This vaccine is a 0.5-mL dose shot given subcutaneously (in the fatty layer of tissue under the skin). Give children the first dose at 12 to 15 months of age and the second dose at 4 to 6 years of age. Give MMR to children who have not received the second dose by their 11- to 12-year-old visit. There should always be at least 4 weeks between the first and second dose.
ProQuad®, the quadruple vaccine, is indicated for children 12 months to 12 years of age if a second dose of measles, mumps, and rubella vaccine is to be administered.
Adults born before 1957 are assumed to be immune to measles by natural infection. Give adults born in 1957 or later, who do not have medical restrictions, at least one dose of MMR vaccine during their lifetime. Give two lifetime doses of MMR vaccine to certain adults born in 1957 or later including healthcare workers, those who travel overseas, or those who attend college, or post-secondary educational institutions. These adults should receive two doses of MMR or have other evidence of measles immunity (lab test or physician-diagnosed measles).
A second dose of MMR is also recommended for adults who have been recently exposed to measles or who are in an outbreak setting, were previously vaccinated with killed measles vaccine, were vaccinated with an unspecified measles vaccine between 1963 and 1967, or plan to travel internationally.
M-M-R II® is administered to military basic trainees, unless they have positive blood tests or documented evidence of two prior vaccinations. For other adults and children, DoD follows guidelines of the Advisory Committee on Immunization Practices (ACIP). In general, ACIP prefers use of M-M-R II® to monovalent (Attenuvax®) or bivalent vaccines, to optimize immunity to all three diseases.