Guidelines for Adult Immunisation

Available Vaccines



Mumps is a mild childhood infection most commonly affecting children aged between 5 and 9 years old. It is caused by a mumps virus (genus Rubulavirus, family Paramyxoviridae) and transmitted from human to human through direct contact or by airborne droplets. Individuals with mumps are contagious from 2 days before, through 9 days after the onset of parotid swelling. The initial clinical features include fever, malaise, headache, and the characteristic parotid swelling. Mumps may also affect adults who are at a higher risk of complications such as meningitis, orchitis and hearing loss. Very rarely, encephalitis with long term neurological sequalae (including paralysis, seizures and cranial nerve palsies) may occur. Orchitis occurs in a fifth of post-pubertal males who develop mumps. In 20% of orchitis cases, both testes are affected, but mumps orchitis is rarely associated with permanently impaired fertility. Symptomatic oophoritis and mastitis are relatively uncommon and apparently without long-lasting consequences. Acquisition of mumps during the first 12 weeks of pregnancy is associated with a 25% incidence of spontaneous abortions, but foetal malformations following mumps virus infection during pregnancy have not been reported. Pancreatitis is reported as a complication in approximately 4% of cases, but the relationship between mumps, pancreatitis and diabetes mellitus remains speculative.


  • A number of live-attenuated mumps vaccines are available, in the form of combination vaccine with measles, rubella, or varicella vaccines or some combination of these. When using the combined measles-mumps-rubella (MMR) vaccine, or measles-mumps-rubella-varicella (MMRV) vaccine, the protective immune responses to each individual vaccine antigen as well as vaccine associated adverse events, remain largely unchanged. They are safe, effective and provide long-lasting immunity.

Vaccines Available in Malaysia


1. MMR II®
(Live attenuated measles, mumps and rubella vaccine)
Merck Sharp & Dohme (Malaysia) Sdn Bhd/Merck Sharp & Dohme Corp. USA

2. Proquad®
(Live attenuated measles, mumps and rubella plus varicella vaccine)
Merck Sharp & Dohme (Malaysia) Sdn Bhd/Merck Sharp & Dohme Corp. USA

3. Priorix®
(Live attenuated measles, mumps and rubella vaccine)
GlaxoSmithKline Pharmaceutical Sdn Bhd/GlaxoSmithKline Biologicals S.A., Belgium

4. Priorix Tetra®
(Live attenuated measles, mumps and rubella plus varicella vaccine)
GlaxoSmithKline Pharmaceutical Sdn Bhd/GlaxoSmithKline Biologicals S.A., Belgium

5. SII Measles, Mumps and Rubella Virus Vaccine®
(Live attenuated measles, mumps and rubella vaccine, single or 10 doses)
SM Pharmaceuticals Sdn Bhd/Serum Institute of India

Mode of Administration

  • Mumps vaccines are administered subcutaneously.

Co-administration with Other Vaccines

MMR can be administered simultaneously with diphtheria, tetanus toxoids and acellular or whole-cell pertussis vaccine (DTaP/DTP), oral or inactivated poliovirus vaccine, H. influenzae type b conjugate vaccine, hepatitis B vaccine, or live attenuated influenza vaccine without impairing antibody responses or increasing rates of serious adverse events. There is an increased, albeit small, risk of febrile seizures following tetravalent measles-mumps-rubella-varicella vaccine when compared to concomitant administration of MMR and varicella vaccine in children aged 12-23 months when the vaccines are given for the first time. There was no increase in febrile seizures after the second dose of MMRV.

Contraindications and Adverse Effects

  • Caution should be exercised when administering MMR to people who have a history of an anaphylactic reaction to gelatin or gelatin-containing products.

  • Those who have a history of anaphylactic reactions to neomycin should not receive the vaccine; a history of contact dermatitis to neomycin is not a contraindication to vaccination.

  • Mumps-containing vaccine should be given at least 2 weeks before the administration of blood products or deferred until 3 -11 months after such administration, depending on the nature of the blood product as passively acquired antibodies can interfere with response to the vaccine. (Refer to Table 10.1)

  • Mumps-containing vaccine should not be given to pregnant women because of the theoretical risk of foetal damage. Likewise, vaccinated women should avoid pregnancy for 1 month after vaccination.

  • MMR or MMRV vaccine should not be given to people with acquired immunocompromised immunity (leukemia, lymphoma, generalised malignancy, or therapy with corticosteroids, alkylating drugs, antimetabolites, or radiation).

  • Aside from low-grade fever, the most common adverse reaction to mumps vaccination is parotitis, occurring in less than 1-3% of vaccines. Orchitis, pancreatitis and sensorineural deafness following mumps vaccination are rare and encephalitis following vaccination does not occur more frequently than the background rate in the normal population.

  • To date, the most frequently reported adverse events for MMR vaccines received by the National Pharmaceutical Regulatory Agency (NPRA) are pyrexia, maculo-papular rash and pruritus.

Target Groups in Malaysia

  • MMR vaccine is recommended for all children and for certain high-risk groups of adolescents and adults including travelers, university and college students.

  • All healthcare workers (HCWs) and any staff who are in regular contact with patients should be immune to mumps. Transmission of mumps in health-care settings affects both HCWs and patients. It is recommended that all HCWs without history of mumps or mumps vaccination should be vaccinated.

Evidence for Effectiveness

  • In studies of trivalent formulations with measles and rubella vaccines, seroconversion following administration of MMR containing the Jeryl Lynn strain ranged between 90% and 98%.

  • Serologic studies show that neutralising antibodies remain for at least 12 years after vaccination.


  1. The Malaysian National Centre of Adverse Drug Reactions database. Accessed October 10, 2019.
  2. Mumps Vaccines Mumps virus vaccines. WHO position paper (2007). WHO Weekly Epidemiol Record 82: 49-60
  3. National Pharmaceutical Regulatory Agency (NPRA),, Ministry of Health Malaysia. Senarai Produk Vaksin Berdaftar Dengan Pihak Berkuasa Kawalan Dadah. Updated September 5, 2019
  4. Rubin, S.A. & Plotkin, S.A. (2018).  Mumps vaccine in Stanley Plotkin, Walter Orenstein and Paul Offit.
  5. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP) for the Control and Elimination of Mumps. (2006). PsycEXTRA Dataset, 55(22), 629-630. doi:10.1037/e566472006-004 Vaccines. (7th Ed). PA: Elsevier.