Can the MMRV (Measles, Mumps, Rubella, and Varicella) vaccine be used in adults?

MMRV Vaccine Use in Adults

MMRV (Measles, Mumps, Rubella, and Varicella) vaccine should NOT be used in adults, as it is only licensed for use in children aged 12 months to 12 years. 1

Appropriate Vaccination Options for Adults

• Adults requiring protection against measles, mumps, rubella, and varicella should receive separate vaccines:

  • MMR (Measles, Mumps, Rubella) vaccine for protection against measles, mumps, and rubella 1
  • Single-antigen varicella vaccine for protection against varicella 1

• For adults without evidence of immunity to varicella, two doses of single-antigen varicella vaccine should be administered subcutaneously, 4-8 weeks apart 1

• For adults without evidence of immunity to measles, mumps, and rubella, one or two doses of MMR vaccine should be administered depending on risk factors 1, 2

MMR Vaccine Recommendations for Adults

First Dose

• All adults born in or after 1957 without evidence of immunity should receive at least one dose of MMR vaccine 1

Second Dose Indications

• Students in postsecondary educational institutions 1, 2
• Healthcare workers 1, 2
• International travelers 1, 2
• Adults recently exposed to measles or in outbreak settings 1, 2
• Adults previously vaccinated with killed measles vaccine or unknown type during 1963-1967 1, 2
• Adults in communities experiencing mumps outbreaks in affected age groups 1, 2

Varicella Vaccine Recommendations for Adults

• All adults without evidence of immunity to varicella should receive two doses of single-antigen varicella vaccine 1
• Special consideration for vaccination should be given to:
  • Healthcare personnel 1
  • Family contacts of immunocompromised persons 1
  • Teachers and childcare employees 1
  • Residents and staff of institutional settings 1
  • College students 1
  • Military personnel 1
  • Nonpregnant women of childbearing age 1
  • International travelers 1

Evidence of Immunity

For Varicella:

• Documentation of 2 doses of varicella vaccine at least 4 weeks apart 1
• U.S.-born before 1980 (except for healthcare personnel and pregnant women) 1
• History of varicella based on healthcare provider diagnosis 1
• History of herpes zoster based on healthcare provider diagnosis 1
• Laboratory evidence of immunity or laboratory confirmation of disease 1

For Measles, Mumps, and Rubella:

• Documentation of age-appropriate vaccination 1, 2
• Laboratory evidence of immunity 1
• Laboratory confirmation of disease 1, 2
• Birth before 1957 (except for healthcare personnel) 1, 2

Common Pitfalls and Considerations

• MMRV vaccine is specifically contraindicated in adults due to licensing restrictions 1
• If more than 8 weeks elapse after the first dose of varicella vaccine, the second dose may be administered without restarting the schedule 1
• MMR and varicella vaccines can be administered on the same day at different injection sites 3
• If not administered on the same day, these live virus vaccines should be separated by at least 28 days 3
• Pregnant women should not receive MMR or varicella vaccines; vaccination should be deferred until after pregnancy 1
• Women should avoid pregnancy for 4 weeks following MMR or varicella vaccination 1

Effectiveness and Safety

• Two doses of MMR vaccine are highly effective in preventing measles (96%), mumps (86%), and rubella (89%) 4
• Two doses of varicella vaccine are 95% effective in preventing varicella of any severity 4
• The safety profile of separately administered MMR and varicella vaccines is well-established in adults 3