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Question

When should the measles vaccine be given early?

H. Cody Meissner

H. Cody Meissner, MD, FAAP

Answer

When should the measles vaccine be given early?

Ordinarily, babies receive their first dose of the measles, mumps and rubella (MMR) vaccine between 12-15 months of age. A second dose of MMR is recommended between ages 4 and 6―before a child enters kindergarten or first grade. This is the recommended, standard, two-dose MMR vaccine series for all children who receive the first MMR dose on or after the 12 month birthday.

If there is a measles outbreak in your area, or you plan on traveling somewhere where there is a measles outbreak, your pediatrician may recommend your baby receive an extra dose of the MMR vaccine. This may be given as early as 6 months of age.

With a record number of measles cases in Philippines, Ukraine and Israel and many other countries, the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that all children and adult travelers receive all recommended vaccinations, particularly the measles vaccine, before traveling outside the United States (including Canada and Mexico).

Is this extra dose safe? Is it effective?

  • Yes. This extra dose of the measles vaccine is safe. But the measles vaccine administered at 6 through 11 months may not be as effective as later doses will be. This is because some of mother's virus-fighting antibodies may still be in a baby's body―providing some limited immunity but making the vaccine less effective until about 1 years old. Still, the early dose can offer some added protection when there is a high risk of measles exposure.

Does an early dose of the measles vaccine replace the routine, first-birthday dose?

  • No. A dose of the measles vaccine administered 6 through 11 months of age should not be counted as part of the standard, two-dose MMR series.

Babies who receive the measles vaccine between 6 through  11 months because of possible exposure to measles still need to receive the standard, two-doses of the MMR vaccine, for a total of three doses, with both the second and third doses administered after the 12 month birthday. 

Does an early, third dose of the measles vaccine affect the recommended timing of the two-standard doses in any way?

  • After an early dose of MMR vaccine administered at 6 through 11 months of age, the second dose should be at 12 to 15 months of age and the third dose should be administered at least 28 days after the second dose and can be administered up to 6 years of age.

Children who already have received two doses of MMR vaccine at least a month apart, with the first dose given no earlier than the first birthday, do not need an additional dose when they enter school unless required by state law.

Can my child get the second dose of the MMR vaccine early, too? 

  • Yes. The recommendation that children receive a dose of MMR vaccine between 4-6 years is not a hard-and-fast rule. It will be just as effective if the vaccine is administered as soon as 28 days after the preceding dose. For example, if your baby gets the first MMR dose at 12-month wellness visit, you can ask your doctor to give the second dose at the 15-month visit. That would complete the series, and your baby wouldn't need to receive another MMR shot before starting school (unless required by state law). Just be sure to save your immunization records.

  • If your school system does require another shot just before kindergarten, and your child already received a second shot , don't panic; the additional "booster" dose will be safe. 

What if my child didn't get the routine MMR vaccines on time?

  • Depending on immunization laws in your state, your child may not be able to start school or college without proof he or she received two doses of measles, or has proof of having had measles. A student who hasn't had either can be readmitted after receiving the first dose of MMR. In this situation, a second dose should be administered as soon as possible, but no sooner than 28 days  after the first dose.

What about the MMRV vaccine?

  • Some children may receive the measles, mumps, rubella and varicella (MMRV) vaccine, which adds protection against chickenpox. Like MMR, the first MMRV vaccine can be given from 12 through 15 months of age. The second dose can also be given between ages 4 and 6 (or at least 3 months after the first-standard dose). However, the MMRV vaccine is licensed only for use in children 12 months through 12 years of age, so MMRV can't be given before 12 month birthay. An early dose of MMR administered at 6 through 11 months of age can be followed up with two doses of MMRV.

Remember:

If all of this seems confusing, don't worry. Your pediatrician is a great resource for any information you need about measles and the vaccine. 

Additional Information:


H. Cody Meissner

H. Cody Meissner, MD, FAAP

​H. Cody Meissner, MD, FAAP, is professor of pediatrics at Floating Hospital for Children, Tufts Medical Center. He also is an ex officio member of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases and associate editor of the AAP Visual Red Book.

Last Updated
7/16/2019
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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