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MMRV vaccine

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MMRV vaccine
Combination of
Measles vaccineVaccine
Mumps vaccineVaccine
Rubella vaccineVaccine
Varicella vaccineVaccine
Clinical data
Trade namesProquad, Priorix Tetra
Other namesMeasles, Mumps, Rubella, and Varicella Virus Vaccine Live
AHFS/Drugs.comMonograph
License data
Pregnancy
category
Routes of
administration		Subcutaneous, intramuscular
ATC code
Legal status
Legal status
Identifiers
CAS Number
ChemSpider
  • none
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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

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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

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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]

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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

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  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 (August 2018). "MMR and MMRV vaccines". Vaccine. Progress in Vaccines. 36 (36): 5402–5407. doi:10.1016/j.vaccine.2017.07.051. PMID 28757060.
  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. 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.
  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

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