Health professionals should refer to the Communicable Diseases Manual for detailed guidance on public health management of measles contacts. If support is required, health professionals should contact their local public health service.
Post-exposure MMR vaccination
We recommend prompt vaccination with MMR for all contacts without acceptable evidence of immunity.
Unvaccinated or partially vaccinated (those with only one documented dose of MMR) contacts should be vaccinated promptly with MMR. MMR given within 72 hours of exposure may reduce the risk of developing disease. If immunisation is given more than 72 hours after exposure it is less likely to prevent infection.
Further cases of measles may occur if someone is already incubating the disease, but the liberal use of MMR should reduce the likelihood of ongoing transmission.
It is safe to give MMR to people who are already immune, and we recommend that contacts without evidence of immunity should be vaccinated promptly.
Evidence of immunity
Acceptable evidence of immunity is:
- anyone born before 1 January 1969
- documentation of immunity (positive measles IgG) or previous infection
- for children aged 12 months to under 15 months: documentation of at least one dose of measles-containing vaccine after their first birthday
- for individuals aged 15 months and older: documentation of two doses of measles-containing vaccine, given at least one month apart and given from 12 months of age:
Note that from 1 October 2020 the MMR vaccine was moved from being given at 15 months and 4 years to being given at 12 months and 15 months.
It is safe to give MMR (or NHIG, as indicated in the measles chapter of the immunisation handbook) to people who are already immune.
Exclusion from school or work of contacts having received MMR
Vaccination with MMR post-exposure cannot guarantee protection.
Previously unvaccinated contacts who have received their first documented MMR vaccination post-exposure (regardless of timeframe) should quarantine (i.e., stay home unless seeking health care) from seven days after first exposure until 14 days after their last exposure, unless they subsequently provide acceptable evidence of immunity.
Partially vaccinated contacts (those with only one documented dose of MMR):
Will not be requested to quarantine, but
- Should be excluded from higher risk settings*, unless the setting is one where all others present have acceptable presumptive evidence of immunity, and
- The contact will continue to be monitored for signs and symptoms consistent with measles for at least 14 days, and
- A second MMR needs to be administered as soon as possible (but at least four weeks from the first dose).
* Higher risk settings include early childhood education centres, healthcare, and other settings where there may be high levels of contact and with susceptible people who may be more prone to developing severe disease if infected.
Previously partially vaccinated contacts who receive their second dose of MMR within 72 hours after first exposure are not considered susceptible and will not be excluded from high risk settings.