Dosing & Uses
Not indicated
Dosage Forms & Strengths
measles virus/mumps virus/rubella virus/varicella virus
injection, lyophilized powder for reconstitution
- ≥1000 TCID50/≥13,000 TCID50/≥1000 TCID50/≥1,999 PFU
Measles, Mumps, Rubella, & Varicella Vaccination
Routine vaccination (2 doses): First dose of 0.5 mL SC/IM 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
Current vaccination schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.html
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 additional dose
- MMRV vaccine, may also be used when a third dose of mumps vaccine is indicated among children aged ≤12 yr
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (13)
- belimumab
belimumab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Do not give live vaccines concurrently with certolizumab.
- ibrutinib
ibrutinib decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunization with live virus vaccines is generally not recommended.
- onasemnogene abeparvovec
onasemnogene abeparvovec decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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.
Serious - Use Alternative (76)
- abrocitinib
abrocitinib decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- alefacept
alefacept decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- anakinra
anakinra decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- anifrolumab
anifrolumab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- aspirin
aspirin, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- aspirin rectal
aspirin rectal, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- atoltivimab/maftivimab/odesivimab
atoltivimab/maftivimab/odesivimab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- balsalazide
balsalazide, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- baricitinib
baricitinib decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.
- cabazitaxel
cabazitaxel decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- choline magnesium trisalicylate
choline magnesium trisalicylate, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- ciltacabtagene autoleucel
ciltacabtagene autoleucel decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.
- cyclosporine
cyclosporine decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.
deflazacort decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.
- diflunisal
diflunisal, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- elivaldogene autotemcel
elivaldogene autotemcel, measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- everolimus
everolimus decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- fingolimod
fingolimod decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.
- glatiramer
glatiramer decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- golimumab
golimumab decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- guselkumab
guselkumab, measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- hydroxyurea
hydroxyurea decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- leflunomide
leflunomide decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- mercaptopurine
mercaptopurine decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- mesalamine
mesalamine, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- methylprednisolone
methylprednisolone decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- mycophenolate
mycophenolate decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- ocrelizumab
ocrelizumab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.
- prednisone
prednisone decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.
- rilonacept
rilonacept decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- risankizumab
risankizumab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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.
- salicylates (non-asa)
salicylates (non-asa), measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- salsalate
salsalate, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- sarilumab
sarilumab, measles, mumps, rubella and varicella vaccine, live. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid concurrent use of live virus vaccines, owing to potentially increased risk of infections. The interval between live vaccinations and initiation of sarilumab therapy should be in accordance with current vaccination guidelines regarding immunosuppressive agents.
- satralizumab
satralizumab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- sulfasalazine
sulfasalazine, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
- tacrolimus
tacrolimus decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- temsirolimus
temsirolimus decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- teplizumab
teplizumab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- tralokinumab
tralokinumab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.
- upadacitinib
upadacitinib decreases effects of measles, mumps, rubella and varicella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- ustekinumab
ustekinumab decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.
- voclosporin
voclosporin decreases effects of measles, mumps, rubella and varicella 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.
- willow bark
willow bark, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.
Monitor Closely (13)
- anthrax immune globulin
anthrax immune globulin decreases effects of measles, mumps, rubella and varicella 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.
- betibeglogene autotemcel
betibeglogene autotemcel, measles, mumps, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.
- hepatitis B immune globulin (HBIG)
hepatitis B immune globulin (HBIG) decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.
- immune globulin SC
immune globulin SC decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor.
- leniolisib
leniolisib decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Use Caution/Monitor. Separate by 3 months.
- ublituximab
ublituximab decreases effects of measles, mumps, rubella and varicella 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, rubella and varicella 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, rubella and varicella vaccine, live by pharmacodynamic antagonism. Minor/Significance Unknown.
- Rho(D) immune globulin
Rho(D) immune globulin decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Minor/Significance Unknown. Separate by 3 months.
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
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
Caution in children with thrombocytopenia, of those who experienced thrombocytopenia after vaccination
Avoid close contact with high-risk individuals susceptible to varicella since transmission of varicella vaccine virus may occur between vaccinees and susceptible contacts
Safety and efficacy for postexposure prophylaxis have not been established
Safety and efficacy in HIV-infected children have not been established
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
- 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
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Immune globulins and transfusion
- Immune globulins (IG) 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
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Salicylates
- Reye syndrome reported following salicylate administration during wild-type varicella infection
- Avoid salicylates for 6 weeks after vaccination
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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)
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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
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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
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.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
Administration
SC or IM Preparation
Withdraw the entire volume of the supplied diluent into a syringe; use only the diluent supplied with the vaccine since it is free of preservatives or other antiviral substances
Inject the entire content of the syringe into the vial containing the powder
Gently agitate to dissolve completely
Visually inspect the resulting solution; when reconstituted, the solution is a clear pale yellow to light pink liquid
Administer immediately after reconstitution; if not used immediately, may be stored at room temperature, protected from light, for up to 30 min
Discard if not used within 30 minutes
SC or IM Administration
Withdraw the entire amount of the reconstituted vaccine from the vial into a syringe and inject the entire volume SC/IM
Administer SC/IM in the outer aspect of the deltoid region of the upper arm or into the higher anterolateral area of the thigh
Storage
Unopened frozen lyophilized powder
- Maintain temperature at -58°F to +5°F (-50°C to -15°C)
- May be stored refrigerated at 36-46°F (2-8°C) for up to 72 hr before reconstitution
- Discard if not reconstituted and administered within 72 hr of refrigeration
- Protect from light
Unopened refrigerator-stable lyophilized powder
- Shelf-life of 24 months when refrigerated at 2-8ºC or colder (36-46ºF or colder)
- May also be stored in a freezer; if subsequently transferred to refrigerator, DO NOT REFREEZE
- Protect from light
Reconstituted vaccine
- Administer immediately after reconstitution
- Do not freeze reconstituted vaccine
- Discard if not used within 30 minutes
Diluent vial
Store separately at room temperature (20-25ºC [68-77ºF]), or refrigerate
Images
Patient Handout
measles,mumps,rubella,varicella live vacc (PF) subcutaneous
MEASLES/MUMPS/RUBELLA/VARICELLA VACCINE - INJECTION
(MEE-zulz/mumps/roo-BEL-a/VAR-i-SEL-a)
COMMON BRAND NAME(S): ProQuad
USES: This medication is a combination of vaccines against several virus infections: measles (also known as rubeola), mumps, rubella (also known as German measles), and varicella (also known as chickenpox). These are common childhood infections that may cause serious (rarely fatal) problems. Vaccination is the best way to protect against these infections.This vaccine contains live viruses that have been weakened. It works by causing the body to produce its own protection (antibodies) against the viruses that cause measles, mumps, rubella, and chickenpox.This combination of vaccines is usually used by children between 12 months and 12 years old.
HOW TO USE: Read all vaccine information available from your health care professional before receiving the vaccine. If you have any questions, ask your health care professional.This vaccine is given by injection by a health care professional. Depending on the brand of vaccine your child receives, it will be given either under the skin or into the muscle of the upper arm.Vaccines are usually given in a series of doses to provide the best protection. Closely follow the vaccination schedule provided by the health care professional. Keep all scheduled medical appointments. It may be helpful to mark a calendar as a reminder.This combination of vaccines may be given at the same time as other childhood vaccines (such as haemophilus, hepatitis B) using a separate needle and injection site.There are various combinations of vaccines available. Based on your child's age, vaccination history, and previous reaction to vaccines, the health care professional will decide which vaccines are best for your child. Discuss the risks and benefits of vaccination with the health care professional.
SIDE EFFECTS: Pain/redness/swelling at the injection site, fever, rash, and fussiness may occur. If any of these effects last or get worse, tell the health care professional promptly.Rarely, some people have symptoms such as fainting, dizziness, vision changes, or ringing in the ears just after getting a vaccine injection. Tell the health care professional right away if your child has any of these symptoms. Sitting or lying down may help, since these symptoms usually don't last long.Remember that this medication has been prescribed because the health care professional has judged that the benefit to your child is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell the health care professional right away if your child has any serious side effects, including: easy bruising/bleeding, joint pain/stiffness, seizures, mental/mood changes (such as confusion).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact the health care professional.Contact the health care professional for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967. In Canada, you may call the Vaccine Safety Section at Public Health Agency of Canada at 1-866-844-0018.
PRECAUTIONS: Before your child receives this product, tell the health care professional if your child is allergic to it; or if your child has any other allergies. This product may contain inactive ingredients (such as neomycin), which can cause allergic reactions or other problems. Talk to your health care professional for more details.Before receiving this product, tell the health care professional your child's medical history, especially of: current fever/illness (such as untreated tuberculosis), bleeding/blood clotting problems (such as hemophilia, low platelets), immune system disorders (such as due to HIV infection, certain cancers such as leukemia/lymphoma, cancer or radiation treatment), scheduled organ transplant, brain/nervous system disorders (such as seizures, head injury), history of Guillain-Barre syndrome.There is a small risk that your child may expose others to infection with chickenpox for up to 6 weeks after your child has been vaccinated. If your child develops a rash after getting the vaccine, if possible, your child should avoid being in the same room with newborn babies (especially if born prematurely), pregnant women who have not had chickenpox, and people with immune system problems until the rash has dried or crusted over.Tell your health care professional if you are pregnant or plan to become pregnant. This vaccine should not be given if you are pregnant. It may harm an unborn baby. Avoid getting pregnant for 4 weeks after receiving this vaccine. Talk to your health care professional for details.This vaccine may pass into breast milk. However, it is unlikely to harm a nursing infant. Consult the health care professional before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your child's medications work or increase your child's risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products your child uses (including prescription/nonprescription drugs and herbal products) and share it with the health care professional. Do not start, stop, or change the dosage of any medicines without your child's doctor's approval.Some products that may interact with this vaccine include: drugs that weaken the immune system (such as azathioprine, cyclosporine, cancer chemotherapy, corticosteroids such as prednisone), recent blood transfusion or use of blood products (such as immunoglobulins), certain antiviral drugs (such as acyclovir, famciclovir, and valacyclovir).Avoid giving your child aspirin or aspirin-like medications (such as salsalate) for 6 weeks after your child has been vaccinated.This product may interfere with certain lab tests (such as tuberculosis skin tests), possibly causing false test results. Make sure lab personnel and all the health care professionals know that your child has recently received this product.
OVERDOSE: Not applicable.
NOTES: Even if your child has already had any of the diseases that this vaccine prevents, your child may not be protected from getting those diseases again. Your child should still receive this vaccine if the health care professional orders it.
MISSED DOSE: It is important that your child receives each vaccination as scheduled. Be sure to make a note of when your child received their last vaccination for their medical record.
STORAGE: Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Protect from light. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised July 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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