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The MMR vaccine is an immunization vaccine against measles, mumps, and rubella (German measles). It is a mixture of live attenuated viruses of the three diseases, administered via injection. It was first developed by Maurice Hilleman while at Merck. A licensed vaccine to prevent measles first became available in 1963, and an improved one in 1968. Vaccines for mumps and rubella became available in 1967 and 1969, respectively. The three vaccines (for mumps, measles, and rubella) were combined in 1971 to become the measles-mumps-rubella (MMR) vaccine.〔(''Measles: Questions and Answers,'' ) (Immunization Action Coalition ).〕 The MMR vaccine is generally administered to children around the age of one year, with a second dose before starting school (i.e. age 4/5). The second dose is a dose to produce immunity in the small number of persons (2–5%) who fail to develop measles immunity after the first dose.〔 In the United States, the vaccine was licensed in 1971 and the second dose was introduced in 1989. It is widely used around the world; since introduction of its earliest versions in the 1970s, over 500 million doses have been used in over 60 countries. The vaccine is sold by Merck as ''M-M-R II'', GlaxoSmithKline Biologicals as ''Priorix'', Serum Institute of India as ''Tresivac'', and Sanofi Pasteur as ''Trimovax''. It is usually considered a childhood vaccination. However, it is also recommended for use in some cases of adults with HIV.〔(【引用サイトリンク】title=Case 4: Discussion - Appropriate Vaccinations - Initial Evaluation - HIV Web Study )〕〔(【引用サイトリンク】title=Measles, Mumps, and Rubella -- Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP) )〕 ==Effectiveness== Before the widespread use of a vaccine against measles, its incidence was so high that infection with measles was felt to be "as inevitable as death and taxes." Reported cases of measles in the United States fell from hundreds of thousands to tens of thousands per year following introduction of the vaccine in 1963. Increasing uptake of the vaccine following outbreaks in 1971 and 1977 brought this down to thousands of cases per year in the 1980s. An outbreak of almost 30,000 cases in 1990 led to a renewed push for vaccination and the addition of a second vaccine to the recommended schedule. Fewer than 200 cases have been reported each year between 1997 and 2013, and the disease is no longer considered endemic.〔Centers for Disease Control and Prevention (Summary of notifable diseases—United States, 1993 ) Published October 21, 1994 for Morbidity and Mortality Weekly Report 1993; 42 (No. 53)〕〔Centers for Disease Control and Prevention (Summary of notifable diseases—United States, 2007 ) Published July 9, 2009 for Morbidity and Mortality Weekly Report 2007; 56 (No. 53)〕〔Centers for Disease Control and Prevention. (Epidemiology and Prevention of Vaccine-Preventable Diseases ). Atkinson W, Wolfe S, Hamborsky J, McIntyre L, eds. 11th ed. Washington DC: Public Health Foundation, 2009〕 The benefit of measles vaccination in preventing illness, disability, and death has been well documented. The first 20 years of licensed measles vaccination in the U.S. prevented an estimated 52 million cases of the disease, 17,400 cases of intellectual disability, and 5,200 deaths. During 1999–2004, a strategy led by the World Health Organization and UNICEF led to improvements in measles vaccination coverage that averted an estimated 1.4 million measles deaths worldwide. Between 2000 and 2013, measles vaccination resulted in a 75% decrease in deaths from the disease.〔(【引用サイトリンク】 title=Measles Fact Sheet #286 )〕 Measles is endemic worldwide. Although it was declared eliminated from the U.S. in 2000, high rates of vaccination and good communication with persons who refuse vaccination is needed to prevent outbreaks and sustain the elimination of measles in the U.S.〔 Of the 66 cases of measles reported in the U.S. in 2005, slightly over half were attributable to one unvaccinated individual who acquired measles during a visit to Romania. This individual returned to a community with many unvaccinated children. The resulting outbreak infected 34 people, mostly children and virtually all unvaccinated; 9% were hospitalized, and the cost of containing the outbreak was estimated at $167,685. A major epidemic was averted due to high rates of vaccination in the surrounding communities. Mumps is another viral disease of childhood that was once very common. If mumps is acquired by a male who is past puberty, a possible complication is bilateral orchitis which can in some cases lead to sterility.〔 〕 Rubella, otherwise known as German measles, was also very common before the advent of widespread vaccination. The major risk of rubella is in pregnancy. If a pregnant woman is infected, her baby may contract congenital rubella from her, which can cause significant congenital defects. The combined MMR vaccine was introduced to induce immunity less painfully than three separate injections at the same time, and sooner and more efficiently than three injections given on different dates. In 2012, the Cochrane Library published a systematic review of scientific studies. Its authors concluded, "Existing evidence on the safety and effectiveness of MMR vaccine supports current policies of mass immunisation aimed at global measles eradication and in order to reduce morbidity and mortality associated with mumps and rubella."〔 As measles and rubella cause upper respiratory disease that leads to complications of pneumonia and bronchitis which are also caused by varicella, MMR vaccine is beneficial to control exacerbations of chronic obstructive pulmonary disease (COPD) and asthma. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「MMR vaccine」の詳細全文を読む スポンサード リンク
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