Measles Vaccine

Indications

Measles vaccine (live) is used to protect against measles, a highly infectious viral illness that causes high fever, cough, runny nose, red eyes and a rash, and can lead to pneumonia, brain swelling (encephalitis), blindness and death, especially in young and malnourished children. It is given to infants and children under the national immunisation programme, and may also be given to older children and adults who are not immune, during outbreaks, or after contact with a measles case.

How It Works

The vaccine contains a live but weakened (attenuated) form of the measles virus. It cannot cause normal measles in a healthy person, but it multiplies slightly in the body and trains the immune system to make antibodies and immune cells against the virus. If the person is later exposed to real measles, the immune system recognises it and fights it off quickly. Two doses give long-lasting protection in nearly everyone.

Dosage and Administration

The vaccine is given by a doctor, nurse or trained vaccinator as a single 0.5 ml injection under the skin (or into the muscle, as stated on the pack), usually in the upper arm or thigh. The number of doses and the ages at which they are given follow the national immunisation schedule; in Bangladesh, measles-containing vaccine is usually given at 9 months and again at 15 months. The vaccine is mixed (reconstituted) with its own diluent just before use and must be used within the time stated on the pack.

Interactions

• Immunoglobulins, blood or plasma given within the previous 3 months (sometimes longer) can stop the vaccine from working; the vaccinator will advise on timing.
• Other live vaccines should be given on the same day or at least 4 weeks apart.
• The vaccine can weaken the tuberculin (TB) skin test for 4 to 6 weeks, so that test should be done before or on the same day as vaccination, or delayed.
• Medicines that weaken the immune system, such as high-dose steroids, cancer treatment or transplant medicines, may make the vaccine unsafe or less effective.

Contraindications

• Severe allergic reaction (anaphylaxis) to a previous dose or to any ingredient, including Neomycin or gelatin where present.
• Pregnancy.
• Severely weakened immunity, such as from leukaemia, lymphoma, advanced HIV, or treatment with high-dose steroids or cancer medicines.
• Untreated active tuberculosis.
• Vaccination is postponed during a high fever or serious acute illness; a mild cold is not a reason to delay.

Side Effects

Pain, redness or swelling where the injection was given may occur. About 1 to 2 weeks after vaccination some children develop a fever, a mild rash or swollen glands for a few days. Febrile fits (seizures with fever) can occasionally occur. A temporary drop in platelets (causing easy bruising) is rare.

Get urgent medical help if there is difficulty breathing, swelling of the face or throat, or collapse soon after the injection, or if the child has a fit, unusual bleeding or bruising, or becomes very drowsy or confused.

Pregnancy and Lactation

Live measles vaccine must not be given during pregnancy, and women should avoid becoming pregnant for 1 month after vaccination. If given by mistake in pregnancy, speak to your doctor; harm to the baby has not been shown. The vaccine can be given to breastfeeding women.

Precautions and Warnings

• Tell the vaccinator about any allergy, fits, bleeding problem, weak immunity or recent blood transfusion.
• People with a history of febrile seizures or low platelets may still be vaccinated after a doctor's assessment.
• Keep the person under observation for about 15 to 30 minutes after the injection.
• Paracetamol can be used for fever after vaccination.

Overdose

Overdose is unlikely because the vaccine is given as a measured single dose by health workers. An extra dose is not expected to cause serious harm.

Therapeutic Class

Viral vaccine (live attenuated measles vaccine).

Storage

Store in a refrigerator at 2 to 8°C and protect from light. The diluent must not be frozen. Keep as directed on the pack within the vaccine cold chain and out of the reach of children.