MMRV Vaccine Age Limitations
The MMRV (Measles, Mumps, Rubella, and Varicella) vaccine is licensed for use among children through age 12 years, after which separate MMR and varicella vaccines should be used. 1
Age-Specific Recommendations
- MMRV vaccine is approved for administration to children from 12 months through 12 years of age 1
- The routinely recommended ages for measles, mumps, rubella, and varicella vaccination are 12–15 months for the first dose and 4–6 years for the second dose 1
- Children not vaccinated according to the routine schedule may receive the first dose of MMRV vaccine up to age 12 years 1
- After 12 years of age, separate MMR and varicella vaccines must be used instead of MMRV 1, 2
First Dose Administration Guidelines
- For the first dose at age 12–47 months, either MMR vaccine plus varicella vaccine or MMRV vaccine may be used 1, 2
- Unless the parent or caregiver specifically requests MMRV vaccine, CDC recommends using separate MMR and varicella vaccines for the first dose in children 12-47 months 1, 2
- 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, 2
- For the first dose at age ≥48 months, use of MMRV vaccine is generally preferred over separate injections 1, 2
Second Dose Administration Guidelines
- For the second dose at any age (15 months–12 years), MMRV vaccine is generally preferred over separate injections of MMR and varicella vaccines 1
- The second dose may be administered before age 4 years, provided ≥3 months have elapsed since the first dose 1
- Considerations for using MMRV should include provider assessment, patient preference, and the potential for adverse events 1
Special Considerations
- A personal or family history (sibling or parent) of seizures of any etiology is a precaution for MMRV vaccination 1, 2
- Children with such history should generally receive separate MMR and varicella vaccines rather than MMRV 1, 2
- Some evidence suggests that adverse events after MMR2 immunization may be more common in older children (10-12 years) compared to younger children (4-6 years), though both age groups are within the approved range 3
Effectiveness and Safety
- Vaccine effectiveness against measles is 95% after one dose and 96% after two doses 4, 5
- Vaccine effectiveness against varicella (any severity) after two doses in children is approximately 95% in a 10-year follow-up 4, 5
- The safety profile of MMRV vaccine is generally comparable to that of separately administered MMR plus varicella vaccines 6, 7
Remember that while MMRV can be used up to age 12 years, for adolescents and adults aged 13 years and older who need protection against these diseases, separate MMR and varicella vaccines must be administered instead of MMRV 1, 2.