MMRV vaccine

Combination vaccine against measles, mumps, rubella, and varicella viruses

  • US DailyMed: Proquad
Pregnancy
category
Routes of
administrationSubcutaneous, intramuscularATC code
  • J07BD54 (WHO)
Legal statusLegal status
  • AU: S4 (Prescription only)[2][3]
  • CA: ℞-only / Schedule D[4][5]
  • US: ℞-only[6]
  • EU: Rx-only[7]
  • In general: ℞ (Prescription only)
IdentifiersCAS Number
  • 1704519-64-1 checkY
ChemSpider
  • none
 ☒NcheckY (what is this?)  (verify)

The MMRV vaccine is a combination vaccine which combines the attenuated virus measles, mumps, rubella (German measles), and varicella (chickenpox). The MMRV vaccine has similar immunogenicity and overall safety profiles to the MMR vaccine administered with or without the varicella vaccine. The MMRV vaccine is typically given to children between one and two years of age.[8]

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[9][10] by GlaxoSmithKline has been approved in Germany and Australia.[11][12][13]

Recommendations

The MMRV vaccine, a combined MMR and varicella vaccine, simplifies administration of the vaccines.[14] 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.[15][16]

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.[17]

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.[17] 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 Proquad compared to the separate administration of MMR and Varicella vaccines.[18][19]

Legal status

Proquad was approved for medical use in the United States in September 2005, [20][21] in the European Union in April 2006,[7] in Australia in February 2007,[2] and in Canada in May 2014.[4]

Priorix Tetra was approved for medical use in Australia in November 2005,[3] and in Canada in June 2008.[5]

References

  1. ^ "Measles virus vaccine / mumps virus vaccine / rubella virus vaccine / varicella virus vaccine (Proquad) Use During Pregnancy". Drugs.com. 16 October 2019. Archived from the original on 19 October 2019. Retrieved 26 January 2020.
  2. ^ a b "Proquad measles mumps rubella varicella live virus vaccine injection vial with prefilled diluent syringe (126157)". Therapeutic Goods Administration (TGA). 26 May 2022. Archived from the original on 10 June 2024. Retrieved 10 June 2024.
  3. ^ a b "Priorix-Tetra vaccine 0.5mL powder for injection vial with diluent syringe (107286)". Therapeutic Goods Administration (TGA). 26 May 2022. Archived from the original on 31 January 2023. Retrieved 10 June 2024.
  4. ^ a b "Proquad Product information". Health Canada. 9 May 2014. Archived from the original on 10 June 2024. Retrieved 10 June 2024.
  5. ^ a b "Priorix Tetra Product information". Health Canada. 4 June 2008. Archived from the original on 10 June 2024. Retrieved 10 June 2024.
  6. ^ "DailyMed - Proquad- measles, mumps, rubella and varicella virus vaccine live injection, powder, lyophilized, for suspension". Archived from the original on 6 April 2020. Retrieved 9 October 2020.
  7. ^ a b "Proquad EPAR". European Medicines Agency (EMA). 6 April 2006. Archived from the original on 21 October 2020. Retrieved 8 October 2020.
  8. ^ Kowalzik F, Faber J, Knuf M (28 August 2018). "MMR and MMRV vaccines". Vaccine. Progress in Vaccines. 36 (36): 5402–5407. doi:10.1016/j.vaccine.2017.07.051. ISSN 0264-410X. Archived from the original on 14 February 2023. Retrieved 6 June 2024.
  9. ^ 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. PMID 12962524. S2CID 46973762.
  10. ^ "GlaxoSmithKline Clinical Trial Register". GlaxoSmithKline. Archived from the original on 30 November 2007. Retrieved 19 October 2019.
  11. ^ "Priorix-tetra". The Australian Immunisation Handbook. 4 June 2018. Archived from the original on 19 October 2019. Retrieved 18 October 2019.
  12. ^ Bauchau V, Van Holle L, Cohen C (November 2015). "Modelling Hospitalisation Ratios for Febrile Convulsions and Severe Varicella Under Combined Measles, Mumps, Rubella, and Varicella (MMRV-Priorix-Tetra) Compared to Separate MMR + V Vaccination". Drug Safety. 38 (11): 1095–1102. doi:10.1007/s40264-015-0326-4. PMC 4608986. PMID 26251259.
  13. ^ "PEI Table of vaccines for measles with a valid marketing authorisation". PEI , Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und biomedizinische Arzneimittel (in German). 19 October 2019. Archived from the original on 19 October 2019. Retrieved 18 October 2019.
  14. ^ 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. PMID 17596807. S2CID 41981427.
  15. ^ Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP) (March 2008). "Update: recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding administration of combination MMRV vaccine" (PDF). MMWR. Morbidity and Mortality Weekly Report. 57 (10): 258–260. PMID 18340332. Archived (PDF) from the original on 19 October 2020. Retrieved 19 January 2021.
  16. ^ Marin M, Broder KR, Temte JL, Snider DE, Seward JF (May 2010). "Use of combination measles, mumps, rubella, and varicella vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP)" (PDF). MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports. 59 (RR-3): 1–12. PMID 20448530. Archived (PDF) from the original on 16 March 2023. Retrieved 10 June 2024.
  17. ^ a b "MMRV (Measles, Mumps, Rubella & Varicella) VIS". CDC. 21 May 2010. Archived from the original on 20 January 2015.
  18. ^ Klein NP, Fireman B, Yih WK, Lewis E, Kulldorff M, Ray P, et al. (July 2010). "Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures". Pediatrics. 126 (1): e1–e8. doi:10.1542/peds.2010-0665. PMID 20587679.{{cite journal}}: CS1 maint: overridden setting (link)
  19. ^ "CBER clinical review of studies submitted in support of licensure of Proquad" (PDF). US Food and Drug Administration. August 2005. Archived (PDF) from the original on 6 May 2017. Retrieved 16 December 2019.
  20. ^ "Proquad". U.S. Food and Drug Administration (FDA). Archived from the original on 23 July 2017. Retrieved 8 October 2020.
  21. ^ "Proquad". U.S. Food and Drug Administration (FDA). STN: 125108. Archived from the original on 11 November 2020. Retrieved 8 October 2020.

Further reading

  • Centers for Disease Control and Prevention (CDC) (December 2005). "Notice to Readers: Licensure of a Combined Live Attenuated Measles, Mumps, Rubella, and Varicella Vaccine" (PDF). MMWR Morb. Mortal. Wkly. Rep. 54 (47): 1212–14. Archived (PDF) from the original on 20 January 2022. Retrieved 26 January 2020.
  • Ma SJ, Li X, Xiong YQ, Yao AL, Chen Q (November 2015). "Combination Measles-Mumps-Rubella-Varicella Vaccine in Healthy Children: A Systematic Review and Meta-analysis of Immunogenicity and Safety". Medicine. 94 (44): e1721. doi:10.1097/MD.0000000000001721. PMC 4915870. PMID 26554769.
  • World Health Organization (January 2009). The immunological basis for immunization series: module 7: measles (update 2009). World Health Organization (WHO). hdl:10665/44038. ISBN 9789241597555.
  • World Health Organization (November 2010). The immunological basis for immunization series: module 16: mumps. World Health Organization (WHO). hdl:10665/97885. ISBN 9789241500661.
  • World Health Organization (December 2008). The immunological basis for immunization series: module 11: rubella. World Health Organization (WHO). hdl:10665/43922. ISBN 9789241596848.
  • World Health Organization (May 2008). The immunological basis for immunization series : Module 10: Varicella-zoster virus. World Health Organization (WHO). hdl:10665/43906. ISBN 9789241596770.
  • Ramsay M, ed. (December 2019). "Chapter 21: Measles". Immunisation against infectious disease. Public Health England. Archived from the original on 12 November 2019. Retrieved 9 October 2020.
  • Ramsay M, ed. (April 2013). "Chapter 23: Mumps". Immunisation against infectious disease. Public Health England. Archived from the original on 12 November 2019. Retrieved 9 October 2020.
  • Ramsay M, ed. (April 2013). "Chapter 28: Rubella". Immunisation against infectious disease. Public Health England. Archived from the original on 12 November 2019. Retrieved 9 October 2020.
  • Ramsay M, ed. (March 2013). "Chapter 34: Varicella". Immunisation against infectious disease. Public Health England. Archived from the original on 12 November 2019. Retrieved 9 October 2020.
  • Hamborsky J, Kroger A, Wolfe S, eds. (2015). "Chapter 13: Measles". Epidemiology and Prevention of Vaccine-Preventable Diseases (13th ed.). Washington D.C.: U.S. Centers for Disease Control and Prevention (CDC). ISBN 978-0990449119. Archived from the original on 30 December 2016. Retrieved 9 October 2020.
  • Hamborsky J, Kroger A, Wolfe S, eds. (2015). "Chapter 15: Mumps". Epidemiology and Prevention of Vaccine-Preventable Diseases (13th ed.). Washington D.C.: U.S. Centers for Disease Control and Prevention (CDC). ISBN 978-0990449119. Archived from the original on 30 December 2016. Retrieved 9 October 2020.
  • Hamborsky J, Kroger A, Wolfe S, eds. (2015). "Chapter 20: Rubella". Epidemiology and Prevention of Vaccine-Preventable Diseases (13th ed.). Washington D.C.: U.S. Centers for Disease Control and Prevention (CDC). ISBN 978-0990449119. Archived from the original on 30 December 2016. Retrieved 9 October 2020.
  • Hamborsky J, Kroger A, Wolfe S, eds. (2015). "Chapter 22: Varicella". Epidemiology and Prevention of Vaccine-Preventable Diseases (13th ed.). Washington D.C.: Centers for Disease Control and Prevention (CDC). ISBN 978-0990449119. Archived from the original on 7 February 2015. Retrieved 9 October 2020.
  • Roush SW, Baldy LM, Hall MA, eds. (March 2019). "Chapter 7: Measles". Manual for the surveillance of vaccine-preventable diseases. Atlanta GA: U.S. Centers for Disease Control and Prevention (CDC). Archived from the original on 1 August 2020. Retrieved 9 October 2020.{{cite book}}: CS1 maint: overridden setting (link)
  • Roush SW, Baldy LM, Hall MA, eds. (March 2019). "Chapter 9: Mumps". Manual for the surveillance of vaccine-preventable diseases. Atlanta GA: U.S. Centers for Disease Control and Prevention (CDC). Archived from the original on 1 August 2020. Retrieved 9 October 2020.{{cite book}}: CS1 maint: overridden setting (link)
  • Roush SW, Baldy LM, Hall MA, eds. (March 2019). "Chapter 14: Rubella". Manual for the surveillance of vaccine-preventable diseases. Atlanta GA: U.S. Centers for Disease Control and Prevention (CDC). Archived from the original on 1 August 2020. Retrieved 9 October 2020.{{cite book}}: CS1 maint: overridden setting (link)
  • Roush SW, Baldy LM, Hall MA, eds. (9 January 2020). "Chapter 17: Varicella". Manual for the surveillance of vaccine-preventable diseases. Atlanta GA: Centers for Disease Control and Prevention (CDC). Archived from the original on 1 August 2020. Retrieved 9 October 2020.{{cite book}}: CS1 maint: overridden setting (link)

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