MMR is also known as Measles, mumps and rubella. Measles is rare nowadays in the Netherlands but it has not yet been eliminated throughout the world. The Measles vaccine has been a part of the Dutch National Immunisation Programme since 1976. Incidence of the disease in the country has reduced dramatically since then. In other countries, the disease is still prevalent and can be a risk factor for travellers who have not been vaccinated or have not had measles previously. Persons at risk are adults born between 1965 and 1975 and children under a certain age.
Because they were born before the measles vaccination was included in the Dutch National Immunisation Programme and during their early years were less exposed to measles pathogens than older people, adults born between 1965 and 1975 are more susceptible to measles as their bodies are less likely to have developed antibodies. Measles vaccines are recommended for this group of persons if they have never had the disease before and are going to a country where there is a high risk of contracting measles.
Under the Dutch National Immunisation Programme, children between 14 months and 9 years are vaccinated against measles, mumps, and rubella. In some cases, for example if a child is going to travel to a high risk area, it makes sense to be vaccinated against these diseases earlier, for example from the age of six months. If the vaccine is given before the child is 12 months old, it will be repeated as a part of the Dutch National Immunisation Programme at the age of about 14 months.
The causative agent of measles is a respiratory infection known as ‘morbillivirus’. This highly contagious disease is spread by droplets in the air or by direct contact. The symptoms of measles include: fever, a cough, a rash and white patches with red spots on the inside of the cheeks which then spread to the face and the rest of the body. In some cases an ear infection or pneumonia can also occur. Serious complications such as acute inflammation of the brain are possible.
The highly contagious mumps virus can be spread by the droplets that are released into the air when we cough or sneeze. The disease usually begins with fever followed by swollen salivary glands. Patients have swollen cheeks. Young children sometimes develop meningitis or inflammation of the brain. In rare cases, mumps can cause deafness in one ear, rheumatism or pancreatitis. Complications such as inflammation of the testicles for boys and ovarian inflammation for girls can occur. Both of these have the potential to cause sterility.
Rubella is caused by a virus known as Rubivirus which is extremely contagious. The virus is transmitted through coughing, sneezing or by direct contact. 50% of patients develop a rash, which first appears on the face and then spreads over the entire body. Common symptoms are flaccidity and swollen lymph nodes behind the ears. Rubella is particularly dangerous for women in the early stages of pregnancy.
In 95% of cases, vaccination provides lifetime immunity for adults. For children older than 6 months but younger than 12 months vaccination should be repeated at the age of 14 months and again at 9 years old as at these ages the immune system is still not developed enough to ensure long-term protection.
As mentioned earlier, the measles vaccination has been a part of the Dutch National Immunisation Programme since 1976. Mumps and rubella vaccinations have been included in the programme since 1987. Incidence of these diseases in the Netherlands have reduced dramatically since that time. In other countries, however, these diseases are still prevalent and can present a risk to travellers (both adults and children) who have not been vaccinated. The MMR vaccine is not given to pregnant women because of the rubella component, which can cause birth defects. Women should therefore also avoid becoming pregnant for up to one month after vaccination.