MMR and Varicella Vaccines Administration
Yes, MMR and varicella vaccines can be safely administered together at the same visit as separate injections. 1
Administration Options
Simultaneous Administration
- MMR vaccine and varicella vaccine can be administered simultaneously at separate injection sites during the same visit 1
- Simultaneous administration of these vaccines produces seroconversion rates and adverse reaction rates similar to those observed when the vaccines are administered separately 1
- Administering vaccines simultaneously increases the probability that a child will be fully immunized at the appropriate age 1
Combination MMRV Vaccine vs. Separate Injections
- For children aged 12-47 months receiving their first dose, either MMR vaccine plus varicella vaccine or the combination MMRV vaccine may be used 1
- For the second dose at any age (15 months-12 years) or for the first dose at age ≥48 months, MMRV vaccine is generally preferred over separate injections 1
Age-Specific Recommendations
First Dose (12-47 months)
- For children receiving their first dose at 12-47 months of age, CDC recommends MMR vaccine and varicella vaccine as separate injections unless the parent or caregiver specifically requests MMRV 1
- This recommendation is based on evidence that MMRV is associated with a higher risk of fever and febrile seizures 5-12 days after the first dose in children 12-23 months (approximately one extra febrile seizure per 2,300-2,600 MMRV vaccine doses) 1
Second Dose or First Dose at ≥48 months
- For the second dose at any age or first dose at ≥48 months, MMRV vaccine is generally preferred over separate injections 1
- Research shows no increased risk of febrile seizures after the second dose of MMRV compared to MMR+V or MMR alone 2
Special Considerations
Timing and Intervals
- If not administered simultaneously, live vaccines (such as MMR and varicella) should be given at least 28 days apart 1
- Both vaccines can be administered at the routinely recommended ages: 12-15 months for the first dose and 4-6 years for the second dose 1
Precautions
- A personal or family history (sibling or parent) of seizures of any etiology is a precaution for MMRV vaccination 1
- Children with such history should generally receive separate MMR and varicella vaccines rather than MMRV 1
Immunogenicity
- Studies have shown that response to MMR and varicella vaccines administered on the same day is identical to vaccines administered a month apart 1
- Both subcutaneous and intramuscular routes of administration produce comparable immunogenicity when MMR and varicella vaccines are given concomitantly 3
Clinical Implications
- Simultaneous administration of MMR and varicella vaccines is an effective strategy to ensure complete immunization 1
- The 10-year vaccine efficacy data supports that proper vaccination against varicella (either as separate vaccine or as part of MMRV) provides long-term protection 4
- Both MMR and varicella vaccines can also be co-administered with other childhood vaccines such as DTaP-IPV without significant interference with immune responses 5