MMR vaccination: benefits and side effects

In order to protect your child against so-called childhood diseases , the Standing Vaccination Committee (STIKO) of the Robert Koch Institute recommends specific vaccinations against the most common infectious diseases every year. These recommendations also include vaccination against measles , mumps and rubella (MMR vaccination) from the age of eleven months. Even if these three illnesses are often harmless in infancy, the STIKO wants to use the recommended early vaccination times to achieve the highest possible vaccination rate in the population and thus minimize the risk of infection. The long-term goal is to eradicate each disease.

What is the benefit of the MMR vaccine?

As with any multiple vaccination, you should find out exactly what the individual vaccines do and what disease they protect against before you carry them out. Especially with combined vaccinations, such as the MMR vaccination, it should be noted that not all pathogens are equally aggressive and the individual vaccinations may therefore not have the same priority.

Measles : The highly contagious viral infection is widespread worldwide and causes, among other things, a temporary, pronounced immune deficiency. This immune deficiency is the reason why complications such as ear or pneumonia, febrile seizures or epileptic seizures develop particularly frequently with a measles infection. In rare cases, encephalitis can cause permanent brain damage.

In addition to adolescents and adults, the risk groups include infants in particular. This circumstance could be described as a kind of long-term vaccination side effect in mothers. Since most mothers today did not develop the measles antibodies during the course of a measles infection, but received them as part of a vaccination, the antibody level in their blood is no longer high enough to pass on sufficient nest protection to their newborn. As a result, most babies are not adequately protected against measles from about the ninth month of life. Since complications can be dangerous, especially for babies, due to the immature immune system, many parents decide to get an early vaccination against measles as part of the MMR vaccination.

Mumps : This viral infection mainly affects the salivary glands, primarily the parotid gland. Mumps is transmitted by droplet infection and cannot be treated by conventional medicine, only the symptoms can be treated. In children, the disease usually runs its course without major problems, but in rare cases and in advanced age, complications such as meningitis, testicular inflammation or inflammation of the auditory nerve can occur, which can result in permanent hearing loss.

Rubella : The causative agent responsible for rubella is the rubella virus. In children, the infection usually runs its course without complications. Nevertheless, vaccination is strongly recommended from the end of the first year of life, since the virus can have a severe course of the disease in adults, especially pregnant women. Possible complications are joint and nerve inflammation and, in the case of pregnant women, the transmission of the virus to the unborn child in the first four months, which can lead to severe deformities or even a miscarriage. Consistent vaccination as part of the MMR vaccination should significantly reduce the risk of infection for all age groups.

When and how an MMR vaccination?

The STIKO recommends the MMR vaccination from the age of eleven months. Since two to five percent of those vaccinated are so-called vaccination failures, in which a one-time vaccination with the corresponding antigens does not cause immunity against the pathogens, the STIKO recommends a repeat vaccination in the second year of life, which catches any failures and with which an immunity of 99 percent of the vaccinated is to be achieved.

Deviations from the recommended dates are generally possible, although there should be a break of at least four weeks between the two vaccinations. An MMR vaccination before the age of nine months should also be avoided, as the antibodies transmitted by the mother are usually still present in such high numbers at this point in time that they could neutralize the injected vaccine virus and thus render the vaccination ineffective.

Measles Protection Act: compulsory vaccination for school and kindergarten children

With the decision of the Measles Protection Act on November 14, 2019, school and kindergarten children are now subject to compulsory vaccination. According to the Federal Ministry of Health, the same applies to people who work in community facilities or medical facilities such as educators, teachers, day care workers and medical staff. Proof must be provided by the vaccination card, the yellow children’s examination booklet or a doctor’s certificate. “Children who are already being cared for in kindergarten and school or other community facilities must provide proof by July 31, 2021,” the ministry said in the publication. The Measles Protection Act is scheduled to come into force on March 1, 2020. Parents who do not comply with the vaccination obligation can expect a fine of up to 2,500 euros.

What do vaccination critics advise on the subject of MMR vaccination?

Doctors who are critical of vaccinations often advise that vaccinations, if at all, be carried out later than recommended by the STIKO. This is supported by the argument that the three infectious diseases in small children in our latitudes are mostly harmless and without major complications. In addition, patients who have had the disease once have lifelong immunity to the virus, whereas an MMR vaccination may require a booster years later. If your child does not go through the infections in infancy and therefore does not develop immunity, you still have the option of having them vaccinated against the pathogens before they start school.

Of course, the combination of the three vaccines against measles, mumps and rubella is not a must. Especially in connection with an individual vaccination decision, the use of individual vaccines may be advisable. For example, you can choose to only vaccinate your child against measles. However, there is a problem with vaccination against mumps. A single vaccine against this infectious disease has not been available for many years, which is why immunization against it is only possible as part of the MMR triple vaccination.

A combination of the MMR vaccination and the vaccination against chickenpox, the so-called MMR-V vaccination, has also been available for several years. You can find out more about the chickenpox vaccination in our article on the subject.

To keep track of the dates of the recommended vaccination schedule, you can print out our vaccination calendar .

MMR vaccination before entering kindergarten?

You should also keep in mind that proof of vaccination may be required when entering kindergarten or daycare. However, there is no legal basis for this. In such cases, you should always state that vaccinations are not compulsory in Germany. Your child should therefore not be refused entry to kindergarten because of missing vaccinations. The Infection Protection Act (IfsG) only provides that children who are acutely affected by an infectious disease, such as measles, whooping cough or chickenpox, are temporarily not allowed to visit the relevant facility. A fundamental rejection due to a deviation from the recommended vaccination plan of the STIKO is not acceptable.

If your kindergarten still insists on a vaccination, it is advisable to have a written certificate of necessity issued to you. In most cases, the issue is off the table because many institutions are well aware of the unlawfulness of their condition.

If a refusal due to a lack of vaccinations is stipulated in the statutes of the respective institution, you can refer the management to various articles of the Basic Law (Article 2: right to human integrity; Article 3, paragraph 3: principle of equal rights; Article 6, paragraph 2: parental rights) , which can counteract the individual provisions. Municipal institutions are usually bound by the Basic Law. Independent carriers can escape this obligation under certain circumstances. Since there are different regulations in each federal state, you should get legal assistance from a lawyer if you are in doubt.

Who should not get the MMR vaccine?

Even if vaccination against the three infectious diseases measles, mumps and rubella is strongly recommended by the STIKO, there are certain circumstances under which you should refrain from having your child vaccinated with MMR:

• If your child has previously had a severe vaccination reaction after a vaccination that went beyond the usual level of vaccination reactions, it should not be treated again with the same preparation. Alarming vaccination reactions are, for example, severe shortness of breath, fainting, seizures or a very high, persistent fever.
• In the case of acute infections that require treatment, you should refrain from an MMR vaccination for the time being. Vaccination should then take place no earlier than two weeks after recovery. Banal infections, such as a simple cold, are usually not an obstacle.
• In the case of an acute measles disease in the immediate vicinity, the vaccination should be postponed until the sick person has recovered.
• If you have a known allergy to an ingredient in the vaccine, such as the antibiotic neomycin, you should choose an alternative vaccine, if available. An allergy to chicken protein can also be problematic with the MMR triple vaccine, since some of the vaccine viruses are cultivated on cell cultures from chicken embryos and can therefore contain components of chicken protein.
• The vaccines against MMR are live vaccines, which means that they contain weakened but reproducible viruses that can cause the disease against which the vaccine is vaccinated in a mild form. In the case of an existing immunodeficiency, whether congenital or acquired, vaccination should therefore be avoided.
• It is essential to refrain from an MMR vaccination during pregnancy, as the unborn child could be infected by the vaccine virus, which can result in serious long-term damage. If there is a suspicion of an infection with one of the three pathogens during pregnancy, for example because you have come into contact with a sick person, a passive vaccination is usually used. So-called immunoglobulins are administered to you, corresponding antibodies that act directly against the viruses.

You can find more information on this topic in our articles on viral infections during pregnancy .

Important: Before you or your child get vaccinated, you should definitely have a detailed consultation with your doctor. He can draw your attention to possible risks and recommend alternatives if necessary.

Possible side effects of the MMR vaccination

The most common side effects of the MMR vaccination, as with many other vaccinations, are redness, swelling and slight pain at the injection site. Fatigue, slight fever, rashes and joint pain can also occur after the vaccination.

In about five percent of cases, a weakened form of one or more of the infectious diseases occurs about ten days after the MMR vaccination. The so-called vaccination measles in particular are not uncommon. These vaccine diseases are expressed through the same symptoms as the actual disease, but the course of the disease is usually not as severe as with a “natural” infection.

Since the MMR vaccination is an immunization with a live vaccine, it is basically possible that the same complications can develop as with a real infection. The combination of the various active ingredients and their interactions favor this course more than the administration of individual vaccines, since the weakening of the immune system by one of the pathogens can cause another vaccine virus to cause severe symptoms. However, such complications after vaccinations occur much less frequently than in the course of actual infections.