Disease factor/risk of sequelaeMeaslesMumpsRubellaMMR vaccine
Disease factor
Highest number of U.S. cases894,134 cases in 194117 152,209 cases in 196818 12 million cases in 1964–1965; 57,686 cases in 196919 Highly efficacious in preventing disease
Congenital rubella: 20,000 cases in 1964–196519
Recent number of U.S. cases86 cases in 200020 338 cases in 200020 176 cases in 200020 No cases of congenital rubella reported after immunization of pregnant women, but theoretic risk is 2%21
Congenital rubella: 9 cases in 200020
Transmission routeDropletsDirect contact, airborne droplets, fomites by salivaOral droplets
Congenital rubella: transplacental passage
Transmission risk in susceptible household contacts90% in susceptible household contacts17 Rate not available, because 30% to 40% of infections are subclinical18 50% to 60% in susceptible family members and almost 100% in closed populations19
Incidence of defects in congenital rubella: 50% with infection during first month of pregnancy; 20% to 30% with infection during second month; 5% with infection during third or fourth month11(pp495–500)
Risk of sequelae
Mortality1 to 2 deaths per 1,000 measles cases11(pp385–96),17 2.5 to 50 deaths per 1 million mumps cases, because of 1.4% to 2% fatality rate from encephalitis18,22 1 death per 30,000 rubella cases, because of 20% fatality rate from encephalitis19 1 death, but not attributed to vaccine14
Fatal measles pneumonitis in a 21-year-old man with advanced HIV infection23
Congenital rubella: no data available
Encephalitis1 to 2 cases per 1,000 measles cases17 1 case per 400 to 6,000 mumps cases22 1 case per 5,000 to 6,000 rubella cases19 1 case per 1 million doses14
Subacute sclerosing panencephalitis8.5 cases per 1 million measles cases17 20 reported cases of progressive rubella panencephalitis19 0 to 0.7 cases per 1 million doses14,17
Pneumonia3% of young adults with measles23 2 cases per 1 million doses14
ThrombocytopeniaRare22 1 case per 3,000 rubella cases19 0.5 to 33 cases per 1 million doses11(pp385–96),14
Orchitis14% to 35% of adolescent and adult men with mumps14,18 0.3 cases per 1 million doses14
Anaphylaxis5 cases per 1 million doses (none fatal)14