Measles vaccine

Measles vaccine protects against becoming infected with measles. Nearly all of those who do not develop immunity after a single dose develop it after a second dose. When the rate of vaccination within a population is greater than 92%, outbreaks of measles typically no longer occur; however, they may occur again if the rate of vaccination decreases. The vaccine's effectiveness lasts many years. It is unclear if it becomes less effective over time. The vaccine may also protect against measles if given within a couple of days after exposure to measles.

The vaccine is generally safe, even for those infected by HIV. Most children do not experience any side effects; those that do occur are usually mild, such as fever, rash, pain at the site of injection, and joint stiffness; and are short-lived. Anaphylaxis has been documented in about 3.5–10 cases per million doses. Rates of Guillain–Barré syndrome, autism and inflammatory bowel disease do not appear to be increased by measles vaccination.

The vaccine is available both by itself and in combinations such as the MMR vaccine (a combination with the rubella vaccine and mumps vaccine) or the MMRV vaccine (a combination of MMR with the chickenpox vaccine). The measles vaccine is equally effective for preventing measles in all formulations, but side effects vary for different combinations. The World Health Organization (WHO) recommends measles vaccine be given at nine months of age in areas of the world where the disease is common, or at twelve months where the disease is not common. Measles vaccine is based on a live but weakened strain of measles. It comes as a dried powder that is mixed with a specific liquid before being injected either just under the skin or into a muscle. Verification that the vaccine was effective can be determined by blood tests.

The measles vaccine was first introduced in 1963. In that year, the Edmonston-B strain of measles virus was turned into a vaccine by John Enders and colleagues and licensed in the United States. In 1968, an improved and even weaker measles vaccine was developed by Maurice Hilleman and colleagues, and began to be distributed, becoming the only measles vaccine used in the United States since 1968. About 86% of children globally had received at least one dose of the vaccine as of 2018. In 2021, at least 183 countries provided two doses in their routine immunization schedule. It is on the World Health Organization's List of Essential Medicines. As outbreaks easily occur in under-vaccinated populations, non-prevalence of disease is seen as a test of sufficient vaccination within a population.

One dose is about 93% effective while two doses of the vaccine are about 97% effective at preventing measles. Before the widespread use of the vaccine, measles was so common that infection was considered "as inevitable as death and taxes." In the United States, reported cases of measles fell from 3 to 4 million with 400 to 500 deaths to tens of thousands of cases per year following introduction of two measles vaccines in 1963 (both an inactivated and a live attenuated vaccine (Edmonston B strain) were licensed for use, see chart at right). Increasing uptake of the vaccine following outbreaks in 1971 and 1977 brought this down to thousands of cases per year in the 1980s. An outbreak of almost 30,000 cases in 1990 led to a renewed push for vaccination and the addition of a second vaccine to the recommended schedule. No more than 220 cases were reported in any year from 1997 to 2013, and the disease was believed no longer endemic in the United States. In 2014, 667 cases were reported.

The benefits of measles vaccination in preventing illness, disability, and death have been well documented. Within the first 20 years of being licensed in the U.S., measles vaccination prevented an estimated 52 million cases of the disease, 17,400 cases of intellectual disability, and 5,200 deaths. From 1999 to 2004 a strategy led by the WHO and UNICEF led to improvements in measles vaccination coverage that averted an estimated 1.4 million measles deaths worldwide. The vaccine for measles led to the near-complete elimination of the disease in the United States and other developed countries. While the vaccine is made with a live virus which can cause side effects, these are far fewer and less serious than the sickness and death caused by measles itself; side effects ranging from rashes to, rarely, convulsions, occur in a small percentage of recipients.

Measles vaccination averted 57 million deaths between 2000 and 2022, as per World Health Organization report.

Measles is common worldwide. Although it was declared eliminated from the U.S. in 2000, high rates of vaccination and excellent communication with those who refuse vaccination are needed to prevent outbreaks and sustain the elimination of measles. Of the 66 cases of measles reported in the U.S. in 2005, slightly over half were attributable to one unvaccinated teenager who became infected during a visit to Romania. This individual returned to a community with many unvaccinated children. The resulting outbreak infected 34 people, mostly children and virtually all unvaccinated; three of them were hospitalized. The public health response required making almost 5,000 phone calls as part of contact tracing, arranging and performing testing as needed, and arranging emergency vaccination for at-risk people who had had contact with this person. Taxpayers and local healthcare organizations likely paid more than US$167,000 in direct costs to contain this one outbreak. A major epidemic was averted due to high rates of vaccination in the surrounding communities.