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Vaccination against Measles, Mumps and Rubella

Measles, mumps and rubella are all vaccine preventable diseases. Without immunisation,
children and adults may suffer severe disease, and even death, if infected with these viruses. It is
therefore recommended that all children are immunised against Measles, Mumps and Rubella to
prevent the potentially serious and even fatal complications that can occur with infection with
these viruses.
The current National Immunisation Program Schedule recommends vaccinating children at two
different time points in young childhood. The first is at 12 months of age with the MeaslesMumps-Rubella (MMR) vaccine. The second vaccination should be given at 18 months with the
Measles-Mumps-Rubella-Varicella (MMRV) vaccine. Previously, the second dose of MMR
vaccine was given at 4 years of age. However now the second dose of MMR vaccine has been
combined with protection against varicella (MMRV) and is administered at 18 months of age.
It is also recommended that all women with low levels of rubella antibodies are immunised at
least 28 days before becoming pregnant. For women who are already pregnant and have low
levels of rubella antibodies it is recommended that they be immunised shortly after delivery and
before discharge from the maternity unit. This vaccination should NOT be given to women who
are pregnant or who may become pregnant within 28 days of receiving the vaccine.
What are Measles, Mumps and Rubella?
Measles, Mumps and Rubella are a group of three different diseases caused by three different
viruses. These diseases can be associated with significant and potentially fatal conditions. They
are all preventable with vaccination.
Measles
The measles virus is highly infections and spreads through respiratory secretions. It may take up
to 10-14 days after becoming infected with the virus before you notice any symptoms. Typically
the first symptoms are fever and malaise (general weakness). This may be followed by a cough,
rash and/or inflammation of the lining of the nose and/or eyes (stuffy or runny nose and eyes).
The rash that develops after measles infection generally starts on the face and upper neck before
spreading to other parts of the body.

Measles infection can often result in severe disease and may even result in death. Frequent
complications of measles infection include:
Middle ear infection (Otitis media) in 9% of cases

Lung infection (Pneumonia) in 6% of cases

Diarrhoea in 8% of cases
Rarer complications include infection of the brain (encephalitis), which occurs in 1 in every 1000
cases. Rarely a condition called subacute sclerosing panencephalitis can occur (up to 1 in every
100,000 cases). This is a condition of progressive inflammation of the brain that may only show
signs later in life and often years after measles infection. There is currently no cure for this
disease.

Measles infection during pregnancy can result in miscarriage and premature delivery.
Although measles has been eradicated from Australia due to successful vaccination, ongoing
cases continue to occur from infected travellers.
Mumps
Mumps is a vaccine preventable infection of the salivary glands that is spread through respiratory
secretions, saliva and possibly urine. It may take up to 12-25 days after becoming infected with
the virus before you notice any symptoms. Disease can range from mild upper respiratory tract
infections to widespread systemic disease. Symptoms may include:

Malaise (general weakness)

Loss of appetite

Fever

Headache

Aching muscles.
Characteristic swelling of the parotid gland occurs in about two thirds of cases.
Meningitis, an infection of the membranes that line the brain and spinal cord, occurs in
approximately 10% of patients with mumps infection. Infection of the brain (encephalitis) is less
common and occurs in approximately 1-2 per 10,000 cases. Where infection of the brain

develops death may occur in 1 in every 100 cases. Hearing loss is relatively common where there
is meningitis and/or encephalitis. In most cases the hearing loss is temporary, however, rarely the
deafness can be permanent (1 in 20,000 cases). Inflammation of the testes (Orchitis) is reported
in 15-30% of cases and in rare cases this can lead to sterility (inability to conceive children).
Mumps infection may also affect many other organs in the body including the liver, pancreas,
heart, thyroid and breasts and ovaries in females.
Mumps infection during pregnancy is not associated with an increased risk of deformity,
however, infection in the first trimester may result in spontaneous abortion.
Rubella (German measles)
Rubella (German measles) is a vaccine preventable infection that is spread via respiratory
droplets. It may take up to 14-23 days after becoming infected with the virus before you notice
any symptoms. Symptoms include:

Rash;

Swelling of the lymph nodes (Lymphadenopathy); and/or

Painful joints (Arthritis and arthralgia).


Up to half of all rubella infections may not show any symptoms at all. While complications are
rare, they can be severe and including inflammation of the brain (encephalitis) and changes to the
levels of certain cells in the blood that are important for fighting infection and clotting the blood.
Rubella infection in pregnancy can result in infection of the foetus, causing congenital rubella
syndrome (CRS). There are a wide range of complications associated with CRS including
intellectual disabilities, cataracts (clouding of the lens of the eye that can result in blindness),
deafness, heart defects, poor growth and inflammatory lesions of the brain, liver, lungs and bone
marrow. The earlier in the pregnancy that a woman is infected with rubella, the greater the
likelihood of one or multiple abnormalities arising. Infection in the first trimester is associated
with rates of one or more abnormalities as high as 90%. Where the infection occurs later on in
the pregnancy the rate of one or more abnormalities reduces such that at 16 weeks gestation, this
rate falls markedly to 10 to 20%.
Which vaccines are available that protect against Measles, Mumps and Rubella?

Currently there are two different combinations of


vaccines available in Australia that protect against measles, mumps and rubella. This includes
vaccines that immunise against:

measles, mumps and rubella MMR Vaccine; and

measles, mumps, rubella and varicella (chicken pox) MMRV Vaccine


Measles-Mumps-Rubella MMR Vaccine
The Measles-Mumps-Rubella (MMR) Vaccine immunises against Measles, Mumps and Rubella.
It is recommended for all children aged 12 months of age as per the current National
Immunisation Program Schedule.
Side effects of the MMR vaccine
The frequency of reactions to MMR immunisation are much fewer than the complications of
natural measles.
Adverse events are generally mild and well tolerated. Most common side effects include:
Feeling unwell,

Fever, and

Rash
More serious reactions are rare but may include:

Severe allergic reaction (Anaphylaxis) in less than 1 in 1,000,000) related to an allergy


to gelatin or neomycin, not egg allergy

Bruising or bleeding (3-5 per 100,000) due to changes in the numbers of cells in the
blood responsible for blood clotting. Where this occurs it occurs at rates that are considerably
less than the rates that occur with natural infection

Inflammation of the brain (encephalitis) ~1 in 1,000,000 in cases where this has


occurred it remains uncertain whether it occurred as a result of the vaccination, however if it
does it is at least 1000 times less frequent than the rates that occur with natural infection.
The risks of serious complications as a result of becoming infected with measles, mumps or
rubella from infected persons are much greater than the very small risks of side effects from

MMR immunisation.
Autism and Inflammatory bowel disease
Several studies and expert review panels have concluded that there is no causal relationship
between the MMR vaccine and autism or inflammatory bowel disease (IBD). There was some
unfounded concern previously that the MMR vaccine was linked to a new syndrome of
inflammatory bowel disease that led to decreased absorption of essential vitamins and nutrients
through the gastrointestinal tract and in turn developmental disorders such as autism. A number
of weaknesses in the studies that led to this concern have been demonstrated. Since then over 20
subsequent studies have failed to show any association between the MMR vaccine and these
diseases. Many expert reviews, including a review by the World Health Organisation, have
concluded that the current scientific data does not demonstrate a causal link between the measles
virus vaccine and autism or inflammatory bowel disease. In fact most proponents of the link have
retracted the claim. A substantial body of evidence is now available to refute the link.
Measles-Mumps-Rubella-Varicella MMRV vaccine
The MMRV vaccine is a vaccine that immunises against measles, mumps, rubella and varicella.
Previously the second dose of MMR vaccine was given at age 4 years, however, now that it has
been combined with the varicella vaccine it should be administered at 18 months of age.
Side effects of the MMRV vaccine
Adverse events following immunisation with varicella containing vaccines are generally mild
and well tolerated. The most common adverse events reported are injection site reactions such as:
Pain;

Redness; and/or

Swelling
Other adverse reactions include rash and fever. In very rare cases (less than 0.01%) there has
been a temporal relationship (a relationship in time) with conditions such as anaphylaxis (severe
allergic reaction), encephalitis (inflammation of the brain), ataxia (loss of muscle control during
movements) and changes to the numbers of specific types of cells in the blood. However, it is not
known whether these are the result of immunisation with the vaccine or just a coincidence.

There may be additional side effects related to the measles mumps and rubella components and
are discussed under the MMR vaccine above.
Comparison of the effects of disease and side effects of vaccines

When should the MMR and MMRV vaccines be administered?


As per the National Immunisation Program Schedule the MMR immunisation is recommended at
12 months of age. A second dose in the form of MMRV is recommended at 18 months of age.
Note that previously the second dose of MMR vaccine was given at 4 years of age (instead of the

MMRV at 18 months of age). Therefore if your child is greater than 18 months of age and not yet
received their second MMR immunisation, it can be given at 4 years of age as per the old
schedule.
MMR vaccine may be given to infants aged less than 12 months but greater than 9 months of age
in special circumstances, including during outbreaks or travel to highly endemic areas.
All persons born during or since 1966 who are greater than 18 months of age, should have
documented evidence of receiving 2 doses of a MMR containing vaccine at least 4 weeks apart.
Alternatively there should be evidence of protection for measles, mumps and rubella by way of a
blood test. If this is lacking, immunisation should be considered.
Use of the MMRV vaccine should be avoided in those aged greater than or equal to 14 years of
age secondary to limited information regarding safety and immunogenicity in this age group.
Both the MMR and MMRV vaccines can be given at the same time as other live attenuated or
inactivated vaccines provided separate syringes and injection sites are used. If not given at the
same time, the administration of other live attenuated parenteral vaccines should be at least 4
weeks apart. Similarly if two doses of MMR-containing vaccine are required, the minimum
interval between administering doses is 4 weeks.
Who shouldnt be immunised with the MMR and/or the MMRV vaccines?

There are a number of conditions in which administration of the


MMR and MMRV vaccines should be absolutely avoided. These include:

Anaphylaxis to vaccine components either following a previous dose or following


previous exposure to any vaccine component

Persons who are immunocompromised (including secondary to HIV/AIDS and other


medical condition or those receiving systemic immunosuppressive therapy such as
chemotherapy, radiation therapy or oral corticosteroids)

Pregnant women
Anyone planning a pregnancy or of child bearing age should avoid falling pregnant at least 28
days following immunisation with MMR / MMRV.

Precautions should be taken in those receiving immunoglobulin containing products or who are
taking aspirin regularly. Your Doctor will be able to discuss this in more detail with you as it
needs to be determined on an individual basis.
If you or your child have a personal or close family history of seizures or convulsions it is
important to be aware that immunisation with either MMR or MMRV can result in a febrile
response 5-12 days after vaccination. If this is the case your Doctor can give you advice about
the use of paracetamol and other measures to help reduce fever.
What about those with an egg allergy?
According to the current version of the Australian Immunisation Handbook, children with an egg
allergycan be administered MMR or MMRV. Although measles and mumps vaccine viruses are
grown in chick embryos, they contain negligible amounts of egg ovalbumin, the protein that is
normally associated with egg allergy.
What are the components of each of the vaccines?
The components of each of the vaccines (per 0.5mL reconstituted dose as per the manufacturers
guidelines) available in Australia are listed below.
M-M-R II 1000 tissue culture infectious dose 50% (TCID50) of Enders attenuated
Edmonston measles virus, 12 500 TCID50 of the Jeryl Lynn B level mumps virus, and 1000
TCID50 of the Wistar RA 27/3 rubella virus; sorbitol; sucrose; hydrolysed gelatin; human
albumin; fetal bovine serum; neomycin.
Priorix 103.0 cell culture infectious dose 50% (CCID50) of the Schwarz measles virus,
103.7CCID50 of the RIT 4385 mumps virus, and 103.0 CCID50 of the Wistar RA 27/3 rubella
virus; lactose; neomycin; sorbitol; mannitol.
Priorix-tetra 103.0 CCID50 of the Schwarz measles virus, 104.4 CCID50 of the RIT 4385
mumps virus, 103.0 CCID50 of the Wistar RA 27/3 rubella virus, and 103.3 plaque-forming units
(PFU) of Oka varicella-zoster virus; lactose; neomycin; sorbitol; mannitol.
ProQuad 103.0 TCID50 of Enders attenuated Edmonston measles virus, 104.3 TCID50 of the
Jeryl Lynn B level mumps virus, 103.0 TCID50 of the Wistar RA 27/3 rubella virus, and
103.99 PFU of Oka/Merck varicella virus; sucrose; hydrolysed gelatin; urea; sorbitol;

monosodium L-glutamate; human albumin; neomycin; residual components of MRC-5 cells;


bovine serum albumin.

Kindly written and reviewed by Dr Allison Johns Bsc (Hons) MBBS, Doctor at Child and
Adolescent Health Services, Women and Newborn Health Services and Editorial Advisory
Board Member of Virtual Medical Centre.
References
1.

Australian Government Department of Health. National Immunisation Program Schedule


(online). 20th April 2015. (cited 16 September 2015). Available from: [URL Link]
2.
Australian Government Department of Health. The Australian Immunisation Handbook:
Rubella. 10th Ed (online) 16th July 2015. (cited 2 August 2015). Available from: [URL Link]
3.
Australian Government Department of Health. The Australian Immunisation Handbook:
Measles. 10th Ed (online) 16th July 2015. (cited 2 August 2015). Available from: [URL Link]
4.
Australian Government Department of Health. The Australian Immunisation Handbook:
Mumps. 10th Ed (online) 16th July 2015. (cited 2 August 2015). Available from: [URL Link]
5.
Australian Government Department of Health. Immunise Australia Program. Mumps.
th
10 February 2014. (cited 25 November 2014). Available from: [URL Link]
6.
Australian Government Department of Health. Immunise Australia Program. Rubella.
th
10 February 2014. (cited 25 November 2014) Available from: [URL Link]
7.
Australian Government Department of Health. The Australian Immunisation Handbook
th
10 Ed (online) 2013. (cited 22 November 2014). Available from [Full text]
8.
National Centre for Immunisation Research & Surveillance. MMR vaccine, inflammatory
bowel disease and autism. December 2009. (cited 29 November 2014). Available from: [PDF
File]
9.
Australian Government Department of Health. The Australian Immunisation Handbook:
Varicella. 10th Ed (online) 17th January 2014. (cited 16 September 2015). Available from:
[PDF File]
10.
Australian Technical Advisory Group on Immunisation. The Australian Immunisation
Handbook. 10th ed. Canberra: Australian Government Department of Health and Ageing;
2013. Inside back cover. (cited 16 September 2015). Available from: [PDF File]
11.
Australian Government Department of Health and Ageing. National Vaccine Storage
Guidelines Strive for 5 2nd Edition (online). July 2013. (cited 16 September 2015). Available
from: [PDF File

Kelompok Vaksin Measles Mumps Rubella Vaksin Rubella


Tuesday, October 29th 2013. | Vaksin Rubella
Vaksin Rubella

Penyakit rubella
Source: www.idph.state.il.us
Dalam website ini telah kita bahas tentang penyakit Rubella, baik virus penyebabnya, bahaya
virus ini terhadap janin yang sedang dikandung oleh ibu yang terinfeksi virus Rubella ini, yaitu
efek aborsi janin tersebut, atau janin meninggal sewaktu kelahiran (still birth), lahir dengan
kecacatan fisik (efek teratogenik) dan cacat mental, yang semua ini dikelompokan dalam yang
kita

sebut CRS (Congenital

Rubella

Syndromes),

(http://selukbelukvaksin.com/rubella-

german-measles-campak-jerman/).
Sekarang coba kita lihat apakah penyakit virus ini bisa kita cegah dan memberikan kekebalan
kepada bayi dan orang dewasa, terutama untuk wanita; para calon ibu yang akan mengandung
dan melahirkan, sehingga dengan pemberian vaksinasi yang efektif tetapi juga aman, akan
mengurangi dan mencegah semua kejadian buruk yang berkaitan dengan infekis virus rubella ini.
Pendahuluan
Jauh sebelum kita memiliki vaksin Rubella, penyakit virus ini luas menyebar sampai ke seluruh
dunia, yang setiap 6 hingga 9 tahun sekali akan menyebabkan terjadinya endemi atau Kejadian
Luar Biasa / KLBpenyakit rubella, yang terutama sasaran menyerang anak anak usia sebelum
sekolah (berusia < 5 tahun) dan juga sering menyebabkan terjadi infeksi kelompok dalam
lingkungan asrama sekolah dan tangsi angkatan bersenjata, yang para anggotanya adalah anak
anak muda, yang sensitif terhadap penularan virus dan penyakit rubella.
Pada tahun 1969, vaksin Rubella ini telah didaftarkan di USA dan pemakaian yang luas bisa
menekan jumlah angka kesakitan dari tadinya 200.000 500.000 kasus pertahun hingga hanya
50.000 kasus saja, dan semenjak itu tidak ada lagi kejadian luar biasa penyakit rubella
dikalangan masyarakat di Amerika,

Sedangkan pada bagian dunia atau negara, dimana vaksin rubella ini belum digunakan secara
meluas, masih ditemukan adanya endemi, yang terjadi pada tahun 1971 1972, kemudian tahun
1978 1979 dan 1982 1983.
Hingga saat ini belum ada cara pengobatan penyakit rubella yang bisa diandalkan. Cara ampuh
yaitu dengan memberikan kekebalan tubuh terhadap infeksi virus rubella, sehingga meskipun
terpapar dengan virus rubella, orang tersebut tetap sehat.
Kekebalan Terhadap Penyakit dan Virus Rubella
Ada dua cara mendapatkan kekebalan terhadap penyakit dan virus rubella, yaitu :
1.

Cara Imunisasi Pasif

2.

Cara Imunisasi Aktif

Yang dimaksud dengan Cara Imunisasi Pasif, yaitu :


Dengan mengambil serum orang dewasa yang pernah mengalami infeksi virus rubella dan telah
sembuh, sehingga didalam serum darahnya akan didapatkan antibody untuk menangkal infeksi
virus rubella (immmune serum globulin ISG)
Pada masa sebelum ditemukannya vaksin rubella, kepada wanita hamil yang terpapar dengan
virus rubella disuntikan ISG ini dengan harapan bahwa antibody yang ada dalam serum ini bisa
mencegah infeksi dan menghindarkan janin menjadi cacat karena virus rubella ini. Dan
pengalamannya membuktikan bahwa efektifitas cara ini tidak meyakinkan seperti efektifitas
vaksin anti rubella yang ada saat ini.
Cara Imunisasi Pasif Janin atau bayi yang baru lahir dari ibu yang pernah diberikan vaksiinasi
MMR sebelum hamil.
Pada waktu bayi berusia 0 hingga 0.5 bulan, hampir semua bayi tersebut bisa di deteksi antibody
terhadap virus measles atau campak, virus mumps atau gondongan dan virus campak Jerman
atau rubella.
Antibody ini diperoleh dari ibu nya (maternal antibody). Antibody (Immunoglubulin G/Ig G)
yang berasal dari ibu mulai secara aktif disalurkan ke janin melalui tali pusat semenjak umur
kehamilan mencapai 6 bulan, dan sejak itu jumlah nya semakin meningkat tajam sampai bayi
dilahirkan.
Namun jumlah antibody tersebut akan menurun dengan cepatnya hingga tinggal 50% saja
sebelum bayi tersebut mencapai usia 9 bulan untuk virus campak, dan sebelum mencapai usia 6
bulan untuk virus gondongan dan virus rubella. Pada masa tersebut maka bayi dikatakan kebal
terhadap penyakit campak, penyakit gondongan dan penyakit campak Jerman, karena mereka

memperoleh atibody dari ibu yang telah diberikan vaksinasi MMR. Ini yang dikatakan jenis
Imunisasi Pasif pada Janin dan Bayi.(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC95790/)
Dengan alasan dan latar belakang ini juga, maka ditentukan bahwa jadwal vaksinasi MMR pada
bayi baru mulai diberikan setelah bayi menginjak usia 12 15 bulan atau lebih. Karena pada usia
tersebut, jumlah konsentrasi antibody dari ibu (maternal antibody) sudah menurun, maka
konsekuensinya adalah bayi sudah tidak bisa terlindung oleh antibody dari ibu dan mempunyai
potensi terinfeksi virus penyakit campak, gondongan dan campak Jerman yang beredar
dilingkungan sekitar bayi tersebut, maka pada usia tersebut kita perlu memberikan imunisasi
dengan vaksin anti rubella.
Cara Imunisasi Aktif :
Dengan mengalami infeksi langsung dengan virus rubella maka seseorang akan mendapatkan
kekebalan alamiah yang aktif dan kekebalan ini bisa berlangsung hingga seumur hidup.
Namun ada cara yang lebih sederhana, dan tidak berbahaya namun tetap efektif dan berlangsung
lama hingga seumur hidup juga yaitu dengan memberikan vaksinasi dengan vaksin anti Rubella,
yang sudah ada sejak lama .
Vaksin rubella yang pertama diperoleh dari seorang tentara muda yang terinfeksi dan isolat virus
rubella itu telah dibiakkan berulang kali hingga 77 kali didalam sel ginjal monyet, sehingga
dikenal sebagai virus rubellaHPV 77 (high passage virus 77). Virus ini masih terus dibiakkan
dalam sel binatang lain seperti bebek sebelum dipakai sebagai antigen untuk membuat vaksin,
sehingga dikenal sekarang menjadi virus rubella RA-27/3 yang banyak dipakai untuk
memproduksi vaksin rubella yang kita pergunakan hingga saat ini.
Effektifitas vaksin rubella adalah sangat tinggi, dapat mencapai hingga dan melebihi 95% dalam
pencegahan penyakit rubella pada semua yang telah mendapatkan vaksinasi rubella sebelumnya.
Angka ini mendekati efektifitas imunisasi karena infeksi alamiah (natural immunization)
Vaksin Rubella
Vaksin Rubella adalah jenis vaksin virus hidup yang telah dilemahkan (live attenuated virus
vaccine)
Ada beberapa jenis antigen virus Rubella yang dikembangkan untuk membuat vaksin
Rubella ini, antara lain :

Jensi Vaksin dengan virus type HPV77 yang diisolasi dari seorang tentara yang
menderita penyakit rubella. Virus rubella ini telah dikembangbiakkan hingga 77 kali didalam
sel ginjal monyet, sehingga type virus rubella ini dikenal sebagai HPV77.

Jenis vaksin Cendehill, yaitu jenis virus rubella yang diisolasi dari urine seorang
penderita penyakit rubella. Virus ini juga telah dikembangbiakan puluhan kali didalam
jaringan sel ginjal monyet sebelum dipergunakan untuk membuat vaksin rubella

RA-27/3 adalah jenis virus rubella yang diisolasi dari jaringan ginjal bayi yang terinfeksi
virus rubella, yang kemudian dikembangbiakan sekian puluh kali didalam sel ginjal manusia
(WI38 human diploid cell) untuk dibuatkan vaksin rubella yang kita kenal dan pergunakan
hingga saat ini.

Tujuan pengembangbiakan sekian puluh kali dalam sel atau jaringan makhluk lain adalah
untuk memperoleh virus rubella yang jinak, yang sudah tidak mempunyai potensi atau
kemampuan untuk menginfeksi dan menimbulkan penyakit rubella (efek patogenitas), tetapi
masih mempunyai kemampuan untuk merangsang sel imunitas tubuh manusia untuk
memproduksi antibody (efek antigenitas) untuk melawan dan membunuh virus rubella yang
akan masuk dan menginfeksi tubuh manusia. Ini yang disebut Vaksin hidup yang dilmahkan
(Live attenuated vaccine)
Saat ini hanya jenis virus RA-27/3 tetap dipergunakan untuk membuat vaksin Rubella,
sedangkan 2 jenis sebelumnya telah ditarik dari peredaran.
Vaksin Rubella bisa diperoleh sebagai vaksin Rubella yang monovalent, yaitu RCV (Rubella
Containing Vaccines).
Tetapi saat ini juga sering didapatkan vaksin kombinasi antara vaksin Rubella dengan vaksin
virus lainnya, seperti kombinasi dengan vaksin Campak (vaksin MR vaksin campak rubella),
atau vaksin MMR (vaksin campak, gondongan dan rubella) dan vaksin MMRV yaitu
kombinasi antara vaksin rubella dengan vaksin campak, vaksin gondongan dan vaksin cacar air.
(http://www.who.int/wer/2011/wer8629.pdf)
Cara dan Dosis Pemberian Vaksin Rubella
Vaksin monovalent Rubella (RCV) biasanya diberikan secara suntikan sub kutan (dibawah
jaringan kulit), biasanya diberikan pada saat bayi telah berusia 12 15 bulan, tetapi juga bisa
diberikan pada saat bayi berusia 9 11 bulan atau ber-usia lebih, dan untuk anak remaja dan
orang dewasa.
Pada saat terjadi Kejadian Luar Biasa penyakit campak Jerman (Rubella), atau penyakit
campak dan gondongan, maka vaksinasi MMR ini bisa diberikan juga untuk bayi yang berusia <
9 bulan, dengan tujuan melindunginya dari kemunginan terinfeksi oleh virus virus tersebut,
meskipun daya proteksi vaksin pada bayi ini adalah kurang optimal. Sehingga kita tidak bisa
beranggapan bahwa bayi tersebut telah mendapatkan dosis pertama vaksin MMR, maka pada

saat mencapai usia 12 15 bulan, bayi tersebut tetap akan diberikan vaksinasi MMR dosis yang
pertama sesuai jadwal imunisasi yang berlaku.
Dibanyak negara, termasuk Indonesia, vaksin Rubella diberikan sebagai vaksin kombinasi MR
(Measles Rubella) atau vaksin MMR (Measles Mumps Rubella), dengan jadwal pemberian
vaksin dosis pertama pada saat bayi telah berusia 9 bulan, atau pada saat berusia 12 15 bulan.
Dosis kedua biasanya diberikan pada saat bayi telah berusia 15 18 bulan, atau pada saat anak
usia 4 6 tahun. (http://selukbelukvaksin.com/jadwal-imunisasi-idai-untuk-anak-berusia-0-18tahun/)
Efektifitas vaksin Rubella dan vaksin kombinasi Rubella dengan vaksin virus yang lain adalah
sangat tinggi, yaitu antara 90 100% dan daya proteksinya berlangsung hingga puluhan tahun
kemudian. Ada banyak literature yang mengatakan bahwa jangka waktu proteksi vaksin Rubella
ini

berlangsung

lebih

dari

20

tahun

hingga

seumur

hidup

lamanya.

( http://www.who.int/wer/2011/wer8629.pdf)
Keamanan Vaksin dan Efek Samping Vaksin Rubella
Secara umum, efek samping atau KIPI segera setelah pemberian vaksin Rubella, baik yang
monovalent atau yang kombinasi dengan MR atau MMR dan MMRV, adalah ringan, terutama
pada bayi dan anak anak.
Reaksi samping atau KIPI yang umum dijumpai adalah rasa nyeri, kemerahan dan indurasi
(pembengkakan) ditempat suntikan vaksin tadi. Demam yang derajat sedang dan bentik merah
pada kulit, bayi menjadi rewel, pembesaran kelenjar limpa, nyeri otot dan rasa baal kesemutan
lebih sering dilaporkan. Semua reaksi ini akan menghilang dan sembuh beberapa hari hingga
minggu setelah vaksinasi.
Kontraindikasi dan Perhatian Vaksinasi Rubella
Meskipun tidak ada bukti terjadinya Congenital Rubella Syndrome (CRS) janin pada
pemberian vaksin Rubella secara tidak disengaja kepada ibu hamil, namun karena secara teoritis
dikatakan virus Rubella mempunyai efek teratogenik (menimbulkan cacat fisik) pada janin
dalam kandungan, maka dianjurkan untuk menghindarkan pemberian vaksin Rubella untuk
wanita hamil.
Juga untuk wanita yang ingin hamil, harus menunda kehamilannya minimal satu bulan setelah
pemberian vaksinasi Rubella ini.

Namun Bila Secara Tidak Sengaja, Vaksinasi Rubella Telah Diberikan Pada Wanita Yang
Sedang Hamil, Maka Hal Ini Bukan Menjadi Alasan Kuat Untuk Menggugurkan Janin
Yang Sedang Dikandungnya Itu.
Jenis Vaksin MMR (Measles Mumps dan Rubella) dan Pabrik Pembuatnya
Nama Vaksin &
Pembuat Vaksin

Jenis Virus Measles /


Campak

Jenis Virus Mumps/


Gondongan

Jenis Virus Rubella/


Campak Jerman

MMR II

Jenis virus Moraten


(1000 TCID)

Jenis virus Jerry Lunn


(5000 TCID)

Jenis virus RA27/3


(1000 TCID)

Jenis virus Schwarz


(1000 TCID)

Jenis virus Jerry Lynn


(20.000 TCID)

Jenis virus RA27/3


(1000 TCID)

Jenis virus Schwarz


(1000 TCID)

Jenis virus Urabe


(20.000 TCID)

Jenis virus RA27/3


(1000 TCID)

Jenis virus Schwarz


(1000 TCID)

Jenis virus Urabe

Jenis virus RA27/3


(1000 TCID)

(Merck Sharp and


Dohme)
Priorix
(Glaxo Smith Klein)
Trimovax
(Sanofi Pasteur)
Morupar
(Chiron)

(5000 TCID)

Kelompok Target Untuk Diberikan Vaksinasi Rubella :

Bayi berusia 12 bulan atau lebih

Anak dan remaja yang belum pernah mendapatkan vaksinasi Rubella

Wanita dewasa sebelum kehamilan

Wanita yang pasca melahirkan namun belum pernah mendapatkan vaksinasi Rubella
(masih seronegative terhadap virus rubella)

Pria dewasa yang berada dekat dan atau hidup dalam lingkungan wanita sedang hamil

Tenaga yang bekerja ditempat penitipan dan perawatan anak anak

Tenaga Kesehatan

Mahasiswa yang tinggal bersama dalam asrama dikampus

Tentara yang tinggal bersama dalam barak militer