Several companies supply MMRV vaccines. ProQuad is marketed by
Merck and was approved in 2005, for use in the United States by the
Food and Drug Administration (FDA) for children ages twelve months through twelve years. An MMRV vaccine called Priorix Tetra[4][5] by
GlaxoSmithKline has been approved in Germany and Australia.[6][7][8]
Recommendations
The
World Health Organization (WHO) recommends vaccinating against
measles,
mumps,
rubella (German measles), and
varicella (chickenpox) because the risks of these diseases far outweigh the risks of vaccinating against them. In particular, the World Health Organization recommends
varicella vaccination in countries where the vaccine is affordable, the disease is a relatively important problem, and high and sustained vaccine coverage can be achieved. A few countries have widely implemented this. MMR and varicella vaccine are given at roughly the same time and a booster injection is recommended for both.[citation needed]
The MMRV vaccine, a combined MMR and varicella vaccine, simplifies administration of the vaccines.[9] One 2008 study indicated a rate of
febrile seizures of 9 per 10,000 vaccinations with MMRV, as opposed to 4 per 10,000 for separate MMR and varicella shots; U.S. health officials known as the
ACIP therefore do not express a preference for use of MMRV vaccine over separate injections.[10]
Contraindications
For individuals who are moderately or severely ill, it is generally recommended that they wait until after recovery before getting ProQuad. No such precautions are recommended for minor illnesses, such as a
cold.[citation needed]
It is recommended that aspirin or aspirin containing products be avoided for at least six weeks after receiving ProQuad vaccine (aspirin is not recommended in children under 16 in any case). A serious condition called
Reye's syndrome has been reported in patients with chicken pox and influenza.
Individuals should not receive ProQuad without first consulting their doctor if there is a history of a life-threatening allergic reaction to gelatin, eggs, the antibiotic neomycin, or a previous MMR or chicken pox vaccine.[citation needed]
Doctors are advised to be aware of whether or not a patient has
HIV/AIDS or another disease that affects the
immune system, is taking a medication that affects the immune system, has cancer, a fever or active untreated tuberculosis, is receiving cancer treatment, or has ever had a low platelet count (a blood disorder).[citation needed]
Adverse events
Rare but serious adverse events reported following ProQuad vaccination include
allergic reactions, including swelling of the lips, tongue, or face; difficulty breathing or closing of the throat;
hives; paleness; weakness; dizziness; a fast heart beat;
deafness; long-term seizures, coma, or lowered consciousness; seizures (jerking or staring) caused by fever; or temporary low platelet count.[11]
For children age two and younger, the MMRV vaccine is associated with significantly more
adverse events compared to separate administration of MMR and varicella vaccinations on the same day.[11] There are 4.3 additional
febrile seizures per 10,000 vaccinated children (95% CI 2.6–5.6), 7.5 additional mostly mild fever episodes per 100 vaccinated children (95% CI, 5.4–9.4) and 1.1 additional measles-like rash per 100 children (95% CI, 0.2–1.8). Febrile seizures caused by the MMRV vaccine occur 7 to 10 days after vaccination. In children age 4–6, there is no evidence for an increased risk in febrile seizures after the administration of Merck Proquad compared to the separate administration of MMR and Varicella vaccines.[12][13]
Legal status
Merck ProQuad was approved for medical use in the United States in September 2005,[14][15] in the European Union in April 2006,[3] and in Australia in February 2007.[16]
GSK Priorix Tetra was approved for medical use in Australia in November 2005.[17]
^Wellington K, Goa KL (2003). "Measles, mumps, rubella vaccine (Priorix; GSK-MMR): a review of its use in the prevention of measles, mumps and rubella". Drugs. 63 (19): 2107–2126.
doi:
10.2165/00003495-200363190-00012.
PMID12962524.
S2CID46973762.
^Vesikari T, Sadzot-Delvaux C, Rentier B, Gershon A (July 2007). "Increasing coverage and efficiency of measles, mumps, and rubella vaccine and introducing universal varicella vaccination in Europe: a role for the combined vaccine". The Pediatric Infectious Disease Journal. 26 (7): 632–638.
doi:
10.1097/INF.0b013e3180616c8f.
PMID17596807.
S2CID41981427.