sorry, sumbernya waktu itu lupa saya catat...
Kayaknya sih dari CDC juga.
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Frequently Asked Questions about Measles, Mumps, and Rubella, and MMR
Vaccine
[Q.]Are measles, mumps, and rubella still a problem in the United States?
All three diseases are currently at or near their lowest point ever
reported in the United States. In 1995, a provisional total of 288 measles
cases (lowest ever), 840 cases of mumps (lowest ever), and 200 cases of
rubella (third lowest) were reported.
[Q.]If the chance of the diseases is so low, why do we still give the vaccine?
Measles, mumps, and rubella are all still very common in other parts of
the world, and can be easily imported into the United States. A reduction in
our vaccination efforts would lead to a rapid increase in the number of
susceptible children, which could lead to an outbreak.
[Q.]What kind of vaccine is MMR?
MMR is a attenuated live virus vaccine. After injection, the viruses
replicate (grow), and cause a subclinical or asymptomatic infection in the
vaccinated person. The person's immune system fights the infection caused by
these weakened viruses, and immunity develops.
[Q.]How effective is MMR vaccine?
From 95 percent to 98 percent of persons who receive a single dose of MMR
will develop immunity to all three viruses.
[Q.]Why is MMR vaccine given after the first birthday?
Most infants born in the United States will receive passive protection
against measles, mumps, and rubella in the form of maternal antibody. These
antibodies can destroy the vaccine virus if they are present when the vaccine
is administered. By 12 months of age, almost all infants have lost this
passive protection, so the vaccine viruses can replicate and produce infection
with interference.
[Q.]If a single dose of MMR vaccine is so effective, why do we give a second
dose?
The second dose is to provide another chance to develop measles immunity
for persons who did not respond to the first dose. About 2 percent to 5
percent of persons do not develop measles immunity after the first dose of
vaccine.
[Q.]What is the best age to give the second dose of MMR vaccine?
The second dose of MMR can be given anytime, as long as the child is at
least 12 months old and it has been at least a month since the first dose.
However, the second dose is usually administered before the child begins
kindergarten or first grade (4-5 years of age) or before entry to middle
school (11-12 years of age). The age at which the second dose is required is
generally mandated by state school entry requirements.
[Q.]Can I give a PPD (tuberculin skin test) on the same day as a dose of MMR
vaccine?
Live measles vaccine can reduce the reactivity of a PPD because of mild
suppression of the immune system. A PPD can be done before or at the same time
as measles vaccine is given. However, if measles vaccine is given first, the
PPD should be delayed for at least one month.
[Q.]What is the most common adverse event following MMR vaccine?
Low grade fever and a mild rash, which occur in 5 percent to 10 percent of
recipients.
[Q.]For years our clinic has given MMR intramuscularly (IM) rather than
subcutaneously (SC). Is it less effective IM? If MMR has been given IM instead
of SC should it be repeated?
All live injected vaccines (MMR, varicella, and yellow fever) are
recommended to be given subcutaneously. Intramuscular administration is not
likely to decrease immunogenicity, and doses given IM do not need to be
repeated.
[Q.]Why are people born before 1957 exempt to receiving MMR vaccine?
Persons born in 1957 and before lived through several years of epidemic
measles before the first measles vaccine was licensed. As a result, these
people are very likely to have had measles disease. Serologic surveys suggest
that 95%-98% of persons born before 1957 are immune to measles. The "1957
rule" applies only to measles and mumps, and does NOT apply to rubella.
[Q.]How long after a blood transfusion can a person be given MMR vaccine?
MMR should not be given for 6 months following a transfusion of whole
blood. Different blood products require different waiting periods before
giving measles vaccine. Table 8 in the General Recommendations on Immunization
gives a complete listing of these intervals.
[Q.]Rubella is a very mild disease. Why do we even bother to vaccinate against
it?
Rubella disease in childhood is usually a mild illness. The major public
health importance of rubella is the impact the virus may have on a developing
fetus. If a woman is infected with rubella virus during the first trimester of
pregnancy, the fetus may be stillborn, or may be born with severe birth
defects, such as blindness, deafness, or mental retardation. These defects in
a newborn of a woman who has rubella during pregnancy are collectively known
as congenital rubella syndrome.
[Q.]How common is arthritis following rubella vaccine?
Joint pain is reported by 25 percent to 50 percent of susceptible adult
women vaccinated with rubella vaccine. Up to 70 percent of women who get
rubella disease report joint symptoms of some type. These symptoms are mild
and transient in majority of women. An occasional woman may develop persistent
or recurrent joint symptoms. The exact risk of persistent
symptoms is not known with certainty, but appears to be very low.
[Q.]We require a pregnancy test for all our seventh grade children before
giving an MMR. Is this really necessary?
No. ACIP recommends that women of childbearing age be asked if they are
currently pregnant or attempting to become pregnant. Vaccination should be
deferred for those who answer "yes". Those who answer "no" should be advised
to avoid pregnancy for 3 months following vaccination (1 month for
single-antigen measles and varicella vaccines), them vaccinated.
[Q.]Should we give an MMR to a 15-month-old whose mother is two months
pregnant?
Yes. Measles, mumps, and rubella vaccine viruses are not transmitted from
the vaccinated person, so MMR does not pose a risk to a pregnant household
member.
[Q.]Is there a contraindication or precaution to giving MMR to a breast
feeding mother or to a breast-fed infant?
No. Breast feeding does not interfere with the response to MMR vaccine.
[Q.]Immune globulin (IG) given IV or IM interferes with the response to MMR
and varicella vaccines. How long should you defer MMR and varicella
vaccination after IV or IM administration of IG?
The interval between administration of an antibody-containing product
(e.g., immune globulin, intravenous immune globulin, whole blood or
components) and administration of MMR or varicella vaccines depends on the
antibody concentration of the product. The minimum interval is 3 months, but
may be as long as 11 months (for intravenous immune globulin). Table 8
of the 1994 General Recommendations on Immunization gives a complete list of
available antibody-containing products and suggested intervals to delay
measles-containing vaccines. Contact the National Immunization Program for a
copy of the General Recommendations at 1-800-CDC-SHOT. The effect of
administration of antibody-containing products on varicella vaccine is not
known at this time. Until further data are available, administration of
varicella vaccine should be delayed for at least 5 months after receipt of
blood products.
[Q.]Who should receive rubella vaccine?
All persons without contraindications who are 12 months of age or older,
and do not have documented evidence of one or more doses of rubella vaccine or
serologic evidence of rubella immunity.
[Q.]Do people who received MMR in the 1960s need to have their dose repeated?
Not necessarily. Persons who have documentation of receiving LIVE measles
vaccine in the 1960s do not need to be revaccinated. Persons who were
vaccinated prior to 1968 with either inactivated (killed) measles vaccine or
measles vaccine of unknown type should be revaccinated with at least one dose
of live attenuated measles vaccine. This recommendation is intended to protect
persons who may have received killed measles vaccine, which was available in
1963-1967 and was not effective.
[Q.]If a child receives a single antigen measles vaccine in Mexico over the
age of one, and the child receives an MMR here at least a month later, is that
child required to receive a second MMR at entry to kindergarten or seventh
grade?
In general, the child will not require additional doses of MMR. Measles
vaccine given after the first birthday is considered to be a valid dose,
regardless of the country where it was administered. If the second dose of
measles vaccine was administered at least a month later, this is also
considered to be a valid dose. If your state immunization requirement
specifies 2 doses of measles vaccine, the child does not need additional
doses, since most states require only one dose of mumps and rubella vaccines.
However, some states specify that both doses of measles vaccine be
administered as MMR, in which case the child would need a second dose of MMR.
[Q.]A healthy 15-month-old with no MMR was exposed to chickenpox yesterday.
Can I give the MMR vaccine today?
Yes. Disease exposure, including chickenpox, is not a contraindication to
MMR or any other vaccine.
[Q.]Can mumps vaccine cause orchitis or sterility in a male?
Orchitis occurs in up to 50 percent of adult males who develop mumps
disease but sterility following mumps disease is rare. Neither orchitis nor
sterility have been reported following vaccination with mumps vaccine.
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/~~\ o' |~ Rien.
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