Recommendations and Reports / Vol. 62 / No. 4 June 14, 2013 Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP)U.S. Department of Health and Human Services Centers for Disease Control and PreventionMorbidity and Mortality Weekly ReportRecommendations and ReportsFront cover photos: (Left) A thin-section transmission electron micrograph (TEM) that shows the ultrastructural appearance of a single virus particle, or “virion,” of measles virus. (Center) A transmission electron micrograph (TEM) that shows the presence of numerous paramyxovirus virions, which in this instance, were responsible for a case of the mumps. (Right) A transmission electron micrograph (TEM) that shows a number of rubella virions.The MMWR series of publications is published by the Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333. Suggested Citation: Centers for Disease Control and Prevention. Title. MMWR 2013;62(No. RR-#):inclusive page numbers.Centers for Disease Control and Prevention Thomas R. Frieden, MD, MPH, Director Harold W. Jaffe, MD, MA, Associate Director for Science James W. Stephens, PhD, Director, Office of Science Quality Denise M. Cardo, MD, Acting Deputy Director for Surveillance, Epidemiology, and Laboratory Services Stephanie Zaza, MD, MPH, Director, Epidemiology and Analysis Program OfficeMMWR Editorial and Production StaffRonald L. Moolenaar, MD, MPH, Editor, MMWR Series Christine G. Casey, MD, Deputy Editor, MMWR Series Teresa F. Rutledge, Managing Editor, MMWR Series David C. Johnson, Lead Technical Writer-Editor Denise Williams, MBA, Project EditorMartha F. Boyd, Lead Visual Information Specialist Maureen A. Leahy, Julia C. Martinroe, Stephen R. Spriggs, Terraye M. Starr Visual Information Specialists Quang M. Doan, MBA, Phyllis H. King Information Technology SpecialistsMMWR Editorial Board William L. Roper, MD, MPH, Chapel Hill, NC, Chairman Matthew L. Boulton, MD, MPH, Ann Arbor, MI Virginia A. Caine, MD, Indianapolis, IN Barbara A. Ellis, PhD, MS, Atlanta, GA Jonathan E. Fielding, MD, MPH, MBA, Los Angeles, CA David W. Fleming, MD, Seattle, WA William E. Halperin, MD, DrPH, MPH, Newark, NJ King K. Holmes, MD, PhD, Seattle, WATimothy F. Jones, MD, Nashville, TN Rima F. Khabbaz, MD, Atlanta, GA Dennis G. Maki, MD, Madison, WI Patricia Quinlisk, MD, MPH, Des Moines, IA Patrick L. Remington, MD, MPH, Madison, WI John V. Rullan, MD, MPH, San Juan, PR William Schaffner, MD, Nashville, TNCONTENTSIntroduction .2Methods .2Background and Epidemiology of Measles .2Background and Epidemiology of Rubella and Congenital Rubella Syndrome .4Background and Epidemiology of Mumps .6Vaccines for Prevention of Measles, Rubella, and Mumps.7Vaccine Dosage, Administration, and Storage.12Contraindications and Precautions.12Safety of MMR and MMRV Vaccine .14Immune Globulin for Prevention of Measles .17Evidence of Immunity .18Rationale for Measles, Rubella, and Mumps Vaccination .20Recommendations for Vaccination for Measles, Rubella, and Mumps .20Recommendations during Outbreaks of Measles, Rubella, or Mumps .23Future Directions .25Acknowledgments .25References .25CDC Adoption of ACIP Recommendations for MMWR Recommendations and Reports, MMWR Policy Notes, and Immunization Schedules (Child/Adolescent, Adult) ACIP is chartered as a federal advisory committee to provide expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) on use of vaccines and related agents for the control of vaccine- preventable diseases in the civilian population of the United States. Recommendatio