07 Mar 2025 MMR Vaccination in Adults
MMR vaccination is essential for healthcare professionals, international travelers, and other specific groups.
Measles continues to circulate in the United States, with a large outbreak currently growing in Texas. Adults should be up to date on MMR vaccinations with either 1 or 2 doses (depending on risk factors); unless they have other presumptive evidence of immunity to measles, mumps, and rubella.
1. Adults with presumptive evidence of immunity include:
Presumptive evidence of immunity can be established in any of the following ways:
- Written documentation of adequate vaccines for measles, mumps, and rubella
- Laboratory evidence of immunity (positive IgG titer)
- Laboratory confirmation of disease
- Birth before 1957 (unless they are a healthcare worker)
2. People without presumptive evidence of immunity should get at least one dose of MMR vaccine
3. Certain adults should receive two doses of vaccine, separated by at least 28 days if they don’t have presumptive evidence of immunity.
There is no maximum time between the two doses. These adults include:
- Students at post-high school education institutions
- Healthcare personnel
- International travelers
- Close contacts of immunocompromised people
- People with HIV infection and are not severely immunosuppressed
4. Healthcare workers
- They must have either documentation of two doses of vaccine
- or laboratory evidence of immunity (positive IgG titer).
- Birth before 1957 is not adequate evidence of immunity in this group.
5. Adults who previously received a dose of measles vaccine in 1963–1967:
- and are unsure which type of vaccine it was or are sure it was inactivated (killed) measles vaccine, should be revaccinated with one dose of MMR vaccine
- or, if they fall into high-risk categories (refer #3 and #4), two doses of MMR vaccine.
- People who have documentation of receiving LIVE measles vaccine in the 1960s do not need to be revaccinated unless they fall into high-risk categories (refer #3 and #4).
6. Most adult vaccinated between 1968-1989 received one dose of MMR and do not need further doses:
unless they fall into one of the high-risk categories (refer #3 and #4) and don’t otherwise have presumptive immunity.
In an outbreak setting, when there is sustained or widespread community transmission, PDPH and other health departments may recommend a second dose of the MMR vaccine to some groups that may previously have been considered to have presumptive immunity with just one dose.
* Do not check titers on people who have documentation of two appropriately timed vaccines.