To avoid contracting measles, a highly contagious viral infection that can affect both children and adults, the only reliable method is vaccination. At what age to get vaccinated? Make reminders?
Is the measles vaccine compulsory?
Vaccination against measles is mandatory for infants born from January 1, 2018 (an injection at 12 months followed by a second injection between 16 and 18 months). “It is highly recommended for other children and adults“, specifies Yannick Schmitt, doctor and President of the Autonomous Group of Young Installed General Practitioners and Replacements (ReAGJIR). Measles vaccination is not recommended during pregnancy. On July 31, 2023, the High Authority of Health recommends mandatory measles immunization for health professionals. In concrete terms, students and professionals who are not vaccinated or who cannot attest to contamination will therefore have to be vaccinated. In case of doubt, the HAS opens the possibility that a serological test can be carried out upstream to establish the immune status.
What is the name of the measles vaccine?
This is the vaccine MMR – for measles-mumps-rubella. There are currently two vaccines with different trade names: Priorix and MM-RVaxPro. Rouvax, now withdrawn from the market, contained measles alone.
At what age should the MMR vaccine be given?
► In the baby, the first injection takes place at 12 months and the second between 16 and 18 months.
► The use of live attenuated vaccines, such as MMR, should be delayed for 12 months after the birth in children of treated mothers by infliximab, an anti-inflammatory drug indicated in adults for the treatment of several autoimmune diseases (rheumatoid arthritis, Crohn’s disease, psoriasis, etc.), during pregnancy or breastfeeding, warns the ANSM in a press release dated April 7, 2022. “The immune defenses of infants exposed to infliximab during pregnancy or while breastfeeding may be reduced due to the passage of this molecule into the blood of the fetus and into breast milk. As a result, there is a risk of infection in these infants“. Similarly, the administration of a live vaccine in a child of a breastfeeding mother treated with infliximab is not recommended.
► In adults, ask your attending physician to check whether your MMR vaccination is up to date. Otherwise remediation is recommended. “In all cases, it is recommended that adults can justify two doses. For adults born after 1980, one dose was normally performed. In this case, it is necessary to check that a second dose has been given afterwards (change of recommendations). If no proof of vaccination exists, the two doses at least one month apart“, confirms Yannick Schmitt.
When to recall the MMR vaccine?
For babies, the booster takes place between 4 and 6 months after the first injection. For adults, the booster (2nd dose) takes place one month after the first dose.
How many doses of MMR vaccine for adults?
THE people born since 1980 must have received in total two doses of the trivalent vaccine, respecting a minimum period of one month between the two doses, whatever the history vis-à-vis the three diseases (measles-mumps-rubella). People who have developed one of the three diseases against which the vaccine protects are usually not protected against the other two and give a live attenuated vaccine to a person who is already immunized does not present any disadvantage due to the inactivation of the vaccine virus by pre-existing antibodies, specifies the Ministry of Health in the vaccine calendar. There vaccination against measles, rubella and mumps is contraindicated during pregnancy, “however, inadvertent vaccination of a pregnant woman should not be grounds for termination of pregnancy”. Pregnancy should be avoided within one month of vaccination. Newly vaccinated women intending to become pregnant should be advised to delay planning for one month.
What are the MMR vaccine recommendations for women?
In accordance with the instructions of the Ministry of Health:
► women born before 1980 not vaccinated against rubella and having a pregnancy project, must receive a dose trivalent vaccine (measles, mumps, rubella). This vaccination can be practiced during a consultation of contraception for example. Pre-vaccination and post-vaccination serologies are not useful. If the results of serology confirming the woman’s immunity to rubella are available, it is not necessary to vaccinate her. There is no need to revaccinate women who have received two prior vaccinations, regardless of the result of the serology if it has been performed.
► for women with negative prenatal serology or unknown, since vaccination cannot be performed during pregnancy, it must be performed immediately after childbirth, preferably before leaving the maternity ward, or failing that, at the earliest after leaving, even in the event of breast-feeding (in the absence of suspicion or confirmation of immunodeficiency in the child).
► vaccination against measles and rubella is contraindicated during pregnancy, however, inadvertent vaccination of a pregnant woman does not constitute grounds for termination of pregnancy.
► pregnancy must be avoided in the month following vaccination. Women who have just been vaccinated and who intend to become pregnant should be advised to postpone their plan for one month.
► If you are currently treated with infliximab and you are breastfeeding, it is not recommended to vaccinate your child with a live attenuated vaccine (such as BCG or MMR) unless infliximab is undetectable in their blood. Discuss with your doctor about the benefits of breastfeeding against the risk of exposing the child to diseases prevented by vaccination.
How effective is the MMR vaccine?
The vaccine is very effective. It consists in triggering a reaction of the body so that it manufactures itself a defense against these viruses. Adverse effects are minimal.
MMR vaccine and autism: what do the studies say?
In 1998, a study published in an international journal suggested that the MMR vaccine could be linked to the occurrence of autism. It has since been refuted due to numerous irregularities in its methodology. But many parents continue to be wary of the vaccine. In 2019, a study of around 650,000 children in Denmark, followed for an average of 8.5 years, showed that MMR vaccination was not associated with an increased risk of autism or related disorders. The results of two syntheses of epidemiological studies, and two other follow-up studies also support the absence of a link between MMR vaccination and autism. In February 2020, the medical journal Prescribe estimated that “the prevention of measles, mumps and rubella remained MMR vaccination: a first dose from 12 months, and, in France, a second dose at least one month later, at an age between 16 and 18 months “.
Where to get the MMR vaccine?
Your GP can make the vaccine. For children, it is also possible to have them vaccinated in a PMI center (maternal child protection). For adults, you can go to a free vaccination center.
Price and reimbursement
The measles vaccine is free because reimbursed 100% by Health Insurance for all children up to the age of 17. For other insured persons, the MMR vaccine is reimbursed at 65% by Health Insurance. Its cost is €13.91. However, free only concerns the vaccine and not the act of injection which is covered under the usual conditions.
Thanks to Yannick Schmitt, doctor and President of the Autonomous Group of Young Installed General Practitioners and Replacements (ReAGJIR).