Key points to remember about measles immunisation
- measles is a potentially serious disease caused by a virus
- measles is very infectious – it can spread very easily from one person to another
- immunisation is the only way to prevent measles
What is measles?
Measles is a potentially serious disease caused by a virus. It's very easily spread from one person to another. It is also known by the name morbilli or rubeola.
Measles is the most common vaccine-preventable cause of death among children throughout the world.
For more information about the disease, see Measles on this website.
How serious is measles?
Children usually look and feel quite unwell and miserable with measles. They have a high fever, a cough, a runny nose, loss of appetite and sore red eyes followed by a rash.
In about 30 percent of reported cases of measles, people experience one or more complications. These include:
- diarrhoea (6 percent)
- ear infections (7 percent)
- pneumonia (6 percent)
Pneumonia is responsible for 60 percent of the deaths of people with measles.
One in 1000 people with measles develop inflammation of the brain (encephalitis ) - 15 percent of these people die and approximately one third are left with permanent brain damage.
One in 100,000 people who have had measles will, years later, develop a serious brain inflammation called subacute sclerosing panencephalitis (SSPE). This serious complication always results in death.
Death occurs in about one to two out of 1,000 reported cases of measles overall in western countries.
How common is measles?
Before a measles vaccine was developed, about 90 percent of the whole population would have had measles by the age of 20.
Universal vaccination was introduced into New Zealand in 1969. For many years New Zealand had very poor immunisation coverage with less than half of eligible children receiving the vaccine. As a result there were regular epidemics of measles. As our immunisation rates have improved, the outbreaks have become less frequent and much smaller. If we can achieve our target of 95 percent of the population immune, we can eradicate measles altogether. Until then, outbreaks are likely to continue.
The World Health Organization has targets to eradicate measles worldwide. In countries which have consistently high immunisation coverage, measles has been eliminated from the population.
How do you catch measles?
Measles is very easy to catch. It's spread through the air by infectious droplets through coughing and sneezing. Measles can also be spread by direct contact with secretions from the nose or throat of a person infected with measles, and by touching things or surfaces contaminated by these secretions.
It usually takes 10 – 12 days from contact with someone with measles to the first symptom appearing but it can take up to 18 days. This is called the incubation period.
Who is most at risk from measles?
- all children who have not received at least one dose of the MMR vaccine
- anyone with certain immune deficiencies is at special risk - these children often can't be immunised and rely on protection from those around them
- pregnant women - measles during pregnancy increases the risk of premature labour, miscarriage, and low birth weight infants
How do you prevent measles?
Immunisation given on time is the only way to prevent measles outbreaks.
Which vaccines protect against measles?
The combined measles, mumps, rubella vaccine (MMR) is the only available vaccine to prevent measles in New Zealand.
How effective is the vaccine against measles?
Approximately 90 to 95 percent of those given one dose of MMR are protected. Those who do not develop immunity after the first MMR dose, almost always do so after the second dose.
Who should have the vaccine?
Two doses of the MMR vaccine are usually given, one dose at 15 months of age and a second at 4 years of age.
During a measles outbreak babies as young as 6 months of age can be immunised on the advice of a Medical Officer of Health. These babies will still need MMR at 15 months and 4 years of age because the vaccine tends not to work as well in young infants.
Some adults should also have the MMR vaccine:
- those born after 1969 (when the measles vaccine was introduced to New Zealand) who lack evidence of immunity to measles. (Adults born prior to 1969 are highly likely to have been exposed to measles)
- those travelling to areas where measles is common (endemic) who do not have immunity
The MMR vaccine CAN be given to people with an allergy to egg.
Who should not have the vaccine?
The following people should not have the MMR vaccine:
Receiving the MMR vaccine is not recommended in pregnancy, and women of child bearing age are advised to avoid pregnancy for one month following the MMR vaccine. This is based on a theoretical risk of infection in the fetus which applies to receiving any live vaccine. However, based on many cases of reported vaccination in pregnant women, there is no evidence that the mother or baby are harmed by this vaccine if given during pregnancy. If this situation arises, discuss it further with your doctor or the 0800 IMMUNE(0800 466 863) phone line.
Those known to be immune suppressed ...
... for example, people with some types of cancer or on some treatments for cancer and autoimmune diseases.
Babies under 12 months of age ...
... (the vaccine tends not to work as well in young infants), except in a measles outbreak and on advice of a Medical Officer of Health.
MMR should be delayed in people suffering from a sudden severe illness with high fever (over 38 degrees Celsius). The presence of a minor infection is not a reason to delay vaccination.
Who should seek more advice before having the vaccine?
- anyone who has experienced a severe allergic reaction (anaphylaxis) to a previous dose of any measles containing vaccine or any of the vaccine components, including gelatine. People with an egg allergy CAN have the MMR vaccine
- anyone who has received human immunoglobulin or other blood product within the previous 11 months
- anyone who has received another live vaccine, including varicella or BCG vaccine within the previous month
- HIV infected individuals
- anyone who is unsure if they have an immune deficiency or taking medication to suppress their immune system
Any child with a history of anaphylaxis caused by anything other than the MMR vaccine should be vaccinated under close medical supervision.
Do you need all the doses?
Yes, 5 to 10 percent of those vaccinated may not be protected after one dose, so it's recommended that your child has 2 doses after the age of 12 months (at least one month apart).
How safe is the vaccine?
The risk of MMR vaccine causing serious harm is extremely small. MMR vaccine is considerably safer than getting measles (or mumps and rubella). See the following comparison.
Effects of the disease:
- ear infection (otitis media): 7 percent
- pneumonia: 6 percent
- acute brain inflammation (encephalitis): 1 in 1,000
- degenerative brain disease (subacute sclerosing panencephalitis or SSPE): 1 in 100,000
- maternal measles increases risk for premature labour, miscarriage and low birth weight infants
- overall death rate: 1 to 2 in 1,000
Side effects of the vaccine:
- less than 2 percent experience a vaccine-associated rash and / or a fever of 39.5 degress Celsius or more 6 - 12 days after immunisation
- acute brain inflammation (encephalitis): 1 in a million, unlikely to be caused by the vaccine
- idiopathic thrombocytopenia purpura: 1 in 30,000 doses
- aseptic meningitis from the mumps component: 1 in 800,000 doses
- anaphylaxis: 1 in 3,500,000 doses
- febrile seizures: 25-34 in 100,000 doses
Can the MMR vaccine cause measles?
No. It can cause a very mild, non-infectious rash about five to 12 days after vaccination.
Can the MMR vaccine cause autism?
Extensive research shows there is no evidence that the MMR vaccine causes autism, Crohn’s disease or ADHD.
For more information, see the following:
- Measles, mumps, rubella vaccine, inflammatory bowel disease (IBD) and autism (Immunisation Advisory Centre, NZ): fact sheet, written for parents and caregivers
- MMR vaccine does not cause autism (Immunisation Advisory Centre, NZ): a list of more than 20 articles with conclusions showing there is no scientific evidence that MMR vaccine causes autism.
Does the MMR vaccine contain thiomersal (or mercury)?
This fact sheet was produced in collaboration with IMAC (Immunisation Advisory Centre) and has been adapted from the IMAC fact sheet for parents and caregivers.
© Paediatric Society of New Zealand and Starship Foundation 2005 – 2014
Printed on 26 July 2014. Content is regularly updated so please refer to www.kidshealth.org.nz for the most up-to-date version