The MMRV vaccine combines the

attenuated virus An attenuated vaccine (or a live attenuated vaccine, LAV) is a vaccine created by reducing the virulence of a pathogen, but still keeping it viable (or "live"). Attenuation takes an infectious agent and alters it so that it becomes harmless or less ...

MMR (

measles Measles is a highly contagious infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than , cough, ...

mumps MUMPS ("Massachusetts General Hospital Utility Multi-Programming System"), or M, is an imperative, high-level programming language with an integrated transaction processing key–value database. It was originally developed at Massachusetts Gener ...

rubella Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild, with half of people not realizing that they are infected. A rash may start around two weeks after exposure and ...

) vaccine with the addition of the

chickenpox Chickenpox, also known as varicella, is a highly contagious disease caused by the initial infection with varicella zoster virus (VZV). The disease results in a characteristic skin rash that forms small, itchy blisters, which eventually scab ...

vaccine A vaccine is a biological Dosage form, preparation that provides active acquired immunity to a particular infectious disease, infectious or cancer, malignant disease. The safety and effectiveness of vaccines has been widely studied and verifie ...

or varicella vaccine (V stands for varicella). The MMRV vaccine is typically given to children between one and two years of age. Several companies supply MMRV vaccines. ProQuad is marketed by

Merck Merck refers primarily to the German Merck family and three companies founded by the family, including: * the Merck Group, a German chemical, pharmaceutical and life sciences company founded in 1668 ** Merck Serono (known as EMD Serono in the Unite ...

and was approved in 2005, for use in the United States by the

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...

(FDA) for children ages twelve months through twelve years. An MMRV vaccine called Priorix Tetra by

GlaxoSmithKline GSK plc, formerly GlaxoSmithKline plc, is a British multinational pharmaceutical and biotechnology company with global headquarters in London, England. Established in 2000 by a merger of Glaxo Wellcome and SmithKline Beecham. GSK is the ten ...

has been approved in Germany and Australia.

Recommendations

The

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

(WHO) recommends vaccinating against

, 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. The MMRV vaccine, a combined MMR and varicella vaccine, simplifies administration of the vaccines. One 2008 study indicated a rate of

febrile seizures A febrile seizure, also known as a fever fit or febrile convulsion, is a seizure associated with an increased body temperature but without any intracranial infection. Febrile seizures affect 2–7% of children and are more common in boys than gi ...

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.

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 Cold is the presence of low temperature, especially in the atmosphere. In common usage, cold is often a subjective perception. A lower bound to temperature is absolute zero, defined as 0.00K on the Kelvin scale, an absolute thermodynamic ...

. * 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 Reye syndrome is a rapidly worsening brain disease. Symptoms of Reye syndrome may include vomiting, personality changes, confusion, seizures, and loss of consciousness. While liver toxicity typically occurs in the syndrome, jaundice usually d ...

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. Doctors are advised to be aware of whether or not a patient has

HIV/AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...

or another disease that affects the

immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...

, 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).

Adverse events

Rare but serious adverse events reported following ProQuad vaccination include

allergic reactions Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...

, including swelling of the lips, tongue, or face; difficulty breathing or closing of the throat;

hives Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. Hives may burn or sting. The patches of rash may appear on different body parts, with variable duration from minutes to days, and does not leave any long-lasti ...

; paleness; weakness; dizziness; a fast heart beat;

deaf Deafness has varying definitions in cultural and medical contexts. In medical contexts, the meaning of deafness is hearing loss that precludes a person from understanding spoken language, an Audiology, audiological condition. In this context it ...

ness; long-term seizures, coma, or lowered consciousness; seizures (jerking or staring) caused by fever; or temporary low platelet count. For children age two and younger, the MMRV vaccine is associated with significantly more

adverse events An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An adverse event can ther ...

compared to separate administration of MMR and varicella vaccinations on the same day. There are 4.3 additional

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.

Legal status

Merck ProQuad was approved for medical use in the United States in September 2005, in the European Union in April 2006, and in Australia in February 2007. GSK Priorix Tetra was approved for medical use in Australia in November 2005.

References

External links

* {{DEFAULTSORT:Mmrv Vaccine Chickenpox Combination drugs Combination vaccines GSK plc brands Live vaccines Measles Merck & Co. brands Mumps Rubella