Trade Names:ProQuad- Powder for injection, lyophilized mixture of 4 viruses: at least 3 log 10 measles TCID 50 (50% tissue culture infectious doses), 4.3 log 10 mumps TCID 50 , 3 log 10 rubella TCID 50 , and at least 3.99 log 10 varicella plaque-forming units (PFU) per 0.5 mL dose
Produces active immunity to measles, mumps, rubella, and varicella viruses by inducing antibody production.
Simultaneous vaccination against measles, mumps, rubella, and varicella in children 12 mo to 12 yr of age; may be used in children 12 mo to 12 yr of age if a second dose of measles, mumps, and rubella vaccine is to be administered.
Individuals with a history of anaphylactic reactions to neomycin; individuals with a history of hypersensitivity to gelatin or any component of the vaccine; individuals with blood dyscrasias leukemia, lymphomas of any type, or other malignant neoplasms affecting the bone marrow or lymphatic system; individuals on immunosuppressive therapy (including high-dose systemic corticosteroids); individuals with primary and acquired immunodeficiency states (including AIDS or other clinical manifestation of infection with HIV), cellular immune deficiencies, and hypogammaglobulinemic and dysgammaglobulinemic states; individuals with family history of congenital or hereditary immunodeficiency (unless immune competence of the potential vaccine recipient has been demonstrated); individuals with active, untreated tuberculosis; individuals with an active febrile illness with fever higher than 101.3°F; individuals who are pregnant.
Subcutaneous Single 0.5 mL dose. Allow at least 1 mo from previous dose of measles-containing vaccine. If second dose of a varicella-containing vaccine is required, at least 3 mo should elapse between doses.
Store powder for injection continuously in a frost-free freezer (−15° or colder) for up to 18 mo. Protect from light. Do not store powder for injection in refrigerator; discard any vaccine inadvertently stored in refrigerator. Do not freeze reconstituted vaccine. Store diluent separately at controlled room temperature (68° to 77°F) or in refrigerator (36° to 46°F).
Do not administer vaccine to individuals receiving immunosuppressive doses of corticosteroids or other immunosuppressive agents.Immune globulins, transfusions
May interfere with expected immune response. Defer vaccination for at least 3 mo following blood or plasma transfusions or administration of immune globulin.Salicylates
Risk of Reye syndrome may be increased. Avoid use of salicylates for 6 wk after vaccination.
May result in a temporary depression of tuberculin skin sensitivity. If tuberculin test is to be done, administer before, simultaneously with, or at least 4 to 6 wk after measles, mumps, rubella, and varicella virus vaccine. At least 1 mo should elapse between a dose of measles-containing vaccine and administration of measles, mumps, rubella, and varicella virus vaccine. If a second dose of varicella-containing vaccine is necessary, at least 3 mo should elapse between administration of the 2 doses.
Irritability (7%); aseptic meningitis, encephalitis, encephalopathy, subacute sclerosing panencephalitis (postmarketing).
Measles-like rash (3%); rash, varicella-like rash (2%); viral exanthema (1%).
Pain, soreness, tenderness (22%); erythema (14%); swelling (8%); ecchymosis, rash (2%).
Arthralgia, arthritis (postmarketing).
Upper respiratory infection (1%).
Fever (22%); death (causal relationship not established [postmarketing]).
Category C . Do not administer to pregnant women. If postpubertal women are vaccinated, pregnancy should be avoided for 3 mo.
Undetermined (measles and mumps vaccine viruses); secreted in breast milk and transmitted to breast-fed infants (rubella virus); undetected in breast milk (varicella). Do not administer to breast-feeding women.
Safety and efficacy not established in children younger than 12 mo of age.
Use with caution in patients with history of cerebral injury, individual or family history of convulsions, or any other condition in which stress caused by fever should be avoided.
Contains albumin; theoretical risk of transmission of CJD and viral diseases.
Safety and efficacy have not been established for use in HIV-infected patients.
Patients with a history of anaphylactic or other immediate hypersensitivity reactions (eg, difficulty breathing, hives, hypotension, swelling of mouth or throat) subsequent to egg ingestion may be at increased risk of immediate-type hypersensitivity reactions after receiving the vaccine. Vaccinate these patients with extreme caution; have adequate treatment for reactions readily available. Patients with allergies to chickens or feathers are not at increased risk of reaction to vaccine.
Neomycin allergy presenting as a contact dermatitis is not a contraindication for vaccination.
Vaccination with live attenuated vaccine can result in a more extensive, vaccine-associated rash or disseminated disease in patients on immunosuppressive therapy.
Patients with thrombocytopenia may develop more severe thrombocytopenia; patients who experienced thrombocytopenia following the first dose of live measles, mumps, and rubella vaccine may develop thrombocytopenia with repeat doses.
Transmission of varicella vaccine virus may occur rarely between healthy vaccine recipients who develop varicella-like rash and contacts susceptible to varicella, as well as high-risk patients susceptible to varicella (eg, immunocompromised; pregnant women or newborn infants of mothers without documented positive history of varicella or lab evidence of prior infection). Vaccine recipients should attempt to avoid close association with high-risk individuals susceptible to varicella for up to 6 wk following vaccination.
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