ProQuad Vaccination Schedule for Adults
ProQuad is NOT approved or recommended for use in adults—it is exclusively licensed for children aged 12 months to 12 years. 1, 2, 3
Why ProQuad Cannot Be Used in Adults
ProQuad (MMRV combination vaccine) is specifically contraindicated in adults due to FDA licensing restrictions that limit its use to the pediatric population. 1 The vaccine was studied and approved only for children from 12 months through 12 years of age, with no safety or efficacy data supporting its use in adults. 2, 3, 4
Correct Vaccination Approach for Adults
Adults requiring protection against measles, mumps, rubella, and varicella must receive separate vaccines rather than the combination product. 1
For Measles, Mumps, and Rubella Protection
Adults born in or after 1957 without evidence of immunity should receive at least one dose of MMR vaccine. 5, 1
A second dose of MMR is recommended for high-risk adults including: 5
- Healthcare workers
- Students in postsecondary educational institutions
- International travelers
- Adults recently exposed to measles or in outbreak settings
- Adults previously vaccinated with killed measles vaccine or unknown vaccine type during 1963-1967
Adults born before 1957 are generally considered immune to measles and mumps, though healthcare personnel born before 1957 should still be vaccinated if they lack laboratory evidence of immunity. 5
For Varicella Protection
All adults without evidence of immunity to varicella should receive 2 doses of single-antigen varicella vaccine administered 4-8 weeks apart. 5, 1
Special priority groups for varicella vaccination include: 5
- Healthcare personnel
- Family contacts of immunocompromised persons
- Teachers and childcare employees
- College students
- Military personnel
- Nonpregnant women of childbearing age
- International travelers
Birth before 1980 is NOT considered evidence of immunity for healthcare personnel and pregnant women. 5
Evidence of Immunity
Acceptable evidence of immunity to varicella includes: 5, 1
- Documentation of 2 doses of varicella vaccine at least 4 weeks apart
- Laboratory evidence of immunity or laboratory confirmation of disease
- History of varicella or herpes zoster based on healthcare provider diagnosis (with epidemiologic link or laboratory confirmation for atypical cases)
- U.S.-born before 1980 (except healthcare personnel and pregnant women)
Acceptable evidence of immunity to measles, mumps, and rubella includes: 5, 1, 6
- Documentation of appropriate vaccination (1-2 doses depending on risk factors)
- Laboratory evidence of immunity or laboratory confirmation of disease
- Birth before 1957 (with exceptions for healthcare personnel)
Critical Contraindications
Pregnant women should not receive MMR or varicella vaccines; vaccination must be deferred until after pregnancy. 5, 1
Women should avoid pregnancy for 4 weeks following MMR or varicella vaccination. 1
Women without evidence of immunity should receive the first dose of varicella vaccine upon completion or termination of pregnancy and before discharge from the healthcare facility, with the second dose administered 4-8 weeks later. 5
Common Pitfalls to Avoid
Never attempt to use ProQuad in adults—this represents off-label use of a pediatric-only vaccine with no supporting safety or efficacy data. 1, 2
Do not assume birth before 1980 provides evidence of varicella immunity for healthcare workers or pregnant women—these populations require documentation or serologic testing. 5, 1
Do not give only one dose of varicella vaccine to adults—the complete series requires 2 doses for adequate protection. 5, 1