The HSE recommend the measles-mumps-rubella (MMR) vaccine for babies in Ireland at 12 months with a second dose given in Junior Infants. The MMR vaccine was first introduced in 1988. There are two vaccines available, both of which are combination, live, attenuated (weakened) virus vaccines.
- M-M-RvaxPro manufactured by Merck Sharp & Dohme or
- Priorix manufactured by GlaxoSmithKline
This article provides an overview of the potential risks associated with both the vaccine and the diseases it targets, helping you make an informed decision.
Disease versus Vaccine Risk Summary
| Disease | Risk of getting | Risk of death |
|---|---|---|
| measles | approx 1 in 72,000 (0.001%) for all ages (2011 to 2020) | Pre vaccine (1985) approx 1 in 773,000 (0.0001%) for all ages |
| mumps | approx 1 in 7,000 (0.01%). Risk of hospitalisation: approx 1 in 178,000 (0.0006%) | Pre vaccine (1988) – negligible |
| rubella | rubella declared eradicated in 2016. Last case of CRS in 2009. | Pre vaccine (1988) – negligible |
Risks from each dose of MMR vaccine M-M-RvaxPro
2 doses recommended, at 12 months and Junior infants (as per M-M-RvaxPro patient information leaflet June 2024)
| Observed side effects post administration of M-M-RvaxPro (post marketing) |
|---|
| Aseptic meningitis (fever, feeling sick, vomiting, headache, stiff neck, and sensitivity to light); swollen testicles; infection of the middle ear; inflamed salivary glands; atypical measles (described in patients who received a killed measles virus vaccine, usually given before 1975). Swollen lymph nodes. Bruising or bleeding more easily than normal. Severe allergic reaction that may include difficulty in breathing, facial swelling, localised swelling, and swelling of the limbs. Irritability. Seizures (fits) without fever; seizures (fits) with fever in children; walking unsteadily; dizziness; illnesses involving inflammation of the nervous system (brain and/or spinal cord). An illness consisting of muscle weakness, abnormal sensations, tingling in the arms, legs, and upper body (Guillain-Barré syndrome). Headache; fainting; nerve disorders which can cause weakness, tingling, or numbness; eye nerve disturbances. Discharge and itching of the eyes with crusting of eyelids (conjunctivitis). Inflammation of the retina (in the eye) with changes in sight. Deafness. Cough; lung infection with or without fever. Feeling sick (nausea). Itching; inflammation of the fatty tissue under the skin; red or purple, flat, pinhead spots under the skin; hardened, raised area of the skin; serious illness with ulcers or blistering of the skin, mouth, eyes, and/or genitals (Stevens-Johnson syndrome). Joint pain and/or swelling (usually transient and rarely chronic); muscle pain. Burning and/or stinging of short duration at the injection site; blisters and/or hives at the injection site. Generally feeling unwell (malaise); swelling; soreness. Inflammation of blood vessels. |
| Risk Category | Observed Side Effects |
|---|---|
| up to 1 in 100 (1%) | Nasal congestion and sore throat; upper respiratory tract infection or viral infection; runny nose. Crying. Diarrhoea, vomiting. Hives. Injection-site rash. |
| up to 1 in 10 (1% to 10%) | Rash (including measles-like rash). Injection-site bruising. |
| > 1 in 10 (10%) | Fever (38.5°C or higher). Injection-site redness; injection-site pain; injection-site swelling. |
| Risks from each dose of MMR vaccine Priorix |
|---|
| 2 doses recommended, at 12 months and Junior infants (as per Priorix patient information leaflet Sept 2023) |
| Observed side effects post administration of Priorix (post marketing) |
|---|
| Joint and muscle pain • Punctual or small spotted bleeding or bruising more easily than normal due to a drop in platelets • Sudden life-threatening allergic reaction • Infection or inflammation of the brain, spinal cord and peripheral nerves resulting in temporary difficulty when walking (unsteadiness) and/or temporary loss of control of bodily movements, inflammation of some nerves, possibly with pins and needles or loss of feeling or normal movement (Guillain-Barré syndrome) • Narrowing or blockage of blood vessels • Erythema multiforme (symptoms are red, often itchy spots, similar to the rash of measles, which starts on the limbs and sometimes on the face and the rest of the body) • Measles and mumps-like symptoms (including transient, painful swelling of the testicles and swollen glands in the neck). |
| Risk Category | Observed Side Effects |
|---|---|
| up to 1 in 1000 (0.1%) | Convulsions accompanying high fever • Allergic reactions |
| up to 1 in 100 (1%) | Infection of the middle ear • Swollen lymph glands (glands in the neck, armpit or groin) • Loss of appetite • Nervousness • Abnormal crying • Inability to sleep (insomnia) • Redness, irritation and watering of the eyes (conjunctivitis) • Bronchitis • Cough • Swollen parotid glands (glands in the cheek) • Diarrhoea • Vomiting |
| up to 1 in 10 (1% to 10%) | Pain and swelling at the injection site • Fever higher than 39.5°C • Rash (spots) • Upper respiratory tract infection |
| > 1 in 10 (10%) | Redness at the injection site • Fever of 38°C or higher |
| WHO Vigaccess Adverse Events Reporting System As of June 2024, 178,378 adverse events have been reported for all measles, mumps & rubella vaccines. |
What is measles?
Measles is a viral illness and is transmitted like the common cold. Measles starts with cold-like symptoms that develop about 10 days after you get infected, followed by a rash a few days later. The illness usually resolves itself in 7 to 10 days. Before there was a vaccine, measles was considered a benign childhood illness and a rite of passage, similar to how chickenpox is regarded today in Ireland. Those who get measles usually have lifelong immunity.
Death from measles is not common in developed countries like Ireland. The last measles death was recorded nearly twenty years ago in 2005. Severe measles has been associated with vitamin A deficiency, malnutrition and is more common in those who are chronically ill. Giving adequate supply of vitamin A can prevent morbidity and mortality in children in developing countries.
Well nourished children have little to fear from measles and perhaps something to gain. Measles can have a protective effect against disease in later years:
- children who have had measles have far fewer allergies and atopic diseases, such as asthma, and adults who had measles have a reduced risk of Parkinson’s Disease .
- The Japan Collaborative Cohort (JACC) study concluded that measles and mumps, especially in case of both infections, were associated with lower risks of mortality from cardiovascular disease (CVD).
- This study; Do childhood diseases affect NHL and HL risk? concluded that measles may provide a protective effect against Non Hodgkin’s Lymphoma.
- Researchers at the Department of Health Care and Epidemiology at the University of British Columbia and the Department of Biology at the University of Victoria found that those who never had measles had a significantly increased rate of ovarian cancer.
What is the risk of getting measles in Ireland?
The risk of getting measles between 2011 and 2020, using both confirmed and possible cases, was approximately 1 in 72,000 (0.001%). There were 11 cases of measles reported in the four years between 2020 and 2023.
What is the risk of death from measles in Ireland?
There has been two confirmed deaths from measles in Ireland in over twenty years since 2001. The risk of dying from measles in Ireland in the decade before the vaccine was introduced in 1985 was approximately 1 in 773,000 (0.0001%). Survival rate was between 99.61% and 99.96% for anyone who contracted measles.
Does the MMR vaccine guarantee protection against measles?
No – you may still get measles even if vaccinated. Global efforts to eradicate measles have been hampered by continuous breakthrough infections, often in highly vaccinated populations.
Between the years 2003 and 2018, of the 2351 notified cases of measles in Ireland, 22% were vaccinated and over 29% had unknown vaccination status.
What is mumps?
Mumps is a virus that causes fever and swelling of the salivary glands in the cheeks. It is transmitted like the common cold and usually confers lasting immunity. The swelling of the cheeks is usually the most telling sign of mumps, and a blood test can be used to confirm the diagnosis. Mumps is generally a mild illness.
Symptoms can involve a minor fever, sore throat, swollen glands in the cheeks and usually resolve themselves after 10 days. In up to 40% of cases there are no symptoms and in up to 50% of cases symptoms are nonspecific or primarily respiratory so parents may not even realise their child has mumps. According to the Health Protection Surveillance Centre (HPSC);
“Most infections in children less than two years old are subclinical (no apparent symptoms)”.
This German study found that the median age of mumps increased after initiating vaccines. Those most at risk of complications are post pubertal males where mumps orchitis causes swelling of the testicles. Mumps orchitis rarely leads to sterility .
Well nourished children have little to fear from mumps and perhaps something to gain:
- This study from the University of Berne, Switzerland [Introduction – 4] concluded: “study consistently revealed a lower cancer risk for patients with a history of FICD [febrile infectious childhood diseases].”
- The Japan Collaborative Cohort (JACC) study concluded that measles and mumps, especially in the case of both infections, were associated with lower risks of mortality from cardiovascular disease.
- In females, there may be a distinct benefit in having clinical mumps in terms of a protective effect against ovarian cancer .
What is the risk of getting mumps in Ireland?
The risk of getting mumps in Ireland during the period between 2012 and 2018 was approximately 1 in 7,000 (.01%) for all ages. Risk of hospitalisation was approximately 1 in 178,000 (0.0006%) for all ages.
What is the risk of death from mumps in Ireland?
There have been no deaths from mumps for anyone under 75 in over 50 years.
Does the MMR vaccine guarantee protection from mumps?
No – you may still get mumps if vaccinated. In the years between 2010 and 2018, of the 4,952 cases of mumps, almost 90% were vaccinated. In December 2021, NBC news reported that the Centre for Disease in the USA found that as many as 94% of mumps cases were in those that were vaccinated.
What is rubella?
Rubella, or German measles, is a generally mild viral infection that causes a low-grade fever and a red rash starting on the face and spreading downwards, lasting around three days. The incubation period is typically 14-17 days. While rubella is harmless in children and often provides lifelong immunity, it poses significant risks for pregnant women, as it can cause congenital rubella syndrome (CRS) in the unborn child, leading to severe birth defects.
To prevent CRS, women of childbearing age are advised to check their immunity by testing for rubella antibodies.
The World Health Organization (WHO) officially declared rubella eradicated in the Americas in April 2015 [15] and in Ireland in April 2017 . This achievement also meant the eradication of Congenital Rubella Syndrome (CRS) in these regions, with the last reported case of CRS in Ireland occurring in 2009.
According to Harrison’s Principles of Internal Medicine :
”Rubella was once most frequent among children aged five to nine years, but with the advent of immunisation programs often directed primarily at this group as well as pre-schoolers, a greater proportion of cases is now being reported among older people (15-24 years).”
What is the risk of getting rubella or congenital rubella syndrome (CRS) in Ireland?
The risk for all ages of getting rubella in Ireland during the ten years between 2011 and 2020 was approximately 1 in 2.4 million (0.000004%). The last case of Congenital Rubella Syndrome was in 2009.
What is the risk of death from rubella in Ireland?
Deaths from rubella have always been extremely rare before and after the vaccine was introduced. There were two deaths in the decade before the rubella vaccine was introduced in 1971 and two deaths in the decade before the MMR vaccination was introduced in 1988. In the last forty years there have been a total of four deaths across all age groups.
Does the MMR vaccine guarantee protection against rubella?
No – you may still get rubella even if vaccinated.
Additional vaccine safety data
- See Disease versus Vaccine Risk Summary at the top of this page for list of possible side effects from M-M-RVaxPro and Priorix vaccines.
- In a clinical trial comparing immunogenicity and safety of two MMR vaccines more than half of the healthy children in both groups suffered adverse events, some serious and requiring emergency room visits (see Supplementary Material).
- “Severe allergic reactions can occur to any vaccine but they are very rare and are usually seen in less than 1 in 10,000 people who are vaccinated” [Menitorix PIL, 11/2016]
- As of June 2024, 178,378 adverse events have been reported on the World Health Organisation Vigiaccess database for all measles, mumps & rubella vaccines.
What are the vaccine ingredients?
| Vaccine | Ingredients as listed on patient information leaflets |
|---|---|
| M-M-RVaxpro (MMR) |
Active substances: measles and mumps virus (produced in chick embryo cells). Rubella virus (produced in WI-38 human diploid lung fibroblasts)
Other ingredients: [popup_anything id=”4786″], [popup_anything id=”4787″], [popup_anything id=”4789″], [popup_anything id=”3109″], [popup_anything id=”4790″], [popup_anything id=”2226″], [popup_anything id=”4791″] [popup_anything id=”3623″], [popup_anything id=”2215″], [popup_anything id=”4792″], [popup_anything id=”4802″], [popup_anything id=”4793″], [popup_anything id=”4794″], [popup_anything id=”4795″] |
| Priorix (MMR) |
Active substances: measles, mumps and rubella live attenuated viruses
Other ingredients: [popup_anything id=”2225″], [popup_anything id=”4796″], [popup_anything id=”4649″], [popup_anything id=”2226″], [popup_anything id=”2219″], [popup_anything id=”4797″], [popup_anything id=”2223″], [popup_anything id=”2217″], [popup_anything id=”2215″] |