cases of measles reported in the U.S. in 2005, slightly over half were attributable to one unvaccinated individual who acquired measles during a visit to ].<ref>{{cite journal |journal= MMWR Morb Mortal Wkly Rep |year=2006 |volume=55 |issue=50 |pages=1348–51 |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5550a2.htm |title= Measles—United States, 2005 |author= Centers for Disease Control and Prevention (CDC) |pmid=17183226}}</ref> This individual returned to a community with many unvaccinated children. The resulting outbreak infected 34 people, mostly children and virtually all unvaccinated; 9% were hospitalized, and the cost of containing the outbreak was estimated at $167,685. A major epidemic was averted due to high rates of vaccination in the surrounding communities.<ref name=Parker>{{cite journal |author=Parker AA, Staggs W, Dayan GH ''et al.'' |title=Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States |journal=N Engl J Med |volume=355 |issue=5 |pages=447–55 |year=2006 |pmid=16885548 |doi=10.1056/NEJMoa060775}}</ref>


Measles is ] worldwide. Although it was declared eliminated from the U.S. in 2000, high rates of vaccination and excellent communication with those who refuse vaccination are needed to prevent outbreaks and sustain the elimination of measles.<ref name=Parker/> Of the 66 cases of measles reported in the U.S. in 2005, slightly over half were attributable to one unvaccinated teenager who became infected during a visit to Romania.<ref>{{cite journal | author = Centers for Disease Control and Prevention (CDC) | title = Measles--United States, 2005 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 55 | issue = 50 | pages = 1348–51 | date = December 2006 | pmid = 17183226 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5550a2.htm | archive-url = https://web.archive.org/web/20150313120119/http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5550a2.htm | url-status = live | archive-date = 13 March 2015 }}</ref> This individual returned to a community with many unvaccinated children. The resulting outbreak infected 34 people, mostly children and virtually all unvaccinated; three of them were hospitalized. The public health response required making almost 5,000 phone calls as part of ], arranging and performing testing as needed, and arranging emergency vaccination for at-risk people who had had contact with this person.<ref name="Parker" /> Taxpayers and local healthcare organizations likely paid more than US$167,000 in direct costs to contain this one outbreak.<ref name="Parker" /> A major ] was averted due to high rates of vaccination in the surrounding communities.<ref name=Parker>{{cite journal | vauthors = Parker AA, Staggs W, Dayan GH, Ortega-Sánchez IR, Rota PA, Lowe L, Boardman P, Teclaw R, Graves C, LeBaron CW | title = Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States | journal = The New England Journal of Medicine | volume = 355 | issue = 5 | pages = 447–55 | date = August 2006 | pmid = 16885548 | doi = 10.1056/NEJMoa060775 | doi-access = free }}</ref>
==History==
As a fellow at ], Dr. ] worked with Dr. ], known as "The Father of Modern vaccines", who earned the Nobel Prize in 1954 for his research on cultivating the polio virus that led to the development of a vaccination for the disease. Switching to study measles, Peebles was sent to a school where an outbreak of the disease was under way and was able to isolate the virus from some of the blood samples and throat swabs he had taken from students. Even after Enders had taken him off the study team, Peebles was able to cultivate the virus and show that the disease could be passed on to monkeys inoculated with the material he had collected.<ref name=NYTPeebles>Martin, Douglas. , '']'', August 4, 2010. Accessed August 4, 2010.</ref> Enders was able to use the cultivated virus to develop a measles vaccine in 1963 based on the material isolated by Peebles.<ref>Staff. , '']'', March 22, 1963. Accessed August 4, 2010. "A strain of measles virus isolated in 1954 by Dr. Thomas C. Peebles, instructor in pediatrics at Harvard, and Enders, formed the basis for the development of the present vaccine".</ref> In the late 1950s and early 1960s, nearly twice as many children died from measles as from polio.<ref>Staff. , '']'', March 28, 1963. Accessed August 4, 2010.</ref> The vaccine Enders developed was based on the Edmonston strain of attenuated live measles virus, which was named for the student from which Peebles had taken the culture that led to the virus' cultivation.<ref> ] , '']'', Vol. 90 No. 1 July 1992, pp. 149-153. Accessed August 4, 2010.</ref>


The vaccine has ] such as preventing respiratory infections, that may be greater than those of measles prevention alone.<ref>{{cite journal | vauthors = Mina MJ | title = Measles, immune suppression and vaccination: direct and indirect nonspecific vaccine benefits | journal = The Journal of Infection | volume = 74 | issue = Suppl 1 | pages = S10–S17 | date = June 2017 | pmid = 28646947 | doi = 10.1016/S0163-4453(17)30185-8 }}</ref><!-- <ref name=Sankoh2014/> --> These benefits are greater when the vaccine is given before one year of age.<ref>{{cite journal | vauthors = Nic Lochlainn LM, de Gier B, van der Maas N, van Binnendijk R, Strebel PM, Goodman T, de Melker HE, Moss WJ, Hahné SJ | title = Effect of measles vaccination in infants younger than 9 months on the immune response to subsequent measles vaccine doses: a systematic review and meta-analysis | language = English | journal = The Lancet. Infectious Diseases | volume = 19 | issue = 11 | pages = 1246–1254 | date = November 2019 | pmid = 31548081 | pmc = 6838663 | doi = 10.1016/S1473-3099(19)30396-2 }}</ref><!-- <ref name=Sankoh2014/> --> A high-] vaccine resulted in worse outcomes in girls, and consequently is not recommended by the World Health Organization.<ref name=Sankoh2014>{{cite journal | vauthors = Sankoh O, Welaga P, Debpuur C, Zandoh C, Gyaase S, Poma MA, Mutua MK, Hanifi SM, Martins C, Nebie E, Kagoné M, Emina JB, Aaby P | title = The non-specific effects of vaccines and other childhood interventions: the contribution of INDEPTH Health and Demographic Surveillance Systems | journal = International Journal of Epidemiology | volume = 43 | issue = 3 | pages = 645–653 | date = June 2014 | pmid = 24920644 | pmc = 4052142 | doi = 10.1093/ije/dyu101 }}</ref>
Dr. Maurice Hilleman of ], a pioneer in the development of vaccinations, developed the ] in 1971, which treats measles, ] and ] in a single shot followed by a booster.<ref name=PI/><ref>{{cite news |url=http://www.washingtonpost.com/wp-dyn/articles/A48244-2005Apr12.html |title=Maurice R. Hilleman Dies; Created Vaccines (washingtonpost.com) |format= |work= The Washington Post|accessdate=2009-07-21 | first=Patricia | last=Sullivan | date=2005-04-13}}</ref> One form is called "Attenuvax" with more than 40 peptide sequences.<ref name="pmid15777939">{{cite journal |author=Ovsyannikova IG, Johnson KL, Naylor S, Poland GA |title=Identification of HLA-DRB1-bound self-peptides following measles virus infection |journal=J. Immunol. Methods |volume=297 |issue=1-2 |pages=153–67 |year=2005 |month=February |pmid=15777939 |doi=10.1016/j.jim.2004.12.020 |url=http://linkinghub.elsevier.com/retrieve/pii/S0022-1759(05)00014-1}}</ref> The measles component of the MMR vaccine uses Attenuvax, which is grown in a chick embryo cell culture using the Enders' attenuated Edmonston strain.
==See also==
*]


The immune response to the measles vaccine can be impaired by the presence of parasitic infections such as ].<ref>{{cite journal | vauthors = Natukunda A, Zirimenya L, Nassuuna J, Nkurunungi G, Cose S, Elliott AM, Webb EL | title = The effect of helminth infection on vaccine responses in humans and animal models: A systematic review and meta-analysis | journal = Parasite Immunology | volume = 44 | issue = 9 | pages = e12939 | date = September 2022 | pmid = 35712983 | pmc = 9542036 | doi = 10.1111/pim.12939 }}</ref>
==References==

===Schedule===
The ] (WHO) recommends two doses of vaccine for all children.<ref name=WHO2017Vac /> In countries with a high risk of disease the first dose should be given around nine months of age.<ref name=WHO2017Vac /> Otherwise it can be given at twelve months of age.<ref name=WHO2017Vac /> The second dose should be given at least one month after the first dose.<ref name=WHO2017Vac /> This is often done at age 15 to 18 months.<ref name=WHO2017Vac /> After one dose at the age of nine months 85% are immune, while a dose at twelve months results in 95% immunity.<ref name=Yellow2014/>

In the United States, the ] (CDC) recommends that children aged six to eleven months traveling outside the United States receive their first dose of MMR vaccine before departure<ref>{{cite web|title=Vaccine (Shot) for Measles |date=2 August 2019 |url=https://www.cdc.gov/vaccines/parents/diseases/measles.html |publisher=] (CDC)|access-date=29 January 2020|url-status=live|archive-url=https://web.archive.org/web/20200129171152/https://www.cdc.gov/vaccines/parents/diseases/measles.html|archive-date=29 January 2020}} {{PD-notice}}</ref> and then receive two more doses; one at 12–15 months (12 months for children in high-risk areas) and the second as early as four weeks later.<ref name="CDC schedule" /> Otherwise the first dose is typically given at 12–15 months and the second at 4–6 years.<ref name="CDC schedule">{{cite web | title=Birth-18 Years Immunization Schedule | website=] (CDC) | date=5 February 2019 | url=https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html#note-mmr | access-date=29 January 2020 | archive-date=6 March 2016 | archive-url=https://web.archive.org/web/20160306220930/http://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html#note-mmr | url-status=live }} {{PD-notice}}</ref>

In the UK, the ] (NHS) recommendation is for a first dose at around 13 months of age and the second at three years and four months old.<ref>{{cite web |title=Measles |url=https://www.nhs.uk/conditions/measles/ |website=National Health Service UK |access-date=11 March 2019 |date=20 October 2017 |archive-date=8 March 2019 |archive-url=https://web.archive.org/web/20190308023737/https://www.nhs.uk/conditions/measles/ |url-status=live }}</ref><ref>{{cite web | title=MMR vaccine overview | website=National Health Service UK | date=8 October 2019 | url=https://www.nhs.uk/conditions/vaccinations/mmr-vaccine/ | access-date=29 January 2020 | archive-date=31 January 2013 | archive-url=https://web.archive.org/web/20130131124838/http://www.nhs.uk/Conditions/MMR/Pages/FAQs.aspx | url-status=live }}</ref>

In Canada, ] recommends that children traveling outside North America should receive an ] if they are aged six to 12 months. However, after the child is 12 months old they should receive two additional doses to ensure long-lasting protection.<ref>{{Cite web |url=https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html |title=Measles vaccine: Canadian immunization guide |date=18 July 2007 |website=Public Health Agency of Canada |access-date=13 March 2019 |archive-date=17 March 2019 |archive-url=https://web.archive.org/web/20190317001502/https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html |url-status=live }}</ref>

==Adverse effects==
Adverse effects associated with the MMR vaccine include ], rash, injection site pain, and, in rare cases, red or purple discolorations on the skin known as ], or seizures related to fever (]).<ref>{{cite web | title = Information Sheet: Observed Rate of Vaccine Reactions: Measles, Mumps and Rubella Vaccines | url = https://www.who.int/vaccine_safety/initiative/tools/MMR_vaccine_rates_information_sheet.pdf | publisher = ] (WHO) | date = May 2014 | access-date = 1 December 2018 | archive-date = 17 December 2019 | archive-url = https://web.archive.org/web/20191217095809/https://www.who.int/vaccine_safety/initiative/tools/MMR_vaccine_rates_information_sheet.pdf | url-status = live }}</ref><ref name="Di Pietrantonj_2021">{{cite journal | vauthors = Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V | title = Vaccines for measles, mumps, rubella, and varicella in children | journal = The Cochrane Database of Systematic Reviews | volume = 2021 | issue = 11 | pages = CD004407 | date = November 2021 | pmid = 34806766 | pmc = 8607336 | doi = 10.1002/14651858.CD004407.pub5 }}</ref>

Numerous studies have found no relationship between ].<ref>{{cite book | chapter = Measles, Mumps, and Rubella Vaccine | title = Adverse Effects of Vaccines: Evidence and Causality | chapter-url = https://www.nap.edu/read/13164/chapter/6#152 | location = Washington, D.C. | publisher = The National Academies Press | isbn = 978-0-309-21436-0 | date = 9 April 2012 | doi = 10.17226/13164 | pmid = 24624471 | access-date = 3 November 2017 | archive-date = 7 November 2017 | archive-url = https://web.archive.org/web/20171107020850/https://www.nap.edu/read/13164/chapter/6#152 | url-status = live | collaboration = Committee to Review Adverse Effects of Vaccines | vauthors = Stratton K, Ford A, Rusch E, Clayton EW }}</ref><ref>{{cite web |url= http://cdc.gov/vaccinesafety/concerns/mmr_autism_factsheet.htm |title= Measles, mumps, and rubella (MMR) vaccine |date=22 August 2008 |access-date=21 December 2008 |publisher= Centers for Disease Control and Prevention |archive-url= https://web.archive.org/web/20081008040738/http://www.cdc.gov/vaccinesafety/concerns/mmr_autism_factsheet.htm |archive-date=8 October 2008}}</ref><ref>{{cite book | title = Immunization Safety Review: Vaccines and Autism | url = https://www.nap.edu/catalog/10997/immunization-safety-review-vaccines-and-autism | publisher = Institute of Medicine of the National Academy of Sciences | date = 17 May 2004 | isbn = 978-0-309-09237-1 | doi = 10.17226/10997 | pmid = 20669467 | author1 = Institute of Medicine (US) Immunization Safety Review Committee | access-date = 19 October 2019 | archive-date = 7 October 2014 | archive-url = https://web.archive.org/web/20141007075952/http://www.nap.edu/catalog.php?record_id=10997 | url-status = live }}</ref><ref name="Di Pietrantonj_2021" />

===Contraindications===
Some people shouldn't receive the measles or MMR vaccine, including cases of:
* Pregnancy: MMR vaccine and its components should not be given to pregnant women.<ref>{{cite web | url = https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html | title = Guidelines for Vaccinating Pregnant Women | date = August 2016 | work = Centers for Disease Control and Prevention | access-date = 30 April 2019 | archive-date = 6 April 2020 | archive-url = https://web.archive.org/web/20200406003822/https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html | url-status = live }}</ref> Women of childbearing age should check with their doctor about getting vaccinated prior to getting pregnant.<ref name="www.cdc.gov_2019">{{Cite web|title=MMR Vaccination {{!}} What You Should Know {{!}} Measles, Mumps, Rubella {{!}} CDC|url=https://www.cdc.gov/vaccines/vpd/mmr/public/index.html|date=24 December 2019|website=www.cdc.gov|language=en-us|access-date=30 April 2020|archive-date=26 April 2020|archive-url=https://web.archive.org/web/20200426105545/https://www.cdc.gov/vaccines/vpd/mmr/public/index.html|url-status=live}}</ref>
* HIV-infected children, who may receive measles vaccines if their ] lymphocyte count is greater than 15%.<ref>{{cite book | chapter = Contraindications and Precautions | title = Vaccine Recommendations and Guidelines of the ACIP | chapter-url = https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html | publisher = Centers for Disease Control and Prevention | date = 23 April 2020 | access-date = 30 April 2019 | archive-date = 1 May 2019 | archive-url = https://web.archive.org/web/20190501034917/https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html | url-status = live }}</ref>
* Weakened immune system due to HIV/AIDS or certain medical treatments<ref name="www.cdc.gov_2019"/>
* Having a parent or sibling with a history of immune problems<ref name="www.cdc.gov_2019" />
* Condition that makes a patient bruise or bleed easily<ref name="www.cdc.gov_2019" />
* Recent transfusion of blood or blood products<ref name="www.cdc.gov_2019" />
* ]<ref name="www.cdc.gov_2019" />
* Receiving other vaccines in the past 4 weeks<ref name="www.cdc.gov_2019" />
* Moderate or severe illness. However, mild illness (e.g., common cold) is usually not contraindicated.<ref name="www.cdc.gov_2019" />

==History==

]

], who had shared the 1954 ] for work on the polio virus, sent ] to ] in Massachusetts, where an outbreak of measles was underway; Peebles was able to isolate the virus from blood samples and throat swabs, and was later able to cultivate the virus and show that the disease could be passed on to monkeys inoculated with the material he had collected.<ref name=NYTPeebles>{{cite web | vauthors = Martin D | url = https://www.nytimes.com/2010/08/05/health/05peebles.html | title = Dr. Thomas C. Peebles, Who Identified Measles Virus, Dies at 89 | work = ] | date = 4 August 2010 | access-date = 11 February 2017 | archive-date = 6 April 2020 | archive-url = https://web.archive.org/web/20200406003817/https://www.nytimes.com/2010/08/05/health/05peebles.html | url-status = live }}</ref> Enders was able to use the cultivated virus to develop a measles vaccine in 1963 by attenuation through cultured chicken embryo fibroblasts of the material isolated by Peebles.<ref>{{cite web | title = Work by Enders Brings Measles Vaccine License | url = https://pqasb.pqarchiver.com/courant/access/917283942.html?dids=917283942:917283942&FMT=ABS&FMTS=ABS:AI&type=historic&date=Mar+22%2C+1963&author=&pub=Hartford+Courant&desc=Work+by+Enders+Brings+Measles+Vaccine+License&pqatl=google | archive-url = https://web.archive.org/web/20121103111429/http://pqasb.pqarchiver.com/courant/access/917283942.html?dids=917283942%3A917283942&FMT=ABS&FMTS=ABS%3AAI&type=historic&date=Mar+22%2C+1963&author=&pub=Hartford+Courant&desc=Work+by+Enders+Brings+Measles+Vaccine+License&pqatl=google | archive-date = 3 November 2012 | url-status = dead | work = ] | date = 22 March 1963 | quote = A strain of measles virus isolated in 1954 by Dr. Thomas C. Peebles, instructor in pediatrics at Harvard, and Enders, formed the basis for the development of the present vaccine }}</ref><ref>{{cite journal |vauthors=Griffin DE |title=Measles Vaccine |journal=Viral Immunol |volume=31 |issue=2 |pages=86–95 |date=March 2018 |pmid=29256824 |pmc=5863094 |doi=10.1089/vim.2017.0143 }}</ref>

In the late 1950s and early 1960s, nearly twice as many children died from measles as from polio.<ref>{{cite web | title = The Measles Vaccine | url = https://www.nytimes.com/1963/03/28/archives/the-measles-vaccine.html | work = The New York Times | date = 28 March 1963 | access-date = 30 April 2019 | archive-date = 30 April 2019 | archive-url = https://web.archive.org/web/20190430074633/https://www.nytimes.com/1963/03/28/archives/the-measles-vaccine.html | url-status = live }}</ref> The vaccine Enders developed was based on the Edmonston strain of attenuated live measles virus, which was named for 11-year-old David Edmonston, the Fay student from whom Peebles had taken the culture that led to the virus's cultivation.<ref name="pmid1603640">{{cite journal | vauthors = Hilleman MR | title = Past, present, and future of measles, mumps, and rubella virus vaccines | journal = Pediatrics | volume = 90 | issue = 1 Pt 2 | pages = 149–53 | date = July 1992 | doi = 10.1542/peds.90.1.149 | pmid = 1603640 | s2cid = 33115842 | url = http://pediatrics.aappublications.org/cgi/content/abstract/90/1/149 }}</ref>

In the mid-20th century, measles was particularly devastating in West Africa, where child mortality rate was 50 percent before age five, and the children were struck with the type of rash and other symptoms common prior to 1900 in England and other countries.{{citation needed|date=April 2024}} The first trial of a live attenuated measles vaccine was undertaken in 1960 by the British paediatrician ] in a village near ], Nigeria;<ref>{{Cite web |last=Beautysays |date=27 September 2009 |title=David Morley - a career of service that started in Nigeria |url=https://nigeriahealthwatch.com/david-morley-a-career-of-service-that-started-in-nigeria/ |access-date=29 April 2022 |website=Nigeria Health Watch |language=en-GB |archive-date=29 June 2022 |archive-url=https://web.archive.org/web/20220629135727/https://nigeriahealthwatch.com/david-morley-a-career-of-service-that-started-in-nigeria/ |url-status=live }}</ref> in case he could be accused of exploiting the Nigerian population, Morley included his own four children in the study. The encouraging results led to a second study of about 450 children in the village and at the Wesley Guild Hospital in Ilesha.{{cn|date=June 2022}}

Following another epidemic, a larger trial was undertaken in September and October 1962, in New York City with the assistance of the WHO: 131 children received the live Enders-attenuated Edmonston B strain plus ], 130 children received a "further attenuated" vaccine without gamma globulin, and 173 children acted as control subjects for both groups. As also shown in the Nigerian trial, the trial confirmed that the "further attenuated" vaccine was superior to the Edmonston B vaccine, and caused significantly fewer instances of fever and diarrhea. 2,000 children in the area were vaccinated with the further-attenuated vaccine.<ref>{{cite journal | vauthors = Morley DC, Woodland M, Krugman S, Friedman H, Grab B | title = Measles and Measles Vaccination in an African Village | journal = Bulletin of the World Health Organization | volume = 30 | pages = 733–9 | date = 1964 | issue = 5 | pmid = 14196817 | pmc = 2554995 }}</ref><ref name=indie>{{cite news| vauthors = Pritchard J |title=Obituary: Dr C. A. Pearson|url=https://www.independent.co.uk/news/obituaries/obituary-dr-c-a-pearson-1293756.html|access-date=29 January 2014|newspaper=The Independent|date=13 November 1997|url-status=live|archive-url=https://web.archive.org/web/20140224220736/http://www.independent.co.uk/news/obituaries/obituary-dr-c-a-pearson-1293756.html|archive-date=24 February 2014}}</ref>

] at ], a pioneer in the development of vaccinations, developed an improved version of the measles vaccine in 1968 and subsequently the ] in 1971, which vaccinates against measles, ] and ] in a single shot followed by a booster.<ref name="CDC_2020" /><ref name=PI/><ref>{{cite news |url=https://www.washingtonpost.com/wp-dyn/articles/A48244-2005Apr12.html |title=Maurice R. Hilleman Dies; Created Vaccines (washingtonpost.com) |newspaper=] |access-date=21 July 2009 | vauthors = Sullivan P |date=13 April 2005 |url-status=live |archive-url=https://web.archive.org/web/20121020102622/http://www.washingtonpost.com/wp-dyn/articles/A48244-2005Apr12.html |archive-date=20 October 2012}}</ref> One form is called "Attenuvax".<ref name="pmid15777939">{{cite journal | vauthors = Ovsyannikova IG, Johnson KL, Naylor S, Poland GA | title = Identification of HLA-DRB1-bound self-peptides following measles virus infection | journal = Journal of Immunological Methods | volume = 297 | issue = 1–2 | pages = 153–67 | date = February 2005 | pmid = 15777939 | doi = 10.1016/j.jim.2004.12.020 }}</ref> The measles component of the MMR vaccine uses Attenuvax,<ref name="package insert"/><!--Attenuavax was discontinued as stand alone vaccine in 2009, however MMR II uses Attenuvax as its measles vaccine component--> which is grown in a chick embryo cell culture using the Enders' attenuated Edmonston strain.<ref name="package insert">{{cite web | title=M-M-R II- measles, mumps, and rubella virus vaccine live injection, powder, lyophilized, for suspension | website=DailyMed | date=24 September 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0a9e384f-e717-436b-b9a0-15e53cef0862 | access-date=29 January 2020 | archive-date=6 April 2020 | archive-url=https://web.archive.org/web/20200406003823/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0a9e384f-e717-436b-b9a0-15e53cef0862 | url-status=live }}</ref> Following ] recommendations, Merck decided not to resume production of Attenuvax as standalone vaccine on 21 October 2009.<ref>{{cite web | title=Q&As about Monovalent M-M-R Vaccines | website=] (CDC) | date=26 October 2009 | url=https://www.cdc.gov/vaccines/hcp/clinical-resources/mmr-faq-12-17-08.html | archive-url=https://web.archive.org/web/20191019051430/https://www.cdc.gov/vaccines/hcp/clinical-resources/mmr-faq-12-17-08.html | archive-date=19 October 2019 | url-status=live | access-date=18 October 2019}}</ref>

A 2022 study in the '']'' found that the measles vaccine uptake led to increases in income of 1.1 percent and positive effects on employment due to greater productivity by those who were vaccinated.<ref>{{Cite journal | vauthors = Atwood A |date=2022 |title=The Long-Term Effects of Measles Vaccination on Earnings and Employment |url=https://www.aeaweb.org/articles?id=10.1257/pol.20190509 |journal=American Economic Journal: Economic Policy |language=en |volume=14 |issue=2 |pages=34–60 |doi=10.1257/pol.20190509 |s2cid=248468606 |issn=1945-7731}}</ref>

==Types==
])]]

Measles is seldom given as an individual vaccine and is often given in combination with ], ], or ] (chickenpox) vaccines.<ref name=WHO2017Vac/>
Below is the list of measles-containing vaccines:
* Measles vaccine (standalone vaccine)
* Measles and rubella combined vaccine (])
* Mumps, measles and rubella combined vaccine (])<ref name="package insert" /><ref>{{cite web | title=M-M-RVaxPro EPAR | website=] (EMA) | date=17 September 2018 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/m-m-rvaxpro | access-date=29 January 2020 | archive-date=6 April 2020 | archive-url=https://web.archive.org/web/20200406174101/https://www.ema.europa.eu/en/medicines/human/EPAR/m-m-rvaxpro | url-status=live }}</ref><ref>{{cite web | title=Priorix - Summary of Product Characteristics (SmPC) | website=(emc) | date=14 January 2020 | url=https://www.medicines.org.uk/emc/product/1159/smpc | access-date=29 January 2020 | archive-date=6 April 2020 | archive-url=https://web.archive.org/web/20200406003828/https://www.medicines.org.uk/emc/product/1159/smpc | url-status=live }}</ref>
* Mumps, measles, rubella and varicella combined vaccine (])<ref name="ProQuad label" />

==Society and culture==

Most health insurance plans in the United States cover the cost of vaccines, and ] may be able to help those who do not have coverage.<ref>{{Cite web|title=VFC {{!}} Home {{!}} Vaccines for Children Program {{!}} CDC|url=https://www.cdc.gov/vaccines/programs/vfc/index.html|date=2 April 2019|website=www.cdc.gov|language=en-us|access-date=30 April 2020|archive-date=1 May 2020|archive-url=https://web.archive.org/web/20200501175435/https://www.cdc.gov/vaccines/programs/vfc/index.html|url-status=live}}</ref> State law requires vaccinations for school children, but offer exemptions for medical reasons and sometimes for religious or philosophical reasons.<ref>{{Cite web|title=State Vaccination Requirements {{!}} CDC|url=https://www.cdc.gov/vaccines/imz-managers/laws/state-reqs.html|date=11 March 2019|website=www.cdc.gov|language=en-us|access-date=30 April 2020|archive-date=2 April 2020|archive-url=https://web.archive.org/web/20200402194736/https://www.cdc.gov/vaccines/imz-managers/laws/state-reqs.html|url-status=live}}</ref> All fifty states require two doses of the MMR vaccine at the appropriate age.<ref>{{Cite web|title=MMR Vaccine Mandates for Child Care and K-12|url=https://www.immunize.org/laws/mmr.asp|website=www.immunize.org|access-date=30 April 2020|archive-date=12 June 2020|archive-url=https://web.archive.org/web/20200612231754/https://www.immunize.org/laws/mmr.asp|url-status=live}}</ref> A different vaccine distribution within a single territory by age or social class may define different general perceptions of vaccination efficacy. <ref>{{Cite journal | vauthors = Scirè G |date=2021 |title=Modelling and assessing public health policies to counteract Italian measles outbreaks |url=http://www.inderscience.com/link.php?id=118832 |journal=International Journal of Simulation and Process Modelling |language=en |volume=16 |issue=4 |pages=271 |doi=10.1504/IJSPM.2021.118832 |hdl=10447/513505 |issn=1740-2123|hdl-access=free }}</ref>

== References ==
{{reflist}} {{reflist}}

== Further reading ==
{{refbegin}}
* {{cite book | vauthors = ((World Health Organization)) | title = The immunological basis for immunization series : module 7: measles - Update 2009 | publisher = ] (WHO) | year = 2009 | hdl = 10665/44038 | isbn = 9789241597555 | location = Geneva, Switzerland }}
* {{cite book | title = Immunisation against infectious disease | chapter = Chapter 21: Measles | chapter-url = https://www.gov.uk/government/publications/measles-the-green-book-chapter-21 | publisher = Public Health England | veditors = Ramsay M | url = https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book | year = 2019 | location = London, England | access-date = 22 December 2019 | archive-date = 12 November 2019 | archive-url = https://web.archive.org/web/20191112005859/https://www.gov.uk/government/publications/pneumococcal-the-green-book-chapter-25 | url-status = live }}
* {{cite book | publisher = U.S. ] (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hall E, Wodi AP, Hamborsky J, Morelli V, Schillie S | edition = 14th | location = Washington D.C. | year = 2021 | chapter = Chapter 13: Measles | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/meas.html | url = https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | access-date = 22 December 2019 | archive-date = 30 December 2016 | archive-url = https://web.archive.org/web/20161230001534/https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | url-status = live }}
* {{cite book | vauthors = Gastanaduy PA, Redd SB, Clemmons NS, Lee Adria D, Hickman CJ, Rota PA, Patel M | chapter = Chapter 7: Measles | chapter-url = https://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html | veditors = Roush SW, Baldy LM, Hall MH | title = Manual for the surveillance of vaccine-preventable diseases | publisher = U.S. ] (CDC) | location = Atlanta, Georgia | url = https://www.cdc.gov/vaccines/pubs/surv-manual/ | year = 2019 | access-date = 22 December 2019 | archive-date = 1 August 2020 | archive-url = https://web.archive.org/web/20200801192220/https://www.cdc.gov/vaccines/pubs/surv-manual/ | url-status = live }}
{{refend}}

== External links ==
* {{cite web | title = MMR (Measles, Mumps, & Rubella) Vaccine Information Statement | website = U.S. ] (CDC) | date = 22 October 2019 | url = https://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html }}
* {{cite web | title = MMRV (Measles, Mumps, Rubella & Varicella) Vaccine Information Statement | website = U.S. ] (CDC) | date = 22 October 2019 | url = https://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmrv.html }}
* {{MeshName|Measles Vaccine}}


{{Vaccines}} {{Vaccines}}
{{Eradication of infectious disease}}
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