Measles / Mumps / Rubella (MMR) Vaccine

Section 1.1

Midwives may independently prescribe, order and administer this drug.

The MMR vaccine is a live, attenuated vaccine indicated for active immunization against infection by measles, mumps and rubella. While this vaccine should not be given during pregnancy, for those identified as rubella-susceptible in pregnancy, counselling regarding exposure, reporting and postpartum MMR vaccination is indicated. Pregnant individuals without history of prior immunization or serological proof of immunity should be tested for serologic confirmation of rubella immunity status in early pregnancy.

Indications and Clinical Use:

If rubella-susceptible during pregnancy, the MMR vaccine should be offered in the postpartum period.

Contraindications:

Pregnancy; however, the risk of rubella vaccine teratogenicity is theoretical and has not been observed.  Therefore, inadvertent immunization during pregnancy is not considered an indication for pregnancy termination and women should be reassured. Immunocompromised as a result of disease or therapy.

Warnings and Precautions:

  • Pregnancy should be avoided for one month following vaccination.
  • Rubella-susceptible individuals who receive RhIg postpartum should wait three months before receiving MMR vaccine for rubella protection to ensure optimal anti-rubella antibody response. However, if there is a risk of non-compliance in vaccination at a later date, risk of pregnancy, or contracting rubella in the first three months postpartum, MMR may be given in the immediate postpartum period so long as serologic testing for rubella is done at one to three months postpartum to assess for immune status. Revaccinate if non-immune.
  • Epinephrine (1:1000) and Diphenhydramine hydrochloride should be available for immediate use in the event of an anaphylactic reaction.

Pregnancy:

Contraindicated

Lactation:

Category L3 – No Data – Probably Compatible

Adverse Reactions:

SC: 0.5 mL

*Reconstituted vaccine should be injected promptly, or within eight hours of reconstitution if it is stored refrigerated (2-8° C)

Dosage and Administration:

0.5 mL SC (Do not give IV)