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Do a complete history and physical exam and review your patient’s vaccination history before administering the vaccine. Ask if your patient is taking any medications, has any allergies, or has ever reacted to a vaccine previously. Do not give it if they have ever had a severe allergic reaction (anaphylaxis) to a component of the vaccine or to the antibiotic neomycin. Pregnancy is a contraindication to giving the MMR vaccine – do not give pregnant women this injection. If your female patient is unsure whether she is pregnant, do a urine test to ensure she is not before administering the vaccine. Let her know this is for her and her baby's safety.   Wait until after the baby is born to give the vaccine. Advise women not to get pregnant for 4 weeks after getting the vaccine. Severe immunocompromise is a contraindication to the MMR vaccine. Take a thorough medical history of your patient. Do not give them MMR if they suffer from poor immunity due to any of the following:  HIV with severe immunocompromise (having the virus alone is not a contraindication if they are in generally good health) Any type of cancer or cancer treatment Current chemotherapy or radiation therapy Congenital immunodeficiency Low platelet count Received another vaccine in the past four weeks Received a recent blood transfusion Long-term immunosuppressive therapy, such as with corticosteroids Some circumstances are not contraindications to the vaccine, but may make it more likely the patient will have an adverse reaction or the vaccine may not work properly. Don’t give the vaccine if any of these conditions are present, unless the benefit outweighs the risk. Use your best clinical judgment! Consider deferring the MMR vaccine if:   The patient received antibody-containing blood products in the last 11 months The patient has a history of thrombocytopenia or thrombocytopenia purpura The patient will need TB testing or interferon-gamma release assay (IGRA) testing within the next few days; do not give the vaccine if you suspect active TB is present The patient is moderately to severely ill (mild acute illness is usually not a problem)
Screen for a history of allergic reaction. Do NOT give MMR to a pregnant woman. Avoid the MMR vaccine in immunocompromised patients. Determine if circumstances necessitate waiting on or avoiding certain vaccines.