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measles, mumps, rubella and varicella vaccine, live (Rx)Brand and Other Names:ProQuad, MMRV

 
 
 

Dosing & Uses

AdultPediatric

Not indicated

Dosage Forms & Strengths

vaccine

  • lyophilized single dose (supplied with sterile water diluent)
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Measles, Mumps, Rubella, & Varicella Vaccination

Routine vaccination (2 doses): First dose of 0.5 mL SC between age 12-15 months; administer second dose between age 4-6 yr

Allow at least 3 months between a dose of varicella-containing vaccine and Proquad

Allow at least 4 wk between other measles-containing vaccines and Proquad

Administration

Refrigerator-stable formulation: Refrigerate at 2-8°C (36-46°F) or colder; the lyophilized vaccine may also be stored in a freezer and subsequently transferred to a refrigerator; however, the lyophilized vaccine should not be refrozen

Keep lyophilized vaccine frozen at -58°F and +5°F (-50°C to -15°C); may be stored at refrigerator temperature (36-46°F, 2-8°C) for up to 72 hr before reconstitution

Administer immediately after reconstitution

Do not freeze reconstituted vaccine, discard if not used within 30 minutes

Additional Information

Up-to-date vaccination schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.html

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Interactions

Interaction Checker

measles, mumps, rubella and varicella vaccine, live and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967

            >10%

            Fever >102F (21.5%)

            Inj site pain/tenderness/soreness (22%)

            Inj site erythema (14%)

            1-10%

            Rash (9%, incl inj site, measles-like & varicella-like)

            1nj site swelling (8.4%)

            Irritability (6.7%)

            Postmarketing Reports

            Infections and infestations: Atypical measles, candidiasis, cellulitis, herpes zoster, infection, influenza, measles, orchitis, parotitis, respiratory infection, skin infection, varicella (vaccine strain)

            Blood and the lymphatic system disorders: Aplastic anemia, lymphadenitis, regional lymphadenopathy, thrombocytopenia

            Immune system disorders: Anaphylactoid reaction, anaphylaxis and related phenomena such as angioneurotic edema, facial edema, and peripheral edema, anaphylaxis in individuals with or without an allergic history

            Psychiatric disorders: Agitation, apathy, nervousness

            Nervous system disorders: Acute disseminated encephalomyelitis (ADEM), afebrile convulsions or seizures, aseptic meningitis (see below), ataxia, Bell palsy, cerebrovascular accident, convulsion, dizziness, dream abnormality, encephalitis, encephalopathy, febrile seizure, Guillain-Barré syndrome, headache, hypersomnia, measles inclusion body encephalitis, ocular palsies, paraesthesia, polyneuritis, polyneuropathy, subacute sclerosing panencephalitis, syncope, transverse myelitis, tremor

            Eye disorders: Edema of the eyelid, irritation, necrotizing retinitis (reported only in immunocompromised individuals), optic neuritis, retinitis, retrobulbar neuritis

            Ear and labyrinth disorders: Ear pain, nerve deafness

            Vascular disorders: Extravasation

            Respiratory, thoracic and mediastinal disorders: Bronchial spasm, bronchitis, epistaxis, pneumonitis, pneumonia, pulmonary congestion, rhinitis, sinusitis, sneezing, sore throat, wheezing

            Gastrointestinal disorders: Abdominal pain, flatulence, hematochezia, mouth ulcer

            Skin and subcutaneous tissue disorders: Erythema multiforme, Henoch-Schönlein purpura, herpes

            Musculoskeletal, connective tissue and bone disorders: Arthritis and/or arthralgia (usually transient and rarely chronic, see below); musculoskeletal pain; myalgia; pain of the hip, leg, or neck; swelling

            Reproductive system and breast disorders: Epididymitis

            General disorders and administration site conditions: Injection-site complaints (burning and/or stinging of short duration, eczema, edema/swelling, hive-like rash, discoloration, hematoma, induration, lump, vesicles, wheal and flare), inflammation, lip abnormality, papillitis, roughness/dryness, stiffness, trauma, varicella-like rash, venipuncture site hemorrhage, warm sensation, warm to touch

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            Warnings

            Contraindications

            History of anaphylactic reaction to neomycin (may consult allergist/immunologist if absolutely necessary, give in setting where anaphylactic reaction can be immediately controlled)

            Hypersensitivity to gelatin or any other component

            Blood dyscrasia, leukemia, lymphoma, malignancy affecting bone marrow/lymphatic system

            Immunodeficient patients, family history of immunodeficiency

            Active untreated TB

            Pregnancy

            Fever >101.3°F (38.5°C)

            Cautions

            History of cerebral injury, individual/family history of convulsions, any other condition where stress due to fever needs to be avoided, hypersensitivity to eggs

            Hypersensitivity to neomycin-may cause contact dermatitis

            No information of safety/efficacy if given after exposure

            Febrile seizures

            • Early findings from an ongoing CDC study show that children who get an MMRV vaccine may be twice as likely to have a febrile seizure 7-10 days after getting the shot than children who get MMR and varicella vaccines (2 shots) at the same health care visit
            • During the 7-10 days after vaccination, about one additional febrile seizure would be expected to occur among every 2,000 children vaccinated with MMRV vaccine, compared with children vaccinated with MMR and varicella administered at the same visit
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            Pregnancy & Lactation

            Pregnancy Category: C (contraindicated)

            Lactation: Contraindicated

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Vaccine containes live, attenuated viruses that stimulate active immunity

            Pharmacokinetics

            Duration: At least 1 year; not studied for longer periods

            These products convey active immunity via stimulation of production of endogenously produced antibodies

            Onset of protection from disease is relatively slow, but duration is long lasting (years)

            Pharmacogenomics

            HLA-B7, HLA-B51, HLA-DRB1*13, and HLADQA1*01 is associated with a measles vaccine response

            Homozygosity at HLA-B, HLA-DR, and HLA-DQA1 has been associated with a measles vaccine nonresponse

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            Images

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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            NC NOT COVERED – Drugs that are not covered by the plan.
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            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
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