Explaining MMR Vaccine

The MMR vaccine is a vaccine that works against measles, mumps, and rubella (German measles). Generally, the first dose is given to children around 9 to 15 months of age, with a second dose at 15 months to 6 years of age, with at least 4 weeks between the doses. After two doses, 97% of people are guarded against measles, 88% against mumps, and about 97% against rubella. The vaccine is also recommended for the people who do not have evidence of immunity, those with well-controlled HI V/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized.

Measles, Mumps, and Rubella

Measles is an almost invariable clinical experience of childhood, and most of the time is considered a severe disease. Frequently it is complicated by middle-ear infection or bronchopneumonia. In a few countries, it is a substantial cause of illness and fatalities. According to WHO, encephalitis occurs in about one of every 2000 reported cases; most of the time survivors have permanent brain damage and mental retardation. Death, predominantly from respiratory and neurological causes, occurs in one of every 3000 reported measles cases. The risk of death is greater for infants and adults as compared to children and adolescents.

Contracting measles at the time of pregnancy increases fetal risk. Most commonly, this risk includes premature labor and moderately amplifies the rates of spontaneous abortion and low birth weight. Subacute sclerosing panencephalitis, a sluggish virus infection of the central nervous system, is linked with the measles virus. It is to be highlighted that, in the United States of America, widespread utilization of the MMR vaccine has resulted in the virtual eradication of this infection.

Mumps is an acute disease of children and young adults, caused by a paramyxovirus of which there is only one serotype. Mumps virus generates no symptoms in about one-third of infected people. In those with a clinical symptom, glandular and nerve tissue is most often affected. The most common symptoms are fever and swelling of the parotid glands. Other complicated symptoms, which may occur simultaneously with these signs or in any sequence, are epididymo-orchitis, meningo-encephalitis, cranial nerve involvement (especially eighth cranial nerve damage leading to hearing impairment), pancreatitis, oophoritis, mastitis, and myocarditis. Frequent viruria and abnormal renal function suggest that mumps virus may infect the kidneys. In some cases, one or more of the other implications may be produced in the absence of parotitis.

The most prevailing complication of mumps in children is meningitis, sometimes linked with encephalitis, and in young adults orchitis. Most complications because of mumps infection resolve without permanent damage. Death due to mumps is rare and is mostly because of mumps encephalitis. Many people reach adulthood without developing immunity and potential target populations for immunization; therefore, consist of both children and susceptible adults.

Rubella or German measles leads to a mild exanthematous illness with a few constitutional symptoms and happens most commonly in childhood. If the infection occurs in a woman in early pregnancy however, the virus may cross the placenta to reach the fetus, in which the infection can induce birth defects. These defects may be fatal and permanent and consist of congenital heart disease, cataract formation, deafness, and mental retardation. The prevention of fetal infection, therefore, is the primary aim of rubella immunization.

To meet the requirement of an international standard for an anti-rubella serum for utilization in the assay of rubella antibodies and the control of specific (anti-rubella) immunoglobulins, the WHO Expert Committee on Biological Standardization set up the second International Reference Preparation of Anti-Rubella Serum in 1970. The Requirements for Rubella Vaccine (Live) were taken into account by the Committee in 1977, with an Addendum in 1992.

The Vaccination

According to the Centers for Disease Control and Prevention (CDC), people should get the MMR vaccine to get protected against measles, mumps, and rubella. Children should be injected with two doses of MMR vaccine, beginning with the first dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults should also be synced up on their MMR vaccination. Children may also get MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for utilization in children who are 12 months through 12 years of age.
Who Should Get MMR Vaccine?

  • Children

CDC advises all children should get two doses of MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

  • Adults

Adults who do not show presumptive evidence of immunity should receive a minimum of one dose of MMR vaccine.
Certain adults may require two doses. Adults who are going to be in a specific setting that is at high risk for measles or mumps transmission should make sure they have had two doses separated by at least 28 days. These adults include consist of-

    • Students at post-high school education institutions

    • Healthcare personnel

    • International travelers

    • People who public health authorities determine are at increased risk during an outbreak

  • International Travelers

People 6 months of age and older who are planning to travel internationally should be protected against measles before any international travel.

  • Healthcare Personnel

Healthcare personnel without the trace of immunity should receive at least two doses of MMR vaccine, separated by at least 28 days.

  • Women of Childbearing Age

Women of childbearing age should consult their doctor to make sure they are vaccinated before they get pregnant. Women of childbearing age who are not pregnant and do not have presumptive evidence of immunity should get at least one dose of MMR vaccine.

  • Groups at increased risk for mumps because of a mumps outbreak

At the time of a mumps outbreak, public health authorities might advise an additional dose of MMR vaccine for people who belong to groups at increased risk of getting infected with mumps. Usually, these groups are those who are likely to have close contact, such as sharing sports equipment or drinks, kissing, or living in close quarters, with a person who has mumps. Your local public health authorities or institution are going to communicate with the groups at risen risk that they should receive this dose. If anyone belonging to this category has already two doses of MMR, it is not necessary to get vaccinated unless you are part of this group.

Who Should Not Receive the MMR Vaccine?

Some people should not get MMR vaccine or should wait for a while. These people include:

  • Who have any chronic, life-threatening allergies. A person who has ever had a life-threatening allergic reaction after being injected with a dose of MMR vaccine, or has a complicated allergy to any part of this vaccine, may be advised not to be vaccinated. These people should ask their health care providers if they want information about vaccine components.

  • A person who is pregnant, or thinks she might be pregnant. Pregnant women should wait to get the MMR vaccine until after they are no longer pregnant. Women should avoid getting pregnant for at least 1 month after receiving the MMR vaccine.

  • Those who have a weakened immune system because of disease (such as cancer or HIV/AIDS) or certain medical treatments (such as radiation, immunotherapy, steroids, or chemotherapy).

  • Has a parent, brother, or sister with a history of immune system conditions and problems.

  • Has ever had a condition that makes them getting bruised or bleed easily.

  • Has recently had a blood transfusion or received other blood products. They might be advised to postpone MMR vaccination for a minimum of 3 months or more.

  • People suffering from tuberculosis.

  • Has gotten any other vaccines in the past 4 weeks. Live vaccines injected in a short duration might not work as well.

  • People who are not feeling well. A mild illness, such as a cold, is usually not a factor to delay vaccination. However, doctors generally advise that someone who is moderately or severely ill should probably wait.

Market Scenario for MMR Vaccine

The Global MMR Vaccine Market was approximately valued at USD 697 Million in 2019 and is anticipated to reach about USD 939 Million by 2027, expanding at a CAGR of around 4% during the forecast period.  As explained above measles, mumps and rubella (MMR) vaccines are a fusion of live viruses that are given as an injection. Live viruses are inactivated and cannot replicate in the human cells as the immune system develops a response and defends against the actual infection.

The market growth is propelled by factors such as growing incidences of MMR, surging number of patients with autoimmune disease, increasing focus on immunization programs, and rising awareness among consumers for the vaccine. Conversely, the high cost of vaccine development and lack of information and unavailability of vaccines in rural areas are major restraints of this market. Growth of healthcare providers in growing markets and opportunity for vaccine manufacturer, growth in adoption of MMR Vaccine to prevent coronavirus infectious disease (COVID-19), and surge in adoption of combination vaccines are bolstering the market growth.
The Perspective of Market Segment

In terms of age group, the Global MMR Vaccine Market is bifurcated into infants and preschoolers. The infant segment is projected to expand at a CAGR of 3.7% at the time of the forecast period because of surging government initiatives to cut the prevalence of diseases through immunization. The preschooler segment is anticipated to account for 41.0% share of the market in 2020 attributing to its surging effectiveness in immunity from the measles, mumps, and rubella.

Associated terminologies

Infant: An infant is a term utilized for the newborn baby or neonatal, and toddler. The infant age fluctuates from 12 months to 18 months and is generally given the first dose of the MMR vaccine. In a few cases, infants can get an MMR vaccine from the age of 6 months, for instance for post-exposure prophylaxis Intramuscular IG (IGIM) condition. It is a rare case when the vaccine is rarely repeated if the 1st dose is provided at < 11 months of age. The repeat dose of the MMR vaccine is not always needed and is subjected to some special cases of children. The immunization status of the infant or neonatal is understood to provide the MMR vaccine to the baby before completing the 12months of the age. A dose given at about 11 months of age (before 12 months of age) can offer enough immunogenic, particularly in infants born to mothers with vaccinated antibody measles rather than natural infection. One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella.

Pre-schooler: Children aged between 4 years to 6 years are termed, preschoolers. Children in this age group are not considered n the age group of infants. Most of the children at this age attend formal nursery programs. Usually, informal nursery programs the preschoolers learn basic life skills, independence, and basic skills need when they move forward with primary schooling. The 2nd dose of the MMR vaccine is usually advised to be given in this period of age to children to fully prevent the body from measles, mumps, and rubella virus for a lifetime. Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps.

End-Users Segmentation

Based on end-users, the market is fragmented into hospitals, clinics, and healthcare centers. The hospital segment is anticipated to hold a major share of the market during the forecast period. The growth can be attributed to the surging incorporation of the MMR vaccine in a majority of private and public hospitals globally. The healthcare centers segment is anticipated to grow at a substantial pace because of improvements in infrastructure and universal healthcare systems, especially in developing countries.

Regional Insights about the Market

In terms of regions, the market is segmented into North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. The Asia Pacific is a promising region for the market. The region accounted for 50.0% share of the market in 2020. The market in the region is anticipated to expand at a CAGR of around 4.2% during the forecast period. Surging population and rising healthcare expenditure are propelling the MMR vaccine market in the Asia Pacific. The market in North America is anticipated to expand at a CAGR of 3.6% because of the growing prevalence of measles in the region.

Key Players in the Market

Prominent players in the market include MedImmune, Johnson & Johnson Private Limited, Merck & Co., Inc., Sanofi, Serum Institute of India Pvt. Ltd., Bavarian Nordic, Astellas Pharma India Private Limited, CSL Limited, Emergent BioSolutions Inc., and GlaxoSmithKline PLC.

  • The players are using key strategies such as acquisition, and geographical expansion where a potential opportunity for the MMR Vaccine extraction is integrated into the company’s capacity.

  • For example, in 2020, Merck & Co., Inc. completed the acquisition of Themis, a privately-held company aimed at vaccines and immune-modulation therapies for infectious diseases and cancer.

  • In May 2020, GlaxoSmithKline PLC and Samsung Biologics Co. Ltd., a contract development, manufacturing, and analytical testing services company, entered into a partnership for offering an additional capacity of manufacturing and supplying innovative biopharmaceutical therapies to former.