CDC updates vaccination guide for measles, mumps, rubella

The Advisory Committee on Immunization Practices (ACIP) published three revisions to its guidelines for vaccinating against measles, mumps and rubella (MMR).

The ACIP removed documentation of physician-diagnosed disease as an acceptable criterion for evidence of immunity for measles and mumps and included laboratory confirmation of disease as acceptable evidence of immunity for MMR.

In addition, it expanded recommendations for vaccination to all HIV-infected people older than one year who do not have evidence of current severe immunosuppression. It recommended revaccinating people with perinatal HIV infection who were vaccinated before establishment of effective antiretroviral therapy (ART) with two appropriately spaced doses of MMR vaccine once effective ART has been established. ACIP also changed the recommended timing of the two doses of MMR vaccine for HIV-infected people to age 12 through 15 months and 4 through 6 years.

For measles postexposure prophylaxis, the ACIP expanded recommendations for use of immune globulin administered intramuscularly (IGIM) to include infants (from birth to 6 months old) exposed to measles. It increased the recommended dose of IGIM for immunocompetent people. The ACIP also recommended intravenous immune globulin for severely immunocompromised people and pregnant women without evidence of measles immunity who are exposed to measles.

The new recommendations were published online June 14 by Morbidity and Mortality Weekly Report. (The ACIP adopted the revisions in October 2012.)

Unchanged recommendations include two doses of MMR vaccine for children (at 12 to 15 months and 4 to 6 years). Two doses are recommended for adults at high risk for exposure and transmission (e.g., students attending colleges, health care personnel, and international travelers) and one dose for other adults aged 18 years or older. For prevention of rubella, one dose of MMR vaccine is recommended for people aged 12 months and older.