Measles, Mumps, and Rubella Vaccines

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Norman Rockwell Print, Mumps, Boy in Auto

Norman Rockwell Print, Mumps (Boy in Auto), ca 1972. Norman Rockwell created this work for a Merck advertisement celebrating the impact of the mumps vaccine on American culture. The image of a family having to cancel their vacation when the young son comes down with the mumps pointed to how, thanks to the vaccine, mumps was no longer an unavoidable part of childhood. Childhood vaccination had replaced mumps as an American tradition.

One of the standard childhood vaccinations in the United States is the MMR vaccine, which produces immunity against measles, mumps, and rubella. These three infectious diseases have several things in common. They are all caused by viruses that can spread through coughing and sneezing. Individuals infected with measles, mumps, or rubella are contagious for several days before they show the classic outward signs—rash or swelling—of infection. Finally, many Americans once considered these diseases to be part of a normal childhood—their danger was underestimated.

We now know that two of these illnesses, measles and rubella, can be very dangerous. Far from being a harmless rite of childhood, they are responsible for hundreds of thousands of fetal and child deaths each year. The third illness, mumps, is far less perilous but can have serious (and occasionally permanent) complications.

Although we now protect against all three diseases with one combined vaccine, in the past each disease required its own course of vaccinations. The museum’s collections include objects that document the development of each of these vaccines.

Measles

Measles is an exceptionally contagious disease. The Centers for Disease Control (CDC) reports that 90% of all non-immune people who come in contact with an infected person will also become infected. In fact, the virus can remain alive and airborne for two hours after an infected person has left a room.

Measles can cause ear infections and hearing loss, pneumonia, and swelling of the brain. Children are the most susceptible to severe complications: 1-2 children die for every 1,000 that contract the disease, even if they are under hospital care. That death rate may not seem high—except when one considers the 90% infection rate, which meant that, before a vaccine, almost all children contracted measles by their fifteenth year.

Before a vaccine was developed, quarantining the sick remained the best strategy for curtailing the quick spread of measles. The museum’s collections contain several examples of quarantine signs used in the struggle to contain measles.

Measles quarantine sign, ca 1920s

Measles quarantine sign, ca 1920s. The sign stresses the unusually contagious nature of the disease and warns against coming in contact with a sick person or even entering a sick room.

The announcement of a measles vaccine brought hope and relief to public health organizations. In 1963, pharmaceutical companies produced the first measles vaccines based on a vaccine created in the laboratory of Dr. John Enders at Boston Children’s Hospital.

Gamma globulin vial, ca 1947

Gamma globulin vial, ca 1947. Gamma globulin was originally used as a serum therapy—injections were given in an attempt to prevent or mitigate measles infection. Later, in 1963, gamma globulin was administered alongside the measles vaccine to alleviate the side effects of the vaccine.

A live virus vaccine proved the most effective, but it caused side effects such as fever and rashes. The vaccine, developed by Dr. Maurice Hilleman, director of vaccine research at Merck & Co., relied upon a concurrent injection of gamma globulin (an antibody-packed serum), thereby making the vaccine both safe and potent. Hilleman continued working to further attenuate (weaken) the measles strain, and eventually created a vaccine that could be administered without gamma globulin. His measles vaccine was distributed in 1968 and is still in use today.

Vaccination campaigns drastically reduced the spread of measles in America. However, the disease proved surprisingly difficult to eradicate. Vaccination programs were hindered by a misperception about measles—parents and some physicians continued to underestimate the danger of the disease.

Measles was finally eliminated from the United States in 2000—but it is back. Unvaccinated U.S. residents contract the disease during foreign travel or from foreign visitors, and the disease then quickly spreads to other unvaccinated people within a community. Since 2008, serious outbreaks of measles have occurred among Americans.

Mumps

The characteristic calling card of mumps, a swollen jaw and cheeks, is often comically depicted in American culture. Most people who contract the disease recover fully from the fever, swelling, and aches that usually attend it, while some infected people never experience these symptoms.

The complications of mumps are less comical: inflammation of the testicles, ovaries, brain, and the tissue around the brain and spinal cord, as well as deafness. Adults are often subject to more serious complications than are children. However, before a vaccine was available in the U.S., mumps was a significant cause of acquired deafness in childhood.

Jeryl Lynn Hilleman suffering from the mumps

Jeryl Lynn Hilleman suffering from the mumps.

Jeryl Lynn Hilleman with her sister, Kirsten

Jeryl Lynn Hilleman consoling her sister, Kirsten, in 1966, as Kirsten receives the Jeryl Lynn strain of mumps vaccine.

The mumps vaccine has an unusual history. When vaccine researcher Dr. Maurice Hilleman’s five year-old daughter, Jeryl Lynn, came down with mumps, he collected a sample of the virus from her. After attenuating the virus strain, he created a live virus vaccine that he thought would prove both safe and effective. Clinical trials of the vaccine followed, with Dr. Hilleman’s younger daughter Kirsten participating in one of them.

Live Mumps vaccine, Jeryl Lynn strain

Live Mumps vaccine, Jeryl Lynn strain, For Investigational Use Only, 1966. These vials of vaccine were used to vaccinate Dr. Maurice Hilleman’s daughter Kirsten with a trial vaccine derived from her sister’s case of the mumps.

Mumpsvax, Mumps Virus Vaccine, Merck & Company, 1967

Mumpsvax, Mumps Virus Vaccine, Merck & Company, 1967. In 1967, the FDA approved Merck’s mumps vaccine. The Hilleman-developed vaccine remains in use today, and is still derived from the Jeryl Lynn strain.

Rubella

Rubella (German measles) presents a unique challenge in the history of vaccination in America. The rubella vaccine is not primarily meant to protect the children who receive it—it is meant to protect all unborn children within the same family or community.

Rubella was not understood to be a highly dangerous disease until 1941. In that year, Australian ophthalmologist Norman Gregg discovered a correlation between mothers who had been infected with rubella during pregnancy and infants who were born with cataracts.

Researchers soon realized that women exposed to rubella in early pregnancy are at high risk for miscarriages and still births. Furthermore, surviving infants could be born with visual and hearing impairments, heart defects, neurological damage, and other lifelong disabilities. This condition is known as congenital rubella syndrome (CRS). According to the CDC, a “woman infected with rubella during the first 3 months of pregnancy has up to a 90% chance of giving birth to a baby with CRS.”

The importance of preventing rubella came into focus after the U.S. rubella epidemic of 1964–65, which resulted in an estimated 20,000 cases of CRS, plus another 20,000 fetal deaths. Following this outbreak, American scientists prioritized the production of an effective vaccine and in 1969, three vaccines – Meruvax, Rubelogen, and Cendevax – were released.

Rubella Virus Vaccine, Meruvax, Merck & Co., 1969

Rubella Virus Vaccine, Meruvax, Merck & Co., 1969. In 1969, the FDA approved the first rubella vaccine, Meruvax, which was produced in duck embryos. Like the mumps vaccine, this rubella vaccine was developed by a team led by Dr. Maurice Hilleman.

Rubelogen Virus Vaccine, ca 1971

Rubelogen Virus Vaccine, ca 1971: Two other strains of rubella vaccine were licensed in the U.S. in 1969: Rubelogen, produced in dog kidney cells, and Cendevax, produced in rabbit kidney cells. The nationwide vaccination campaigns necessitated that rubella vaccine be produced and distributed in huge quantities.

Dr. Stanley Plotkin of Philadelphia’s Wistar Institute developed yet another rubella vaccine strain, one that proved superior to all others. In 1979, licensed as Meruvax II, it became the sole rubella vaccine available in the U.S.

Rubella vaccination programs have been very effective—the CDC reports that rubella was eliminated from the United States in 2004. Nevertheless, to prevent a resurgence of rubella, high vaccination rates for children and women of childbearing age must be maintained.

Internationally, rubella remains a threat. The CDC estimates that 110,000 babies are born each year with congenital rubella syndrome, largely in Southeast Asia and Africa.

MMR

In the United States, measles, mumps, and rubella are now prevented by a single combined vaccine, known as MMR (measles, mumps, rubella). The combined vaccine was developed by Dr. Maurice Hilleman in 1971. In 1979 it was modified, substituting Dr. Stanley Plotkin’s more effective rubella vaccine.

The combined vaccine is more convenient for patients, and this convenience actually saves lives. Fewer injections translate as fewer missed doses, and therefore more protection in a shorter time. The MMR vaccine has saved millions of lives worldwide.

“Six Vaccines of the Twentieth Century Which Averted Illness, Disability, and Death and Changed the Face of the World. Dr. Maurice R. Hilleman, December 1999.”

“Six Vaccines of the Twentieth Century Which Averted Illness, Disability, and Death and Changed the Face of the World. Dr. Maurice R. Hilleman, December 1999.” Replica of the six vaccines put into the National Millennium Time Capsule. The MMR vaccine is one of the six. Gift of the Hilleman Family.

Currently not on view
Location
Currently not on view
date made
ca 1920
ID Number
1985.3090.27
nonaccession number
1985.3090
catalog number
1985.3090.27
Currently not on view
Location
Currently not on view
date made
ca 1970
expiration date
1970-09-08
1970-10-06
maker
Merck Sharp and Dohme
ID Number
1982.0043.026
accession number
1982.0043
catalog number
1982.0043.026
According to 1940 product literature supplied by Parke, Davis & Company:Immune Globulin (Human) is a sterile, refined and concentrated globulin obtained from human placental blood and tissues.Indications: Prevention and modification of measles in susceptible contacts.
Description
According to 1940 product literature supplied by Parke, Davis & Company:
Immune Globulin (Human) is a sterile, refined and concentrated globulin obtained from human placental blood and tissues.
Indications: Prevention and modification of measles in susceptible contacts. May also be used therapeutically in early stages of the disease.
Dosage: Children under five years exposed less than five days, 2 cc.; more than five days, 4 cc. Children over five years exposed less than 5 days, 4 cc.; more than five days, 4-10 cc. depending on age. Injections should be made intramuscularly. / Packages: Immune Globulin (Human) is supplied in vials of 2 cc. (Bio. 109) and 10 cc. (Bio. 119).
Location
Currently not on view
date made
ca 1940
maker
Parke, Davis and Company
ID Number
MG.M-04894.06
accession number
155762
catalog number
M-04894.06
The is an example of the first rubella vaccine, Meruvax (Duck Cell Adapted HPV-77 Strain, Passage 5), manufactured around 1970.
Description
The is an example of the first rubella vaccine, Meruvax (Duck Cell Adapted HPV-77 Strain, Passage 5), manufactured around 1970. This vaccine was replaced in 1979 with a new vaccine using a different viral strain and growth medium.
Metaphors of war and combat are almost impossible to avoid when describing humankind's struggle to control infectious disease. The war may be endless, but significant battles have been won (and some lost) along the way, and one of our most effective weapons has been vaccination. One such victory was declared in April 2014 when the Pan American Health Organization of the World Health Organization (PAHO/WHO) announced that rubella, a viral disease commonly known as German measles, had been eliminated from the Americas. Although the disease, spread by contact with an infected person through coughing or sneezing, is still prevalent in other parts of the world and imported cases sporadically appear, the last case of rubella to originate in the western hemisphere occurred in 2009. Rubella is the third human disease to be eliminated from the Americas through vaccination—the first was smallpox in 1971 and the second was polio in 1994. Only smallpox has been eradicated globally.
Rubella, a fairly mild childhood disease, was not considered a particularly dangerous foe until 1941 when an Australian ophthalmologist, Norman Gregg, discovered a link between the incidence of congenital cataracts in infants and mothers infected with rubella during pregnancy. This was the first report of what is now termed congenital rubella syndrome (CRS). Women exposed to rubella in early pregnancy are at high risk for miscarriages and still births, or their infants may be born with visual and hearing impairments, heart defects, neurological damage, and other lifelong disabilities. CRS rose to national attention following the U.S. rubella epidemic of 1964-65, which resulted in an estimated 20,000 cases of CRS and another 20,000 fetal deaths.
Following this outbreak, American scientists raced to produce an effective vaccine before the next rubella epidemic occurred. In 1969, the FDA approved Meruvax, developed at the Merck Sharp & Dohme research laboratories in West Point, Pennsylvania. As with many vaccines, Meruvax employs a live virus, although the rubella virus has been weakened (or attenuated) by growing it in a series of laboratory cell cultures known as "passages." Researchers at Merck used a duck embryo cell culture for the rubella virus.
With a vaccine now available, the United States launched a nation-wide vaccination campaign to dramatically reduce the incidence of the disease. Public health officials decided that vaccinating all pre-adolescent children was the best way to protect pregnant women from contracting the virus.
Successful vaccination campaigns depend on public education and outreach, and rubella presented unique challenges. Parents were being asked to have their children vaccinated in order to protect unborn babies—the health benefit to the vaccinated child was not the issue. Instead, the campaign appealed directly to the individual's sense of responsibility to the wider community.
With federal support, state and local health departments launched aggressive programs offering free vaccination in the schools and through special vaccination days and community clinics. By early 1971, about 23 million children had been vaccinated, representing about 40% of the target population.
In the Michigan campaigns, Rubella Hero medals were awarded to all vaccinated children in Kindergarten through third grade. As the state's Public Health officials declared: "The vaccinated youngster is a brave knight, a dragon fighter, and a Rubella hero insignia includes a representation of the defeated Rubella Dragon. This unique public information approach was developed to fit the unique nature of the entire immunization effort. Essentially the effort aims at vaccination of one segment of the population in order to protect another totally different segment."
But while the vaccinated youngster was a hero, the unvaccinated child was a menace—a lurking threat to pregnant women and their unborn babies. The campaigns also played on emotions of fear and pity to persuade both parents and children to participate in the vaccination effort. Children with CRS, displaying visible signs of hearing and vision loss, bone or brain damage, were featured in campaign literature and on posters—much like the polio poster children from a previous generation.
The U.S. campaign in the early 1970s was largely successful and the expected rubella epidemic of the mid-decade did not occur. Two years after the rubella vaccine was approved, Merck Sharp & Dohme developed a combination vaccine for measles, mumps, and rubella (MMR). Once the MMR vaccine became routine for infants and children, public education about rubella in the U.S. lost much of its urgency and this early campaign is now largely forgotten. Still the war is far from over, and the Centers for Disease Control and Prevention estimates that 110,000 babies are born each year with congenital rubella syndrome, largely in southeast Asia and Africa. Clearly the world is still in need of Rubella Heroes.
Location
Currently not on view
date made
ca 1970
expiration date
1970-12-22
maker
Merck Sharp and Dohme
ID Number
1982.0043.037
accession number
1982.0043
catalog number
1982.0043.037
Currently not on view
Location
Currently not on view
date made
1966 - 1980
ID Number
1985.3109.047
nonaccession number
1985.3109
catalog number
1985.3109.047
Currently not on view
Location
Currently not on view
date made
ca 1971
expiration date
1971-01-05
maker
Smith, Kline and French Laboratories
Recherche et Industrie Therapeutiques, S.A.
ID Number
1982.0043.029A
catalog number
1982.0043.029A
accession number
1982.0043
According to 1940 product literature supplied by Parke, Davis & Company:Immune Globulin (Human) is a sterile, refined and concentrated globulin obtained from human placental blood and tissues.Indications: Prevention and modification of measles in susceptible contacts.
Description
According to 1940 product literature supplied by Parke, Davis & Company:
Immune Globulin (Human) is a sterile, refined and concentrated globulin obtained from human placental blood and tissues.
Indications: Prevention and modification of measles in susceptible contacts. May also be used therapeutically in early stages of the disease.
Dosage: Children under five years exposed less than five days, 2 cc.; more than five days, 4 cc. Children over five years exposed less than 5 days, 4 cc.; more than five days, 4-10 cc. depending on age. Injections should be made intramuscularly. / Packages: Immune Globulin (Human) is supplied in vials of 2 cc. (Bio. 109) and 10 cc. (Bio. 119).
Location
Currently not on view
maker
Parke, Davis and Company
ID Number
1978.0882.58
accession number
1978.0882
catalog number
1978.0882.58
Currently not on view
Location
Currently not on view
date made
ca 1970
expiration date
1970-09-25
maker
Parke, Davis and Company
Philips Roxane Inc.
ID Number
1982.0043.001B
catalog number
1982.0043.001B
accession number
1982.0043
Currently not on view
Location
Currently not on view
date made
ca 1972
expiration date
1972-04-29
maker
Parke, Davis and Company
Philips Roxane Inc.
ID Number
1982.0043.005B
catalog number
1982.0043.005B
accession number
1982.0043
Currently not on view
Location
Currently not on view
date made
ca 1972
expiration date
1972-04-29
maker
Parke, Davis and Company
Philips Roxane Inc.
ID Number
1982.0043.005A
catalog number
1982.0043.005A
accession number
1982.0043
Currently not on view
Location
Currently not on view
expiration date
1970-09-25
maker
Parke, Davis and Company
Philips Roxane Inc.
ID Number
1982.0043.001A
catalog number
1982.0043.001A
accession number
1982.0043
Dark yellow cardboard sign with black text reading, "MUMPS- These Premises Are Under State Quarantine.
Description (Brief)
Dark yellow cardboard sign with black text reading, "MUMPS- These Premises Are Under State Quarantine. No person shall be permitted to enter, leave or take any article from this house without written permission from a legally authorized agent of the Board of Health, excepting physicians, nurses in charge of the sick, or the clergyman. Animals must not be permitted to leave these premises. No person other than those authorized by the Board of Health shall remove this placard. Any person or persons defacing, covering up, or destroying this placard render themselves liable to the penalties of the law. Act of the Assembly approved May 14, 1909, provided that anyone violating the provisions of this Act, upon conviction thereof may be sentenced to pay a fine of not less than $10.00 or more than $100.00, to be paid to the use of said county, or to be imprisoned in the county jail for a period of not less than ten days or more than thirty days, or both, at the discretion of the court.' By order of the Board of Health" with lines for the signature and address of the Health Officer.
Location
Currently not on view
date made
after 1909
ID Number
2005.3079.09
nonaccession number
2005.3079
catalog number
2005.3079.09
Currently not on view
Location
Currently not on view
date made
1966 - 1980
ID Number
1985.3109.046
nonaccession number
1985.3109
catalog number
1985.3109.046
Currently not on view
Location
Currently not on view
date made
1966 - 1980
ID Number
1985.3109.050
nonaccession number
1985.3109
catalog number
1985.3109.050
Yellow cardboard sign with black text reading, "MUMPS- Children--except those of this household with the health officer's permit--must not enter or leave these premises. No person other than those authorized by the Board of Health shall remove this placard.
Description (Brief)
Yellow cardboard sign with black text reading, "MUMPS- Children--except those of this household with the health officer's permit--must not enter or leave these premises. No person other than those authorized by the Board of Health shall remove this placard. Any Person or Persons defacing, covering up, or destroying this Placard render themselves liable to the Penalties of the law. Act of the General Assembly approved June 28, 1923, provides that anyone violating the provisions of this Act, upon conviction thereof may be sentenced to pay a fine of not more than $100.00, to be paid to the use of said county, and costs of prosecution, or to be imprisoned in the county jail for a period of not less tha ten days or more than thirty days, or both, at the discretion of the court.' By order of the Board of Health" with lines for signature and address of health officer and date posted.
Location
Currently not on view
date made
after 1923
ID Number
2005.3079.04
nonaccession number
2005.3079
catalog number
2005.3079.04
Currently not on view
Location
Currently not on view
date made
ca 1971
expiration date
1971-01-05
maker
Smith, Kline and French Laboratories
Recherche et Industrie Therapeutiques, S.A.
ID Number
1982.0043.029B
catalog number
1982.0043.029B
accession number
1982.0043
This Bausch & Lomb Model GGBET microscope is a stereoscopic instrument with coarse and fine focus, quadruple nosepiece, square mechanical stage, inclination joint, sub-stage condenser and iris diaphragm, sub-stage mirror, and V-shaped base.
Description
This Bausch & Lomb Model GGBET microscope is a stereoscopic instrument with coarse and fine focus, quadruple nosepiece, square mechanical stage, inclination joint, sub-stage condenser and iris diaphragm, sub-stage mirror, and V-shaped base. The inscription on the eyepiece reads “BAUSCH & LOMB OPTICAL CO. / ROCHESTER, N.Y.” The 251496 serial number indicates a date of around 1936. A tag on the base reads “PROPERTY OF U.S. GOVERNMENT / PHS / 800 / 35990.”
This was used in the mid-1960s, in the National Institutes of Health Division of Biologics Standards, in connection with the development of a live virus vaccine for rubella (German measles). Dr. Harry M. Meyer, Jr. and Dr. Paul D. Parkman led this project.
Ref: Bausch & Lomb, Scientific Instruments (Rochester, N.Y., 1939), p. 30.
Location
Currently not on view
date made
1936
ID Number
1977.0514.01
accession number
1977.0514
catalog number
1977.0514.01
serial number
251496
Currently not on view
Location
Currently not on view
date made
1966 - 1980
ID Number
1985.3109.055
nonaccession number
1985.3109
catalog number
1985.3109.055
Rectangular white cardboard sign, double sideded with one sign warning of Measles and the other of Scarlet Fever. Both sides have following text, "This Notice is Posted in Compliance with Law.
Description (Brief)
Rectangular white cardboard sign, double sideded with one sign warning of Measles and the other of Scarlet Fever. Both sides have following text, "This Notice is Posted in Compliance with Law. 'Every person who shall wilfully tear down, remove or deface any notice posted in compliance with law shall be fined not more than seven dollars.' --General Statutes of Connecticut, Revision of 1902, Sec, 1173. --Town Health Officer."
Location
Currently not on view
date made
after 1902
ID Number
2005.3080.02
catalog number
2005.3080.02
nonaccession number
2005.3080
Currently not on view
Location
Currently not on view
date made
1966 - 1980
ID Number
1985.3109.049
nonaccession number
1985.3109
catalog number
1985.3109.049
Off-white cardboard sign with black text reading, "MEASLES- Children--except those of this household with the Health Officer's permit--must not enter or leave these premises. No person other than those authorized by the Board of Health shall remove this placard.
Description (Brief)
Off-white cardboard sign with black text reading, "MEASLES- Children--except those of this household with the Health Officer's permit--must not enter or leave these premises. No person other than those authorized by the Board of Health shall remove this placard. Any person or persons defacing, covering up, or destroying this placard render themselves liable to the penalties of the law. Act of the General Assembly approved June 28, 1923, provides that anyone violating the provisions of this Act, upon conviction thereof may be sentenced to pay a fine of not more than $100.00, to be paid to the use of said county, and costs of prosecution, or to be imprisoned in the county jail for a period of not less than ten days or more than thirty days, or both, at the discretion of the court.' By order of the Board of Health" with lines for the signature and address of the Health Officer and the date posted.
Location
Currently not on view
date made
after 1923
ID Number
2005.3079.12
nonaccession number
2005.3079
catalog number
2005.3079.12
Currently not on view
Location
Currently not on view
date made
1966 - 1980
ID Number
1985.3109.048
nonaccession number
1985.3109
catalog number
1985.3109.048
Currently not on view
Location
Currently not on view
date made
1966 - 1980
ID Number
1985.3109.051
nonaccession number
1985.3109
catalog number
1985.3109.051
This object was part of an exhibit on the manufacture and use of biological vaccines for the treatment of smallpox, respiratory infections, influenza, measles, and scarlet fever.
Description
This object was part of an exhibit on the manufacture and use of biological vaccines for the treatment of smallpox, respiratory infections, influenza, measles, and scarlet fever. Under the direction of the Smithsonian’s curator of medicine, the pharmaceutical company, Sharp & Dohme, designed and produced the exhibit which was installed at the Smithsonian in September 1947. The company became a major U.S. producer of biological products including many vaccines, serums, and antitoxins, after acquiring H. K. Mulford & Company in 1929. The Mulford Company was a pioneer in the commercial development of biologicals in the United States beginning with the production of a diphtheria antitoxin in the mid-1890s.
Location
Currently not on view
date made
ca 1947
maker
Sharp and Dohme
ID Number
MG.177206.01
catalog number
177206.01
accession number
177206

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