MMR – measles, mumps, rubella vaccine (live)

Combined live attenuated viral vaccine

ATC code: J07BD52(Measles-mumps-rubella vaccine (MMR))

Updated 24 Sep 2026 · Methodology

Indications

Prevention of measles, mumps and rubella

First line

Combined live attenuated vaccine against measles, mumps and rubella. Core of protection: two doses, the first at 12 months and the second at 3–4 years per the CAV-AEP schedule; the ACIP schedule places the first at 12–15 months and the second at 4–6 years. First line across all schedules (ACIP, CAV-AEP, /AEMPS) and the only effective way to prevent these three infections and their complications, including congenital rubella syndrome. Adults without documented immunity should also receive two doses.

Sources

ICD-10: Z23 · ICD-11: QC00

Vaccination during breastfeeding

First line

MMR during breastfeeding. CDC ACIP and AEP CAV 2024 – compatible. Although live, the rubella vaccine virus can be shed in breast milk and may transiently, asymptomatically infect the infant, but this is harmless and causes no disease. If unvaccinated before pregnancy and rubella-susceptible – vaccinate immediately postpartum, no breastfeeding interruption.

Sources

ICD-10: Z23 · ICD-11: QC00

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Vaccination during pregnancy

Not recommended

Contraindicated during pregnancy. As a live attenuated vaccine, the AEMPS product information (section 4.3) and ACIP contraindicate it in pregnant women because of the theoretical risk of the rubella component to the fetus; pregnancy should be avoided for 4 weeks after vaccination. Vaccination is deferred to the postpartum period, where it is safe. Safety note: accumulated data on women inadvertently vaccinated during pregnancy have recorded no case of congenital rubella syndrome, so inadvertent vaccination is not grounds for terminating the pregnancy.

Sources

ICD-10: Z23 · ICD-11: QC00

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

Live attenuated measles (Edmonston-Zagreb or Schwarz), mumps (Jeryl Lynn), and rubella (RA 27/3) viruses. After injection, viruses briefly replicate and induce full humoral and cellular immunity comparable to natural infection. Effectiveness after 2 doses: measles 97%, mumps 88%, rubella 97%.

Safety

Contraindications

Pregnancy (live vaccine)
Severe immunodeficiency
Anaphylaxis to previous dose or components (neomycin, gelatin)
Untreated active tuberculosis

Serious adverse effects

Anaphylaxis
Transient thrombocytopenia (1 in 30,000)
Febrile seizures in children

Common adverse effects

Injection-site pain
Fever 7–12 days post-vaccination (5–15%)
Measles-like rash (5%)
Arthralgia in adult women (25% from rubella component)

Pregnancy: can you take MMR – measles, mumps, rubella vaccine (live)?

Contraindicated in pregnancy. Contraception for 1 month after vaccination. Accidental vaccination in early pregnancy is not grounds for termination (no observed teratogenicity – monitor).

Breastfeeding: can you take MMR – measles, mumps, rubella vaccine (live)?

Hale L1 · Compatible

Fully compatible. Vaccine viruses are not shed in milk in active form. If rubella-susceptible – vaccinate immediately postpartum. Hale L1.

Calculate RID Full profile on NIH LactMed ↗

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Practical notes

Timing and administration

Contraception for 1 month after vaccination (theoretical fetal teratogenicity risk). Safe for the breastfed infant. Immunity by 2–4 weeks.

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Frequently asked

What is MMR – measles, mumps, rubella vaccine (live) used for?

MMR – measles, mumps, rubella vaccine (live) is evaluated for the following indications with varying evidence strength: Vaccination during breastfeeding (evidence tier A), Prevention of measles, mumps and rubella (evidence tier A), Vaccination during pregnancy (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of MMR – measles, mumps, rubella vaccine (live)?

Common side effects of MMR – measles, mumps, rubella vaccine (live) (≥ 1 in 100): Injection-site pain, Fever 7–12 days post-vaccination (5–15%), Measles-like rash (5%), Arthralgia in adult women (25% from rubella component). See the Safety section for uncommon and serious reactions.

Is MMR – measles, mumps, rubella vaccine (live) safe during pregnancy?

Contraindicated in pregnancy. Contraception for 1 month after vaccination. Accidental vaccination in early pregnancy is not grounds for termination (no observed teratogenicity – monitor).

Is MMR – measles, mumps, rubella vaccine (live) compatible with breastfeeding?

Fully compatible. Vaccine viruses are not shed in milk in active form. If rubella-susceptible – vaccinate immediately postpartum. Hale L1.

Who should not take MMR – measles, mumps, rubella vaccine (live)?

MMR – measles, mumps, rubella vaccine (live) is contraindicated in: Pregnancy (live vaccine); Severe immunodeficiency; Anaphylaxis to previous dose or components (neomycin, gelatin); Untreated active tuberculosis. Full list in the Safety section.

Other drugs in this group

Pneumococcal conjugate vaccine PCV20, RSV vaccine, recombinant (maternal), Tdap – tetanus, diphtheria, acellular pertussis vaccine, COVID-19 vaccine, mRNA (Moderna), Hepatitis A vaccine, inactivated, HPV vaccine, nonavalent, COVID-19 vaccine, mRNA (Pfizer-BioNTech), Hepatitis B vaccine, recombinant