measles mumps and rubella vaccine, live (Rx)

Brand and Other Names:M-M-R II, Priorix

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

measles virus/mumps virus/rubella virus

injection, lyophilized powder for reconstitution

  • ≥1000 TCID50/≥12,500 TCID50/≥1000 TCID50 (M-M-R II)*
  • ≥3.4 log10 CCID50/≥4.2 log10 CCID50/≥3.3 log10 CCID50 (Priorix)**
  • *Tissue culture infectious doses (TCID)
  • **Cell culture infectious doses (CCID)

Immunization Against Measles, Mumps & Rubella

Adults born before 1957 are considered immune to measles and mumps; all adults born in 1957 or later should have documentation of 1 or more doses of MMR vaccine unless contraindicated, or laboratory evidence of immunity to each of the 3 diseases

19-49 years old: 0.5 mL SC/IM; second dose administered 28 days later for high risk adults (see 2nd dose recommendations below)

>50 years old: 0.5 mL SC/IM; administer 1 dose only

Postexposure prophylaxis

  • Administer 0.5 mL/SC/IM x 1 dose within 72 hr after exposure

2nd dose recommendations

  • Student in postsecondary eduction
  • Recent exposure
  • Occupational risk
  • Previously vaccinated with killed measles vaccine
  • Vaccinated with unknown type of measles vaccine during 1963-67
  • International travelers
  • Healthcare personnel should consider receiving 2 doses of MMR vaccine at the appropriate interval for measles and mumps or 1 dose of MMR vaccine for rubella

Additional dose during mumps outbreak

  • CDC ACIP recommendations MMWR January 12, 2018:67(1);33-38
  • Increased risk for acquiring mumps are individuals who are more likely to have prolonged or intense exposure to droplets or saliva from a person infected with mumps, (eg, close contact or sharing of drinks or utensils)
  • During an outbreak, persons identified as being at increased risk who have received ≤2 doses of mumps virus-containing vaccine or have unknown vaccination status should receive 1 dose

Immunization in Pregnancy

Pregnant women who do not have evidence of immunity should receive MMR vaccine upon completion or termination of pregnancy and before discharge from the health-care facility

Pregnancy should be avoided for 28 days following vaccine administration

Vaccination Schedules

Up-to-date vaccination schedules available at www.cdc.gov/nip/publications

Dosage Forms & Strengths

measles virus/mumps virus/rubella virus

injection, lyophilized powder for reconstitution

  • ≥1000 TCID50/≥12,500 TCID50/≥1000 TCID50 (M-M-R II)*
  • ≥3.4 log10 CCID50/≥4.2 log10 CCID50/≥3.3 log10 CCID50 (Priorix)**
  • *Tissue culture infectious doses (TCID)
  • **Cell culture infectious doses (CCID)

Immunization Against Measles, Mumps & Rubella

Routine vaccination: First dose of 0.5 mL SC/IM between age 12-15 months; administer second dose between 4-6 yr

Minimum age for 1st dose is 12 months

International travel

  • 6-12 months: Administer 1 dose of MMR before departure from the United States for international travel; revaccinate with 2 doses of MMR, the first at age 12-15 months (12 months if the child remains in an area where disease risk is high), and the second dose at least 4 weeks later
  • >12 months: Administer 2 doses of MMR before departure from the United States for international travel; the first dose should be administered on or after age 12 months and the second dose at least 4 weeks later

Catch-up vaccination

  • Ensure all school-aged children and adolescents received 2 doses (0.5 mL SC/IM each)
  • Minimum time between 1st and 2nd dose is 4 wk

Perinatal HIV infection

  • Revaccinate persons who were vaccinated before establishment of effective antiretroviral therapy with 2 appropriately spaced doses of MMR vaccine once effective ART has been established

12 months or older with HIV infection

  • Vaccinate all persons with HIV infection who do not have evidence of current severe immunosuppression

Additional dose during mumps outbreak

  • CDC ACIP recommendations
    • MMWR January 12, 2018:67(1);33-38
    • Increased risk for acquiring mumps are individuals who are more likely to have prolonged or intense exposure to droplets or saliva from a person infected with mumps, (eg, close contact or sharing of drinks or utensils)
    • During an outbreak, persons identified as being at increased risk who have received ≤2 doses of mumps virus-containing vaccine or have unknown vaccination status should receive 1 dose
  • Infants aged 6-12 months
    • Local health authorities may recommend measles vaccination of infants in outbreak situations
    • This population may fail to respond to the components of the vaccine; safety and effectiveness of mumps and rubella vaccine in infants aged <12 months have not been established
    • The younger the infant, the lower the likelihood of seroconversion
    • Such infants should receive a second dose of MMR between aged 12-15 months followed by revaccination at elementary school entry
Next:

Interactions

Interaction Checker

and measles mumps and rubella vaccine, live

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (14)

            • belimumab

              belimumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Do not administer live vaccines 30 days before or concurrently with belimumab.

            • certolizumab pegol

              certolizumab pegol decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Do not give live vaccines concurrently with certolizumab.

            • ibrutinib

              ibrutinib decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo after cessation of immunosuppressive therapy.

            • ifosfamide

              ifosfamide decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.

            • ixekizumab

              ixekizumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Ixekizumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating ixekizumab, complete all age appropriate immunizations.

            • lomustine

              lomustine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.

            • mechlorethamine

              mechlorethamine decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo after cessation of immunosuppressive therapy.

            • melphalan

              melphalan decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.

            • methotrexate

              methotrexate decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunization with live virus vaccines is generally not recommended.

            • onasemnogene abeparvovec

              onasemnogene abeparvovec decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Adjust vaccinations to accommodate concomitant corticosteroid administration prior to and following onasemnogene abeparvovec infusion. Avoid live vaccines for at least 1 month when initiating or after high-dose systemic corticosteroid therapy administered for =2 weeks.

            • oxaliplatin

              oxaliplatin decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.

            • procarbazine

              procarbazine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo after cessation of immunosuppressive therapy.

            • secukinumab

              secukinumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Contraindicated. Secukinumab may interfere with immune response of live vaccines and increase risk for vaccine adverse effects; prior to initiating secukinumab, complete all age appropriate immunizations.

            • ustekinumab

              ustekinumab decreases effects of measles mumps and rubella vaccine, live by Mechanism: pharmacodynamic antagonism. Contraindicated. Prior initiating therapy, patients should receive all age-appropriate immunizations as recommended by current guidelines. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            Serious - Use Alternative (66)

            • abrocitinib

              abrocitinib decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Administration of live vaccines is not recommended during abrocitinib treatment and immediately before or after treatment.

            • adalimumab

              adalimumab decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • alefacept

              alefacept decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • anakinra

              anakinra decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • anifrolumab

              anifrolumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Before initiation, update immunization according to current guidelines.

            • antithymocyte globulin equine

              antithymocyte globulin equine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • antithymocyte globulin rabbit

              antithymocyte globulin rabbit decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • atoltivimab/maftivimab/odesivimab

              atoltivimab/maftivimab/odesivimab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Ebola monoclonal antibodies may interfere with immune response of live vaccines. Refer to vaccine guidelines for vaccination timing during and following treatment. .

            • axicabtagene ciloleucel

              axicabtagene ciloleucel decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid live virus vaccines for at least 6 weeks before initiating lymphodepleting therapy, during axicabtagene ciloleucel treatment, and after treatment until full immune recovery is achieved.

            • azathioprine

              azathioprine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • baricitinib

              baricitinib decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live vaccines with baricitinib. Update immunizations in agreement with current immunization guidelines before initiating baricitinib.

            • basiliximab

              basiliximab decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • brexucabtagene autoleucel

              brexucabtagene autoleucel decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid live virus vaccines for at least 6 weeks before initiating lymphodepleting therapy, during brexucabtagene autoleucel treatment, and after treatment until full immune recovery is achieved.

            • budesonide

              budesonide decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • cabazitaxel

              cabazitaxel decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Live attenuated vaccines should not be used in patients receiving immunosuppressive therapy. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects.

            • canakinumab

              canakinumab decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • ciltacabtagene autoleucel

              ciltacabtagene autoleucel decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Vaccination with live virus vaccines is not recommended for at least 6 weeks before starting lymphodepleting chemotherapy, during CAR-T cell treatment, and until immune recovery following treatment. .

            • cortisone

              cortisone decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • cyclosporine

              cyclosporine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Avoid live vaccines in immunocompromised patients due to the risk of developing a clinical infection from the live vaccine. Inadequate immune response to the vaccine may also occur in the presence of immunosuppressants. Avoid live vaccines for at least 3 months after cessation of immunosuppressant therapy unless the benefit of vaccine administration outweighs the potential risk.

            • deflazacort

              deflazacort decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

              deflazacort decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Do not administer live or live attenuated vaccines to patients receiving immunosuppressive doses of corticosteroids.

            • dexamethasone

              dexamethasone decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • dupilumab

              dupilumab, measles mumps and rubella vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating dupilumab, complete all age appropriate immunizations. Avoid use of live vaccines in patients treated with dupilumab.

            • elivaldogene autotemcel

              elivaldogene autotemcel, measles mumps and rubella vaccine, live. Either decreases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: The safety and effectiveness of vaccination during or following elivaldogene autotemcel treatment have not been studied. Vaccination is not recommended during the 6 weeks preceding myeloablative conditioning, and until hematological recovery following elivaldogene autotemcel treatment. Where feasible, administer childhood vaccinations before myeloablative conditioning. .

            • etanercept

              etanercept decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • everolimus

              everolimus decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • fingolimod

              fingolimod decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid live attenuated vaccines during and for 2 months after stopping fingolimod.

            • fludrocortisone

              fludrocortisone decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • glatiramer

              glatiramer decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • golimumab

              golimumab decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • guselkumab

              guselkumab, measles mumps and rubella vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating guselkumab, complete all age appropriate immunizations. No data available on the ability of live or inactive vaccine to elicit an immune response in patients treated with guselkumab.

            • hydrocortisone

              hydrocortisone decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • hydroxyurea

              hydroxyurea decreases effects of measles mumps and rubella vaccine, live by Other (see comment). Avoid or Use Alternate Drug. Comment: Vaccination with live vaccines in a patient receiving hydroxyurea may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection).

            • idecabtagene vicleucel

              idecabtagene vicleucel decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Vaccination with live virus vaccines is not recommended for at least 6 weeks before starting lymphodepleting chemotherapy, during CAR-T cell treatment, and until immune recovery following treatment. .

            • infliximab

              infliximab decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • leflunomide

              leflunomide decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • mercaptopurine

              mercaptopurine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • methylprednisolone

              methylprednisolone decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • muromonab CD3

              muromonab CD3 decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • mycophenolate

              mycophenolate decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • ocrelizumab

              ocrelizumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Vaccination with live-attenuated or live vaccines is not recommended during ocrelizumab treatment and until B-cell repletion.

            • ofatumumab SC

              ofatumumab SC decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Administer all immunizations according to immunization guidelines at least 4 weeks prior to initiation of ofatumumab SC for live or live-attenuated vaccines, and whenever possible.

            • ozanimod

              ozanimod decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live-attenuated vaccines with ozanimod during treatment and for up to 3 months after discontinuing ozanimod. .

            • ponesimod

              ponesimod decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live attenuated vaccines at least 1 month before initiating, during, and for 1-2 weeks after treatment. Coadministration with live attenuated vaccines may increase infection risk.

            • prednisolone

              prednisolone decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • prednisone

              prednisone decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • rilonacept

              rilonacept decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • risankizumab

              risankizumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live vaccines. Before starting risankizumab, complete age appropriate immunizations.

            • ritlecitinib

              ritlecitinib, measles mumps and rubella vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid live attenuated vaccines during or shortly before initiating ritlecitinib. No data are available on vaccination response in ritlecitinib treated patients. Before initiating, review patient immunization status (including herpes zoster) and immunize accordingly in agreement with current immunization guidelines.

            • rituximab

              rituximab, measles mumps and rubella vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.

            • rituximab-hyaluronidase

              rituximab-hyaluronidase, measles mumps and rubella vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Safety of immunization with live viral vaccines following rituximab therapy has not been studied and vaccination with live virus vaccines is not recommended.

            • satralizumab

              satralizumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. ive vaccines are not recommended during treatment. Administer all immunizations according to immunization guidelines. At least 4 weeks before initiating for live or live-attenuated vaccines.

            • siponimod

              siponimod decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.

            • sirolimus

              sirolimus decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • tacrolimus

              tacrolimus decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • temsirolimus

              temsirolimus decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • teplizumab

              teplizumab decreases effects of measles mumps and rubella vaccine, live by Other (see comment). Avoid or Use Alternate Drug. Comment: Administer all age-appropriate vaccinations before starting teplizumab. Live-attenuated vaccines are not recommended within 8 weeks before teplizumab treatment, during treatment, or up to 52 weeks after treatment.

            • tildrakizumab

              tildrakizumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Before initiating tildrakizumab therapy, consider completion of all age appropriate immunizations according to current immunization guidelines. Avoid use of live vaccines in patients treated with tildrakizumab. No data are available on the response to live or inactive vaccines.

            • tisagenlecleucel

              tisagenlecleucel decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Vaccination with live virus vaccines is not recommended for at least 6 weeks before starting lymphodepleting chemotherapy, during CAR-T cell treatment, and until immune recovery following treatment. .

            • tocilizumab

              tocilizumab decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • tralokinumab

              tralokinumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live vaccines. Before starting tralokinumab, complete age appropriate immunizations.

            • triamcinolone acetonide injectable suspension

              triamcinolone acetonide injectable suspension decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • upadacitinib

              upadacitinib decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

            • ustekinumab

              ustekinumab decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Prior initiating therapy, patients should receive all age-appropriate immunizations as recommended by current guidelines. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • vedolizumab

              vedolizumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of live virus vaccines while receiving vedolizumab; live vaccines may be administered concurrently with vedolizumab only if the benefits outweigh the risks.

            • voclosporin

              voclosporin decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.

            Monitor Closely (16)

            • anthrax immune globulin

              anthrax immune globulin decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Immune globulin administration may impair the efficacy of live attenuated vaccines. Defer vaccination with live virus vaccines until ~3 months after administration of anthrax IG. Revaccinate people who received anthrax IG shortly after live virus vaccination following 3 months after the administration of anthrax IG.

            • belatacept

              belatacept decreases effects of measles mumps and rubella vaccine, live by Other (see comment). Use Caution/Monitor. Comment: The use of live vaccines should be avoided during treatment with belatacept. Inform patients that vaccinations may be less effective while they are being treated with belatacept.

            • betibeglogene autotemcel

              betibeglogene autotemcel, measles mumps and rubella vaccine, live. Other (see comment). Use Caution/Monitor. Comment: Follow institutional guidelines for vaccine administration. Safety of live vaccines during or following treatment not studied. .

            • cytomegalovirus immune globulin (CMV IG)

              cytomegalovirus immune globulin (CMV IG) decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.

            • delandistrogene moxeparvovec

              delandistrogene moxeparvovec, measles mumps and rubella vaccine, live. Other (see comment). Use Caution/Monitor. Comment: Consider patient vaccination status before initiating corticosteroid regimen required before delandistrogene moxeparvovec administration. If possible, ensure patients are current with all immunizations according to immunization guidelines. Complete vaccinations at least 4 weeks before starting corticosteroid regimen. High-dose or long-term corticosteroids may decrease immungenicity of vaccines.

            • dengue vaccine

              dengue vaccine, measles mumps and rubella vaccine, live. unspecified interaction mechanism. Use Caution/Monitor. Data are not available to establish safety and immunogenicity of coadministration of dengue vaccine with recommended adolescent vaccines.

            • hepatitis B immune globulin (HBIG)

              hepatitis B immune globulin (HBIG) decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.

            • immune globulin IM (IGIM)

              immune globulin IM (IGIM) decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.

            • immune globulin IV (IGIV)

              immune globulin IV (IGIV) decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.

            • immune globulin SC

              immune globulin SC decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor.

            • leniolisib

              leniolisib decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Use Caution/Monitor. Live, attenuated vaccinations may be less effective if administered during leniolisib treatment.

            • obinutuzumab

              obinutuzumab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunization with live virus vaccines is not recommended during obinutuzumab treatment and until after B-cell recovery.

            • rabies immune globulin, human (RIG)

              rabies immune globulin, human (RIG) decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.

            • tetanus immune globulin (TIG)

              tetanus immune globulin (TIG) decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.

            • ublituximab

              ublituximab decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.

            • vaccinia immune globulin intravenous

              vaccinia immune globulin intravenous decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Defer live vaccines for 3 months after immune globulin administration.

            Minor (2)

            • chloroquine

              chloroquine decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Minor/Significance Unknown.

            • Rho(D) immune globulin

              Rho(D) immune globulin decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Minor/Significance Unknown. Separate by 3 months.

            Previous
            Next:

            Adverse Effects

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

            Frequency Not Defined

            Fever

            Syncope

            Ataxia

            Pain at site

            Headache

            Rash

            Lymphadenopathy

            Myalgia

            Stevens-Johnson syndrome

            Thrombocytopenia

            Optic neuritis

            Encephalitis

            Malaise

            Irritability

            Guillain-Barre synd

            Subacute sclerosing panencephalitis (rare)

            Seizures

            Parotitis

            Bronchospasm

            Leukocytosis

            Conjunctivitis

            Otitis media

            Nerve deafness

            Previous
            Next:

            Warnings

            Contraindications

            Pregnancy (see Pregnancy and Lactation)

            Hypersensitivity

            • 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

            Immunosuppression

            • Individuals with blood dyscrasias, leukemia, lymphomas of any type, or malignancy affecting bone marrow/lymphatic system
            • Primary and acquired immunodeficiency states including AIDS, cellular immune deficiencies, hypogammaglobulinemic and dysgammaglobulinemic states, or family history of congenital or hereditary immunodeficiency
            • Individuals taking immunosuppressive drugs; may be used with topical corticosteroids or low-dose corticosteroids (as commonly used for asthma prophylaxis) or in patients who are receiving corticosteroids as replacement therapy (eg, Addison disease)

            Concurrent illness

            • Active untreated TB
            • Fever >101.3°F (38.5°C)

            Cautions

            Caution when administering MMRV to persons with a history of cerebral injury, individual or family history of convulsions, or any other condition in which stress due to fever should be avoided

            History of anaphylactic or other immediate hypersensitivity reactions (eg, hives, laryngeal edema, difficulty breathing, hypotension, or shock) subsequent to egg ingestion may be at an enhanced risk of immediate-type hypersensitivity reactions after receiving vaccines containing traces of chick embryo antigen; carefully evaluate the potential risk-to-benefit ratio before considering vaccination

            Neomycin allergy most often manifests as contact dermatitis, which is not a contraindication to receiving the vaccine

            Transient thrombocytopenia reported within 4-6 weeks following vaccination with measles, mumps and rubella vaccine; carefully evaluate potential risk and benefit of vaccination in children with thrombocytopenia or in those who experienced thrombocytopenia after vaccination with a previous dose of measles, mumps, and rubella vaccine

            Safety and efficacy for postexposure prophylaxis have not been established

            Safety and efficacy in HIV-infected children have not been established

            Vaccination should be deferred in individuals with a family history of congenital or hereditary immunodeficiency until the individual’s immune status has been evaluated and the individual has been found to be immunocompetent

            Postmarketing reports suggest transmission of vaccine virus may occur to high-risk individuals (eg, immunocompromised, pregnant women without positive varicella history or vaccination, or newborn infants of mothers without positive varicella history)

            Contains albumin; theoretical risk for transmission Creutzfeldt-Jacob disease

            Febrile seizures

            • There is a risk of fever and associated febrile seizure in first 2 weeks following immunization with M-M-RII vaccine; for children who have experienced a previous febrile seizure (from any cause) and those with a family history of febrile seizures there is a small increase in risk of febrile seizure following receipt of M-M-RII vaccine
            • Administration of MMRV (dose 1) to children aged 12-23 months who have not been previously vaccinated against measles, mumps, rubella, or varicella, nor had a history of the wild-type infections, is associated with higher rates of fever and febrile seizures at 5-12 days after vaccination when compared with children vaccinated with dose 1 of both MMR and varicella vaccine administered separately

            Drug interactions overview

            • Immune globulins and transfusion
              • Immune globulins (IG) and other blood products coadministered with MMRV contain antibodies that may interfere with vaccine virus replication and decrease the expected immune response
              • Defer vaccination; appropriate suggested interval between transfusion or IG administration and vaccination will vary with the type of transfusion or indication for, and dose of, IG (eg, 5 months for varicella zoster immune globulin)
              • Refer to prescribing information for specific recommendations
            • Salicylates
              • Reye syndrome reported following salicylate administration during wild-type varicella infection
              • Avoid salicylates for 6 weeks after vaccination
            • Corticosteroids and immunosuppressive drugs
              • Do not administer to individuals receiving immunosuppressive doses of corticosteroids or other immunosuppressive drugs
              • Can result in a more extensive vaccine-associated rash or disseminated disease in individuals on immunosuppressive drugs (see Contraindications)
            • Use with other vaccines
              • At least 1 month should elapse between a dose of a measles-containing vaccine (eg, MMR) and a dose of MMRV, and at least 3 months should elapse between administration of 2 doses of MMRV or varicella-containing vaccines
            • Lab tests
              • MMR vaccine given individually may result in a temporary depression of tuberculin skin sensitivity
              • Therefore, if a tuberculin test is to be done, it should be administered either any time before, simultaneously with, or at least 4 to 6 weeks after MMRV
            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy

            Contraindicated during pregnancy; avoid pregnancy for 3 months following vaccination

            In a 10-year survey involving over 700 pregnant women who received rubella vaccine within 3 months before or after conception (of whom 189 received the Wistar RA 27/3 strain), none of the newborns had abnormalities compatible with congenital rubella syndrome

            Mumps infection during the first trimester of pregnancy may increase the rate of spontaneous abortion

            Although mumps vaccine virus has been shown to infect the placenta and fetus, there is no evidence that it causes congenital malformations in humans

            Reports have indicated that contracting wild-type measles during pregnancy enhances fetal risk; increased rates of spontaneous abortion, stillbirth, congenital defects and prematurity have been observed subsequent to infection with wild-type measles during pregnancy

            There are no adequate studies of the attenuated (vaccine) strain of measles virus in pregnancy; however, it would be prudent to assume that the vaccine strain of virus is also capable of inducing adverse fetal effects

            Lactation

            Unknown if measles or mumps vaccine is secreted in human milk

            The prescribing information describes studies that have shown lactating postpartum women immunized with live attenuated rubella vaccine may secrete the virus in breast milk and transmit it to breastfed infants

            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.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Live, attenuated viruses stimulate active immunity to disease caused by measles, rubella, and mumps viruses

            Pharmacokinetics

            Duration: >15 years after 2 doses

            Onset: Active immunity detected after 1 dose

            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

            Previous
            Next:

            Administration

            SC or IM Preparation

            Single-dose vial

            • M-M-R II
              • Withdraw entire volume of supplied diluent (vial) into the syringe to be used for reconstitution
              • Inject all the diluent into the vial of lyophilized vaccine, and agitate to mix thoroughly
              • Discard if lyophilized vaccine cannot be dissolved
              • Resulting suspension should appear clear yellow
              • Withdraw entire vial contents into syringe
            • Priorix
              • Hold prefilled syringe by barrel and unscrew syringe cap by twisting it counterclockwise
              • Align needle to axis of syringe and attach by gently connecting needle hub into Luer Lock adaptor and rotate a quarter turn clockwise until you feel it lock
              • Cleanse vial stopper and transfer entire contents of prefilled syringe into lyophilized vaccine
              • Without inverting vial, shake vial well until powder is completely dissolved
              • Resulting suspension should appear clear peach-to-fuchsia pink-colored
              • Discard if contains particulate matter or discolored
              • After reconstitution, withdraw entire vial contents of reconstituted vaccine into same syringe after changing needle

            SC or IM Administration

            25 gauge, 5/8-inch needle recommended

            Inject SC into outer aspect of upper arm

            Storage

            Unopened vials

            • M-M-R II
              • Store frozen/refrigerated at -58°F to +46°F (-50°C to +8°C)
              • Protect from light at all times, since light exposure may inactivate the viruses
              • Before reconstitution, refrigerate lyophilized vaccine at 36-46°F (2-8°C)
              • Store the diluent refrigerated or separately at room temperature; do not freeze diluent
            • Priorix
              • Vials of lyophilized vaccine: Refrigerate at 36-46ºF (2-8ºC); protect from light
              • Prefilled ungraduated syringes of sterile water diluent: Refrigerate at 36-46ºF (2-8ºC) or store at controlled room temperature up to 77ºF (25ºC)
              • Do not freeze lyophilized antigen component or sterile water diluent

            Reconstituted vials

            Use as soon as possible after reconstitution

            • M-M-R II
              • 36-46°F (2-8°C) for up to 8 hr; discard if not used within 8 hr
              • Protect from light
            • Priorix
              • 36-46ºF (2-8ºC) for up to 8 hr; discard if not used within 8 hr
              • Do not freeze; discard if reconstituted vaccine has been frozen
            Previous
            Next:

            Images

            No images available for this drug.
            Previous
            Next:

            Patient Handout

            A Patient Handout is not currently available for this monograph.
            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.