Measles Postexposure Prophylaxis (PEP)
For Individuals who are NOT pregnant or immunocompromised
|
Age Group |
Immune Status |
Time Since Exposure |
Recommended PEP |
Home Quarantine Recommendations |
|
All ages (≥ 6 months) |
Documented immunity |
Any time |
PEP not indicated. Has documented immunity (2 MMR doses, IgG positive, or lab confirmation of disease). |
None |
|
< 6 months |
Nonimmune (because of age) |
0–6 days |
Immune Globulin Intramuscular (IGIM) 0.5ml/kg IM (max dose= 15mL) |
Quarantine for 28 days after last exposure |
|
>6 days |
PEP not indicated (too late) |
Quarantine for 21 days after last exposure |
||
|
6 – 11 months |
Nonimmune |
0 – 3 days (≤ 72 hours) |
MMR vaccine (preferred) |
No quarantine if MMR given |
|
4 – 6 days
|
Immune Globulin Intramuscular (IGIM) 0.5ml/kg IM (max dose= 15 mL) |
Quarantine for 28 days after last exposure |
||
|
> 6 days |
PEP not indicated (too late) |
Quarantine for 21 days after last exposure |
||
|
≥ 12 months |
Nonimmune (0 MMR doses or IgG negative) |
0 – 3 days (≤ 72 hours) |
MMR vaccine |
No quarantine if MMR given |
|
> 3 days |
PEP not typically indicated* |
Quarantine for 21 days, then give MMR for future immunity |
||
|
1 dose of MMR |
Any time |
Give 2nd MMR vaccine dose if ≥ 28 days from 1st dose |
No quarantine needed (person had 1 dose when exposed) |
For individuals who ARE pregnant or immunocompromised
|
Health Status |
Age Group |
Immune Status |
Time Since Exposure |
Recommended PEP |
Home Quarantine Recommendations |
|
Severely Immunocompromised |
All Ages |
Will need IG regardless of immune status |
0–6 days |
Immune Globulin Intravenous (IGIV) 400 mg/kg IV (intravenously) |
Quarantine for 28 days after last exposure |
|
>6 days |
PEP not indicated (too late) |
Quarantine for 21 days after last exposure |
|||
|
Pregnant |
N/A |
Immune |
Any time |
PEP not indicated if has documented immunity |
None |
|
Nonimmune |
0 – 6 days |
Immune Globulin Intravenous (IGIV) 400 mg/kg IV (intravenously) |
Quarantine for 28 days after last exposure |
||
|
> 6 days |
PEP not indicated (too late) |
Quarantine for 21 days after last exposure |
Adapted from: Measles | Red Book: 2024–2027 Report of the Committee on Infectious Diseases | Red Book Online | American Academy of Pediatrics and pep-measles-providers.pdf
*IGIM can be given to other persons (e.g., ≥ 12 months of age) who do not have evidence of measles immunity, but priority should be given to persons exposed in settings with intense, prolonged, close contact (e.g., household, childcare, classroom).
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.