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**IMPORTANT INFORMATION** MMR vaccination programme

Date published: 08/11/2019

Please see below important information from the Screening & Immunisation Team, Public Health England (South East):


Dear Colleagues,

I am writing to make you aware of a recent change in the Green Book in relation to the MMR vaccination programme.

The current advice is: if a child is given a second dose of MMR vaccine under 18 months of age, they will still require a third dose at three years and four months of age.*

Therefore the previous advice is no longer correct that if two doses were given over 12 months of age, at least 3 months apart and under 18 months of age, no further dose of MMR is required at the pre-school immunisations.

*Those individuals that were vaccinated with the second dose between 15 and 18 months of age under the previous guidance, who have had their pre-school immunisations will not require recall for a third dose of MMR vaccine.

Green Book Chapter 21:

The first dose of MMR should be given between 12 and 13 months of age (i.e. within a month of the first birthday). Immunisation before one year of age provides earlier protection in localities where the risk of measles is higher, but residual maternal antibodies may reduce the response rate to the vaccine. The optimal age chosen for scheduling children is therefore a compromise between risk of disease and level of protection. If a dose of MMR is given before the first birthday, either because of travel to an endemic country, or because of a local outbreak, then this dose should be ignored, and two further doses given at the recommended times between 12 and 13 months of age (i.e. within a month of the first birthday) and at three years, four months to five years of age (see Chapter 11).

A second dose is normally given before school entry but can be given routinely from eighteen months. Maternal antibodies may reduce the response to the first dose of vaccination up to the age of 18 months (Orenstein et al., 1986; Redd et al., 2004; De Serres et al., 1995). To provide additional protection to those who fail to respond to the first dose, therefore, the second dose should not routinely be given below 18 months. Where protection against measles is urgently required, a second dose can be given one month after the first (Anon., 1998). If the child is given the second dose at less than 18 months of age, then another routine dose (a third dose) should be given after 18 months (and at least one month after the previous dose) in order to ensure full protection.

Link to Green Book Chapter 21:

If you have any queries please contact the Screening & Immunisation Team as follows:
Kent and Medway –
Screening & Immunisation Team
Public Health England (South East)
NHS England and NHS Improvement - South East Region / /