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Giving MMR as single antigen vaccines: Frequently Asked Questions (FAQs)
Quickfind:
| Unlicensed vaccines | Manufacture, transport and storage | Safety | Effectiveness | Practicalities | Miscellaneous questions |
Unlicensed vaccines
Are doctors allowed to give the single vaccines for measles, mumps and rubella (German measles)?
Yes, doctors are legally allowed to obtain and give these vaccines, provided they comply with the Department of Health regulations on unlicensed medicines.
Then why do more doctors not offer them?
Because doctors are under strong pressure from the Department of Health (DoH) to promote and give the MMR vaccine, in the same way as you are being encouraged to give it to your children. Most doctors believe that the MMR is a better and safer option than the single vaccines for your child and the population at large.
What are the implications of the vaccines being unlicensed?
This means that they have not passed through the DoH's quality control procedures. It also means that they have to be ordered on a 'named patient' basis. This requires that each vaccine be ordered for an individual named child with the clinical reasons that the vaccine is needed.
My child is healthy. What would the clinical reason be to order the single vaccines for my child?
If, after informed consideration, you refuse to allow your child to be given the MMR vaccine, then your child is at risk of contracting measles, mumps and rubella. The only way to protect your child in these circumstances is to give him or her the single vaccines. This is the clinical indication.
Have the single vaccines always been unlicensed in the UK?
No. The measles single vaccine was used in this country from 1968 until 1988 when the MMR was introduced. It then continued to be available for those parents as an alternative to the MMR until the DoH withdrew it from ready circulation in 1998.
The single rubella vaccine was available for adult women who were not immune to rubella until the end of 2003. The single rubella vaccine is no longer available on the NHS. The Department of Health recommends adult women who need protection against rubella receive the MMR
Manufacture, transport and storage
Where are the single vaccines made?
They are manufactured either in Europe or the USA by large multinational pharmaceutical companies. See the separate vaccine sheets for more information on this.
Are they 'licensed' for use in other countries?
Yes, they are all licensed for use in other countries including many major European countries and/or the USA
How are the vaccines transported to your clinic?
They are imported by companies that specialise in importing drugs from abroad and have approval from the DoH to import the single vaccines. They arrive at our premises in temperature controlled conditions like all our other vaccines.
How do you store the vaccines?
They are stored, as with other vaccines, in temperature controlled fridges especially designed for vaccine storage.
How long can the vaccines be stored?
The 'shelf life' or expiry date will vary from batch to batch, but is usually a year or longer. Vaccines are never used after their expiry date.
Do the vaccines contain mercury or aluminium?
Neither the MMR nor any of the measles, mumps or rubella single vaccines contain mercury or aluminium.
Safety
Are the single vaccines safe?
They are at least as safe as the MMR.
Do the vaccines have side-effects?
All vaccines have side-effects. The vaccines offered by Holborn Medical Services have no additional side-effects to those occurring with the MMR vaccine. Please see the vaccine information pages for more information.
Who is liable if something goes wrong?
We, the doctors at Holborn Medical Services, remain responsible in the normal way for any advice and treatment that we offer. The pharmaceutical companies remain responsible for the quality of their product.
Do you keep a record of the batch number of the vaccines?
Yes, we keep a record of the batch number of the vaccine in our own records. We will also add this information to your child's personal health record book (usually a 'red' book).
How will my GP know that my child has been immunised?
We will send a letter to your GP.
What are the disadvantages of giving the vaccines separately?
The DoH have several concerns about the giving the MMR as separate vaccines, a course of action of which it strongly disapproves.
Effectiveness
Are the single vaccines as effective as the MMR?
Individually, they are at least as effective as the MMR. However, your child will not be protected against all three illnesses at the same time with the single vaccines.
Do the three separate vaccines contain the same strength as the MMR?
They contain the identical or equivalent strength of vaccine.
Which vaccine do you recommend my child has first?
Measles, because this illness poses more of a risk to your child than mumps or rubella.
How long do you recommend between the vaccines?
We recommend between six months and one year between each immunisation.
Why so long? Can my child have them sooner?
The purpose of having the vaccine separately is to minimise any risk of interaction that could occur between the three live viruses that make up the MMR. We do not know the optimum length of time to separate the vaccines. Some centres offer the vaccines at much shorter intervals. We are concerned that this may not minimise the risk of interaction which we are trying to avoid. Though we recommend a minimum gap of six months between the vaccines, you may choose the interval you wish for your child.
What strains do your vaccine contain?
The vaccines we currently offer contain the following strains. However, please bear in mind that these may change from time to time because of supply problems. We would never use any vaccine that we did not feel was one of the safest and most effective available.
Measles: Schwarz or Moraten (Edmonston Zagreb) strain
Mumps: Jeryl Lynn strain
Rubella: RA 27/3 strain
Will my child require a booster?
Possibly, but not necessarily. The second MMR is given in case one or more of the components of the first dose failed to work. It is not given as a booster that is necessary for all children. Each of the three single vaccines protects about 9 out every 10 children. That means that, of children who have received all three single vaccines, about 7 out of 10 will be protected against all three diseases, but three out of ten will be unprotected against at least one. The MMR is no more effective than the single vaccines. One option is to have a blood test to confirm that your child is protected after one injection. We can arrange this for you as you may not be able to have this done on the NHS through your GP.
Practicalities
What should I do if my child has been given the measles vaccine previously by another doctor?
This does not prevent your child from having any of the other single vaccines.
My child has had the MMR. It is now time for his 'booster'. Is he able to have the single vaccines?
Yes, having the MMR once does not prevent your child from receiving any or all of the single vaccines, though your child may not need to have them all again. It may be worth while having a consultation to discuss this. Alternatively, see Will my child require a booster? above.
Will I be able to travel after my child has been given the vaccine?
Yes. Unless your child shows immediate signs of a bad reaction to the vaccine (which is extremely unlikely) you will be allowed to leave shortly after your child has received the immunisation.
Miscellaneous questions
What are the disadvantages of giving the vaccines separately?
The DoH has several concerns about giving the MMR as separate vaccines, a course of action of which it strongly disapproves for the following reasons:
1. The child will remain unprotected whilst waiting for each individual vacine
2. Parents may not return with the child for all the vaccines
3. More injections are necessary
My child has had chickenpox. How long should I wait before giving him or her a single vaccine?"
I recommend a gap of 6 weeks before giving a child a single vaccine after an attack of chickenpox."
What is the minimum age my child can be given one of the single vaccines?
They can be given at any time from 12 months, but it may be preferable to wait until 14-15 months for the first measles vaccine, by which time the body's immune response should have reached a maximum.
My child has had measles. Does he still need the measles vaccines?
The DoH still believes that your child should be immunised (with the MMR) whether or not he or she has had measles. This is partly because the diagnosis may not have been correct. However, if your child has definitely had measles, then he or she has long term natural protection and immunisation is unnecessary. If in doubt, we can arrange a blood test to check if your child is immune to measles.
Is there any way I can tell if my child is already protected against measles, mumps or rubella, either from previous immunisation or from natural infection?
Yes, there is a blood test available to do this. We can arrange this for you if you wish. Please contact us by telephone or fill in the appropriate on-line form to request a blood test.
Is it safe for my child to be given only the single measles vaccine and to leave out the mumps and/or rubella vaccines?
This is, of course, an option available to you with the single vaccines. We believe that you should be encouraged to make your own informed decisions. You may wish to have a consultation to discuss the risks and benefits of the other single vaccines as well as the risks of the illnesses and the reasons for immunisation.
Is it necessary for my son to be given the rubella vaccine?
It is given primarily to prevent him from catching rubella and passing it on to a pregnant woman who may not be protected which could cause serious damage to her unborn baby. If you wish to discuss this further, please book a consultation.
I hear there are difficulties getting the Mumps Vaccine. If my child starts on a course of Single Vaccines how can I be sure that the Mumps Vaccine will be available?
There have been intermittent difficulties in getting supplies of the single mumps vaccine into the UK. The Holborn Medical Centre's provision of single mumps vaccine has been largely uninterrupted.
What can I do if I have more questions?
You have the opportunity to book a consultation with Dr Halvorsen to disuses any issues of concern surrounding the MMR, single antigen vaccines, or any of the other childhood vaccines.