11 Measles

11.6 Contraindications and precautions

11.6.1 Contraindications

The general contraindications that apply to all immunisations are relevant to MMR vaccines (eg, children with an acute febrile illness should have their immunisation deferred; see section 1.4).

Anaphylaxis following a previous dose of MMR vaccine or any of its components is a contraindication to a further dose of MMR. Children who have anaphylaxis after MMR should be serologically tested for immunity and referred to, or discussed with, a specialist if non-immune to rubella or measles.

Individuals in whom MMR is contraindicated include:

11.6.2 PrecautionsTop

Children with a history of seizures should be given MMR, but the parents/guardians should be warned that there may be a febrile response. Children with current immune thrombocytopenic purpura (ITP) should have the timing of vaccination discussed with the specialist responsible for their care.

Women of childbearing age should be advised to avoid pregnancy for the next four weeks1 after MMR vaccine (see chapter 18).

Tuberculin skin testing (Mantoux) is not a prerequisite for measles vaccination. Antituberculous therapy should be initiated before administering MMR vaccine to people with untreated tuberculous infection (latent) or disease (active). Tuberculin skin testing, if otherwise indicated, can be done on the day of vaccination. Otherwise testing should be postponed for four to six weeks, because measles vaccination may temporarily suppress tuberculin skin test reactivity.3

11.6.3 Egg allergyTop

Egg allergy, including anaphylaxis, is not a contraindication to measles-containing vaccines. Various studies have confirmed these children can be vaccinated safely.3, 22, 23 Other components of the vaccine (eg, gelatin)24 may be responsible for allergic reactions.