From the Guidelines
ProQuad vaccine is recommended for children between 12 months and 12 years of age, with the first dose typically administered at 12-15 months of age and the second dose at 4-6 years, although MMR and varicella vaccines may be preferred for the first dose in children 12-47 months old due to a higher risk of febrile seizures associated with MMRV vaccine in this age group. The ProQuad vaccine combines the MMR (measles, mumps, rubella) vaccine with the varicella vaccine into a single injection, reducing the number of shots a child needs 1. The vaccine works by introducing weakened versions of these viruses to stimulate the immune system to produce antibodies without causing the actual diseases. Some key points to consider when administering the ProQuad vaccine include:
- For the first dose of measles, mumps, rubella, and varicella vaccines at age 12–47 months, either MMR vaccine and varicella vaccine or MMRV vaccine may be used, but MMR vaccine and varicella vaccine are recommended unless the parent or caregiver expresses a preference for MMRV vaccine 1.
- For the second dose of measles, mumps, rubella, and varicella vaccines at any age (15 months–12 years) and for the first dose at age ≥48 months, use of MMRV vaccine generally is preferred over separate injections of its equivalent component vaccines 1.
- A personal or family history of seizures of any etiology is a precaution for MMRV vaccination, and children with such a history generally should be vaccinated with MMR vaccine and varicella vaccine 1.
- The risk of febrile seizures is higher in children 12-23 months old who receive the MMRV vaccine compared to those who receive the MMR and varicella vaccines separately, but this risk does not extend to children 4-6 years old receiving the MMRV vaccine 1. Side effects of the ProQuad vaccine are generally mild and may include fever, rash, or soreness at the injection site, with some children experiencing a mild rash or fever 5-12 days after vaccination 1. It is essential to discuss the benefits and risks of both vaccination options with parents or caregivers before administering the ProQuad vaccine 1.
From the Research
ProQuad Vaccine Overview
- The ProQuad vaccine is a live attenuated, tetravalent measles-mumps-rubella-varicella vaccine indicated for simultaneous vaccination against measles, mumps, rubella, and varicella in individuals from 12 months of age using a two-dose schedule 2.
- It may be used in infants from 9 months of age to conform with a national vaccination schedule, outbreak situations, or travel to a region with a high prevalence of measles 2.
Immunogenicity and Safety
- Clinical data in young children indicates that vaccination with ProQuad is as immunogenic as the component vaccines, provides long-term protection against these potentially serious childhood infections, and has an acceptable safety profile 2.
- A two-dose regimen of ProQuad given at a 3-month interval in healthy infants aged ≥9 months showed non-inferiority of the response rate post-Dose 2 when Dose 1 was administered at 11 months (98%) compared with 12 months (99%) 3.
- The response rate to measles post-Dose 1 increased with age, from 73% to 88% and 90% at 9,11, and 12 months, respectively 3.
- A 1- or 2-dose regimen of MMRV is generally well-tolerated when administered to 12- to 23-month-old children and has a safety and immunogenicity profile similar to that of M-M-RII and VARIVAX administered concomitantly 4.
Effectiveness and Adverse Effects
- Vaccine effectiveness in preventing measles was 95% after one dose and 96% after two doses 5.
- The effectiveness in preventing cases among household contacts or preventing transmission to others the children were in contact with after one dose was 81%, after two doses 85%, and after three doses was 96% 5.
- There is evidence supporting an association between aseptic meningitis and MMR vaccines containing Urabe and Leningrad-Zagreb mumps strains, but no evidence supporting this association for MMR vaccines containing Jeryl Lynn mumps strains 5.
- The analyses provide evidence supporting an association between MMR/MMR+V/MMRV vaccines (Jeryl Lynn strain) and febrile seizures, with an attributable risk estimated to be from 1 per 1700 to 1 per 1150 administered doses 5.