ACIP Issues New Guidelines for Use of Combination Measles, Mumps, Rubella, Varicella Vaccine
Laurie Barclay, MD
May 11, 2010 Specific Recommendations for Use
Specific recommendations for use of the MMRV vaccine are as follows:
Routinely recommended ages for MMRV vaccination continue to be ages 12 to 15 months for the first dose and ages 4 to 6 years for the second dose.
At ages 12 to 47 months, either measles, mumps, and rubella (MMR) vaccine and varicella vaccine or MMRV vaccine may be used for the first dose of measles, mumps, rubella, and varicella vaccines. Clinicians should inform the parents or caregivers regarding the benefits and risks of both vaccination options. The CDC recommends that MMR vaccine and varicella vaccine be given for the first dose in this age group unless the parent or caregiver expresses a preference for MMRV vaccine.
For the second dose of measles, mumps, rubella, and varicella vaccines at any age (15 months - 12 years) and for the first dose at age 48 months or older, the MMRV vaccine is preferred to separate injections of MMR vaccine and varicella vaccine, but provider evaluation, patient preference, and the risk for adverse events should be considered.
A precaution for MMRV vaccination is a personal history of seizures of any cause or a family history of seizures in a sibling or parent. These children generally should be vaccinated with MMR vaccine and varicella vaccine.
"Studies have not demonstrated that antipyretics (e.g., acetaminophen or ibuprofen) prevent febrile seizures," the report authors conclude. "Vaccination with either MMR vaccine or MMRV vaccine can cause fever and, rarely, febrile seizures. Most fevers and febrile seizures after administration of a measles-containing vaccine occur 5–12 days after vaccination with the first dose."
MMWR Morb Mortal Wkly Rep. 2010;59(RR-3):1-12.