AskDrSears - The Vaccine Book: Plain Mumps Vaccine Shortage

Plain Mumps Vaccine Shortage - Should Babies Just Get the Full MMR?

Friday, June 20, 2008

Some parents are choosing to split the 1 year MMR vaccine into three separate shots. Although we don't know if this precaution is necessary, some worried parents prefer the choice of getting plain Mumps vaccine at 1 year, Rubella at 2 years, and Measles at 3 years.

With a shortage of the plain Mumps vaccine expected to last the rest of 2008, parents may not be able to get the Mumps vaccine for their babies for a while. I would suggest getting a rubella vaccine at 1 year, and then Mumps at 2 years (by the time any current one-year-olds are two, the shortage will hopefully be over).

Some parents are wondering if they should get the full MMR vaccine at age 1, not just to get coverage for mumps now, but also to get measles coverage in light of the recent increase in measles outbreaks. I think that this is a very valid choice to consider, especially for infants who are entering childcare or early preschool. For children who are not going to be in daycare or school until age 3 or 4, delaying the measles vaccine is less of a worry.

Labels: Vaccine News

12 Comments:

At June 24, 2008 7:23 AM , Anonymous said...

But what if you get the Rubella shot and then mumps is still not available in a year. Is that possible? Would there be a danger of having to go with the MMR anyway and then having doubled up on Rubella?
At June 24, 2008 9:26 AM , Dr. Bob said...

Yes, but an option in that case would be to just get the full MMR at age 4 or older. That covers the needed boosters for rubella and mumps. You might need a measles booster a few years after that, BUT in most kids getting one measles shot after age 4 works well enough without needing a booster.
At June 30, 2008 6:28 PM , Anonymous said...

Would delaying the MMR until age 4 help avoid any reactions or possible links to autism? Would a more mature immune system help?
At July 4, 2008 11:30 AM , Brigitte (Kate and Grey) said...

There has been an outbreak in our immediate area (25 cases in total in surrounding counties). My breastfed daughter is 19 months and has had very limited immunizations (I also have a breastfed 6 month old son). Neither of which are in daycare (church or otherwise).

However, I am considering the MMR or just the measles vaccine for her (as my homeopathic pediatrician has the measles "in stock", but warned me about the limited mumps vaccine).

I plan on testing for titers before the second doses are needed, but I am willing to get the full MMR as a follow up if there is a mumps outbreak or if there is a shortage that lasts past her first year of school.

In your opinion, what would be my best choice, to get the full MMR or to split them up and just go for the measles for now? Thanks!
At July 11, 2008 3:18 PM , Anonymous said...

I would like to order a measles vaccine separate from the mumps and rubella from my doctors office. Do you know if this is made mercury-free just like the combined vaccine?
Thanks
At July 28, 2008 8:56 PM , Anonymous said...

I am having a hard time finding a pharmacy that will fill a prescription for the separate M, M and R vaccinnes. They said they would have to order a whole case and don't believe they could sell it. That is what my baby's pediatrician said too. So all she has available is the MMR. Does anyone have any suggestions for how we might be able to get these separately?
At July 31, 2008 3:26 PM , anteaterpediatrician said...

re:Would delaying the MMR until age 4 help avoid any reactions or possible links to autism? Would a more mature immune system help?

There is NO evidence that MMR reactions are made less by the vaccinated child being older that I am aware of (certainly many of the illnesses are worse for the youngest infants, but illnesses like chickenpox may hit teens and adults harder than kids), and certainly no evidence that this delay changes the risk of autistic disorders. You just force your child to take on 3 more years of vulnerability to measles. In Orange County, the site of Dr. Sears' practice, there is now measles showing up.

See this note from one of our local hospitals:
UC Irvine Epidemiology and Infection Prevention (EIP) will be sending written notification to patients who were potentially exposed to measles at UC Irvine Medical Center between the dates of 6/23/08 and 7/15/08.

Measles is an airborne, highly contagious virus which is easily transmitted. The index patient was not in airborne precautions during the potentially contagious period.

Any medical center staff, patients or visitors present on these units on the following dates is considered potentially exposed:

Emergency Dept 6/23

PCU 6/23-6/24

Surgical ICU 6/24-6/26

Medical ICU/CCU 6/26-7/11

PCU 7/11-7/15

Symptoms include fever, headache, runny nose, cough, red eyes, and rash. If you have current patients at UC Irvine Medical Center exhibiting these symptoms, please contact Infectious Diseases for a consultation. Since incubation is less than 2 weeks, there should be no further concern after August 1, 2008.

Dr. Sears, do you think it is reasonable to have patients who are not fully protected from measles and other airborne infections isolated in the doctor's office away from healthy children whose parents are protecting their children according to community standards and who are accepting the small risks of the nationally recommended schedule? Such infants are not fully immunized from pertussis until over 6 months or for MMR until after 1 year . Should these parents have protection from parents following the alternative schedule you have written about, whose children are older and more at risk of bringing potentially deadly viruses into a pediatric office? I do know of some offices who have had to close for a week or more after a child with measles entered the open spaces in their facility. Thanks for your comment. Marc Lerner
At August 3, 2008 4:31 PM , Anonymous said...

Dr Sears,

I am considering using your alternative vaccine schedule for my daughter. I was wondering what you thought if I changed the measles vaccine to 1 year, the mumps at 2 years, and the rubella at 3 years? I heard that there has been a measles outbreak and I feel that this vaccine seems more important at this time. Do you think this change would be O.K. Thank you.
At August 22, 2008 4:33 AM , Anonymous said...

I am wondering why the split MMR vaccines are in shortage if many parents are chosing to go that route. Whey are sympathetic doctors like Dr. Sears or other groups not lobbying Merck to produce more? Is there something we can do?
At August 22, 2008 11:57 AM , Ginelle said...

I have a question similar to the Aug 3 post.
I am following the alternative schedule, and my pediatrician has set aside a single Mumps vaccine for my daughter to use at 1 year. However, in light of the recent measles outbreaks, and because measles can sometimes be fatal (I'm not a gambler and 1:1000 are not odds I am comfortable with), I am wondering what your opinion is on getting the measles shot first. I have seen you suggest rubella at 1 year and them mumps at 2 years because of the mumps shortage, but you are still suggesting measles at 3 years. Is your suggestion because of the correlation of viral measles in the intestines and brains of autistic children and giving the vaccine last (of the 3) is to allow for a more established immune system at the time of vaccination? If so, how strongly do you suggest waiting until 3 years? What would you suggest in my circumstance?
Thank you!
At April 25, 2009 8:33 PM , superdelicious said...

Dr. Sears,

Our son was born 13 weeks premature. He is now almost 3 and we have used a delayed vaccination schedule in large part because I did not feel comfortable pumping him full of shots after a 70 day NICU stay and the monthly synergis shots that he received during his first year of life. He is thriving and now has had ALL his vaccines, except for one, Mumps, which I am told is no longer being manufactured.

Our pediatrician is recommending that we do the full MMR to ensure that he has vaccination coverage for mumps and I wanted to get your opinion on this. It feels that at age 3 he will be over vaccinated (he will have essentially had measles and rubella shots twice) which is just what I was trying to avoid with the alternate schedule. He is currently in a playgroup and will be entering a pre-school in September.

I would very much appreciate your advice on this matter.

Thank you.
At April 27, 2009 7:57 AM , Anonymous said...

Superdelicious....I am in the same boat as you. We need the Rubella shot that is no longer manufactured and are now forced to get the MMR which means my 3 yr old son will have extra mumps and measels. I'm very upset and not sure on what to do since he will start school in September.

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