Three Reasons to Not Get an MMR Booster
...and two reasons to get it!
As it is becoming more and more obvious that we are entering a ‘measles year,’ many folks who are fully vaccinated are thinking of checking their measles titers.
Others are simply thinking of getting an MMR booster.
Three Reasons to Not Get an MMR Booster
While that might seem like a good idea, after all, what’s the harm of some extra protection, I’ll offer a good reason to skip it.
Additional doses of MMR for measles protection are not really booster doses. We get the second dose because a small percentage of people do not respond to the first dose. But after two doses of MMR, studies show 99% protection against measles that is long lasting!
Even if you have low measles antibody titers, most folks who are vaccinated with two doses of MMR show an anamnestic immune response and are probably still immune.
Although an extra dose is safe and might even provide a little bit of extra protection, you might consider how it will be perceived if you get sick in the hours, days, or weeks after you get your extra dose of MMR.
After all, we have moved into a time when it isn’t so much the true vaccine adverse events that many people are worried about, but rather what they think are all the terrible reactions that vaccines can cause. And unfortunately, that’s basically anything and everything that happens in the hours, days, weeks, months, and years after you get a vaccine now! There are no more coincidences and these folks seem to have never heard of background rates…
So it will be a gift to RFK Jr and anti-vaccine folks if a lot of adults start getting an extra dose of MMR and even a few of them have a coincidental heart attack, stroke, or develop MS, etc.
To be very clear, this is not any kind of warning that the MMR vaccine isn’t safe.
Need another reason?
There is no official recommendation to get a third dose of MMR or to even routinely check your measles titers.
In fact, the recommendation is to not routinely check titers and if you do and they are low, to not get another dose of MMR!
“In the event that a HCP who has 2 documented doses of MMR vaccine is tested serologically and determined to have negative or equivocal measles titer results, it is not recommended that the person receive an additional dose of MMR vaccine. Such persons should be considered to have presumptive evidence of measles immunity. Documented age-appropriate vaccination supersedes the results of subsequent serologic testing.”
Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
But aren’t some people, especially health care workers, at increased risk to get measles because of how often they are exposed?
Sure, but that’s why we get vaccinated and protected with two doses of the MMR vaccine!
“Of 31 cases of measles, 8 (26%) occurred in HCWs, and 5 (16%) occurred in patients or visitors to medical facilities. Cases of measles occurred in HCWs who were not required to have proof of measles immunity as defined by the 1989 ACIP guidelines.”
Transmission of measles virus in healthcare settings during a communitywide outbreak
Previous studies which found that health care workers were at increased risk of measles than other adults were before we all routinely received two doses of MMR.
To be fair, there is a recommendation to get an MMR booster for protection against mumps if you are at risk during a mumps outbreak though. You should also get a third and final dose of MMR if your rubella titer was negative, something that is routinely checked during each pregnancy.
Six Ways to Avoid Measles
Still worried that you might get caught up in one of the coming measles outbreaks?
Just know that in most outbreaks, almost all of the cases are in children and adults who are unvaccinated and less commonly, partially vaccinated.
And know that while most people don’t need an extra dose of MMR, there are situations when your kids might need to get an early dose of MMR!
If you are traveling out of the United States or you live or are visiting an area where there is an outbreak of measles, your kids will likely need an early dose of MMR, including:
infants who are at least six months old (this is an extra dose, as it will be repeated when they are 12 months old)
toddlers who are at least 12 months old, who should get their second dose at least four weeks after their first dose (this counts as their typical four year old dose though, even though it has been given early!)
preschoolers who are not yet four years old if they haven’t already gotten a second dose after age 12 months (again, this counts as the typical four year old dose)
And if you or your children are unvaccinated, know that this is a great time to get caught up and protected! The herd is disappearing and plans for free riding on the immunity of everyone else in the community isn’t going to work anymore.
References:
Mathis AD, Raines K, Masters NB, et al. Measles — United States, January 1, 2020–March 28, 2024. MMWR Morb Mortal Wkly Rep 2024;73:295–300. DOI: http://dx.doi.org/10.15585/mmwr.mm7314a1.
Carlson A, Riethman M, Gastañaduy P, et al. Notes from the Field: Community Outbreak of Measles — Clark County, Washington, 2018–2019. MMWR Morb Mortal Wkly Rep 2019;68:446–447. DOI: http://dx.doi.org/10.15585/mmwr.mm6819a5.
Fill MA, Sweat D, Morrow H, et al. Notes from the Field. Measles Outbreak of Unknown Source — Shelby County, Tennessee, April–May 2016. MMWR Morb Mortal Wkly Rep 2016;65:1039–1040. DOI: http://dx.doi.org/10.15585/mmwr.mm6538a3
Advisory Committee on Immunization Practices; Centers for Disease Control and Prevention (CDC). Immunization of health-care personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011 Nov 25;60(RR-7):1-45. PMID: 22108587 https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6007a1.htm
Steingart KR, Thomas AR, Dykewicz CA, Redd SC. Transmission of measles virus in healthcare settings during a communitywide outbreak. Infect Control Hosp Epidemiol. 1999 Feb;20(2):115-9. doi: 10.1086/501595. PMID: 10064215. https://pubmed.ncbi.nlm.nih.gov/10064215/
Measles Scenario-Based Human Health Risk Assessment for the United States. https://publichealth.jhu.edu/sites/default/files/2025-02/Measles-Risk-Assessment-2.14.25_1.pdf
I'm having a bit of difficulty with this. First, not a question, is just to say I was in the category of having had measles as a child. Fifty years later, when I had titers drawn as vaccination was a job requirement, I did not show immunity to measles or mumps (I had everything as vaccines werent' yet availble). I had no question I was still immune, but had to get an MMR or not get employment. Easy decision.
My daughter (total PVand anxious about CDs) and her partner were born in 1981 and 1985. So they had one dose. I suggested they get a second. I'm interested on your take - are there data that a second after so many years increase effectiveness?
I'm having a hard time with the idea of not getting an additional vaccine (as in my daughter's case) in order not to give information that can be misinterpreted to RFK, Jr. While I understand COVID vaccine works differently, it's only recommended once a year or when a new one is developed (I won't hold my breath on that now). I get on every 4-6 months (that includes newer vaccines as we've known they were in the works, so I've timed them around travel, new vaccines, etc., not to go beyond 6 months). The premise is the same, however. I am not going to wait until it's a year and the vaccine has waned in order to keep things smooth for RFK, Jr and the AV crowd. I also get Tdap every 4 years because I've worked in schools.
I won't allow concerns about how RFK, Jr. may misinterpret data that he probably won't even have to determine what's best for my heatlh and safety. He's going to do what he does regardless of who has adverse reactions. They don't rely on factual data to begin with. You have enough examples, but I'll add one more. Looking for a quote from Brian Hooker earlier today, I listened to him on a very recent podcast that included the current Texas Measles ["confirmed it was the vaccine that caused the"] outbreak . He said before the vaccine that Measles "Mortablity rate before vaccines was one or two in a million" and measles had benefits, and "prevented various types of cancers."
Thank you, as always, for all your work and provided such a vital and reliable resource.