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The MMR vaccine is a vaccine against measles, mumps, and rubella, abbreviated as MMR. The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, with at least four weeks between the doses. After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella. The vaccine is also recommended for those who do not have evidence of immunity, those with well-controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized. It is given by injection. The MMR vaccine is widely used around the world. Worldwide over 500 million doses were administered between 1999 and 2004, and 575 million doses have been administered since the vaccine's introduction worldwide. Measles resulted in 2.6 million deaths per year before immunization became common. This has decreased to 122,000 deaths per year as of 2012, mostly in low-income countries. Through vaccination, as of 2018, rates of measles in North and South America are very low. Rates of disease have been seen to increase in populations that go unvaccinated. Between 2000 and 2018, vaccination decreased measles deaths by 73%. Side effects of immunization are generally mild and resolve without any specific treatment. These may include fever, as well as pain or redness at the injection site. Severe allergic reactions occur in about one in a million people. Because it contains live viruses, the MMR vaccine is not recommended during pregnancy but may be given while breastfeeding. The vaccine is safe to give at the same time as other vaccines. Being recently immunized does not increase the risk of passing measles, mumps, or rubella on to others. There is no evidence of an association between MMR immunisation and autistic spectrum disorders. The MMR vaccine is a mixture of live weakened viruses of the three diseases. The MMR vaccine was developed by Maurice Hilleman. It was licensed for use in the US by Merck in 1971. Stand-alone measles, mumps, and rubella vaccines had been previously licensed in 1963, 1967, and 1969, respectively. Recommendations for a second dose were introduced in 1989. The MMRV vaccine, which also covers chickenpox, may be used instead. An MR vaccine, without coverage for mumps, is also occasionally used.