Mmrv vaccine side effects

Contents

Measles/Mumps/Rubella/Varicella Virus Vaccine

Measles, mumps, rubella, and varicella are serious diseases caused by viruses. They are spread from person to person through the air.

Measles virus can cause minor symptoms such as skin rash, cough, runny nose, eye irritation, or mild fever. It can also cause more serious symptoms such as ear infection, pneumonia, seizures, permanent brain damage, or death.

Mumps virus causes fever, headache, and swollen glands, but more serious symptoms include hearing loss, and painful swelling of the testicles or ovaries. Mumps can cause breathing problems or meningitis, and these infections can be fatal.

Rubella virus (also called German Measles) causes skin rash, mild fever, and joint pain. Becoming infected with rubella during pregnancy can result in a miscarriage or serious birth defects.

Varicella (commonly known as chickenpox) is a common childhood disease that causes fever, skin rash, and a breakout of fluid-filled blisters on the skin. Most people who receive this vaccine will not get chickenpox, or will get only a mild case and will recover faster. Chickenpox is usually mild, but it can be serious or even fatal in young infants and in adults. It can lead to severe skin infection, breathing problems, brain damage, or death. A person who has had chickenpox can develop herpes zoster (also called shingles) later in life, which causes severe nerve pain, and hearing or vision problems, which may last for months or years.

Measles, mumps, rubella, and varicella are spread from person to person.

The measles, mumps, rubella, and varicella vaccine is used to help prevent these diseases in children. This vaccine works by exposing your child to a small dose of the virus or a protein from the virus, which causes the body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.

Measles, mumps, rubella, and varicella vaccine is for use in children between the ages of 12 months and 12 years old.

Like any vaccine, the measles, mumps, rubella, and varicella vaccine may not provide protection from disease in every person.

The measles, mumps, rubella, and varicella vaccine is usually given only once when the child is between 12 months and 12 years old. If a booster dose is needed, At least 3 months should pass between the first and second doses of this vaccine.

Your child should not receive a booster vaccine if he or she had a life threatening allergic reaction after the first shot. Your child can still receive a vaccine if he or she has a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until the child gets better before receiving this vaccine.

Keep track of any and all side effects your child has after receiving this vaccine. If the child ever needs to receive a booster dose, you will need to tell the doctor if the previous shots caused any side effects.

Becoming infected with measles, mumps, rubella, or varicella is much more dangerous to your child’s health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.

Do not give your child salicylates such as aspirin, Disalcid, Doan’s Pills, Dolobid, Salflex, Tricosal, and others for at least 6 weeks after receiving this vaccine. A serious condition called Reye’s Syndrome has been reported in patients with chickenpox who take aspirin or salicylates.

Your child should not receive this vaccine if he or she is allergic to eggs, gelatin, or neomycin (Mycifradin, Neo-Fradin, Neo-Tab), or if the child has ever had a life-threatening allergic reaction to any vaccine containing measles, mumps, rubella, or varicella.

Your child should also not receive this vaccine if he or she has:

  • active tuberculosis infection;
  • a cancer such as leukemia or lymphoma;
  • a history of Guillain-Barré syndrome;
  • a chronic disease such as asthma or other breathing disorder, diabetes, kidney disease, or a blood cell disorder such as anemia;
  • severe immune suppression caused by disease (such as cancer, HIV, or AIDS), or by receiving certain medicines such as steroids, chemotherapy or radiation;
  • if the child has recently taken aspirin or other similar medicines such as Disalcid, Doan’s Pills, Dolobid, Salflex, Tricosal, and others;
  • if the child has recently received a stem cell transplant;
  • if someone in the child’s household has a weak immune system; or
  • if the child is pregnant.

If your child has any of these other conditions, this vaccine may need to be postponed or not given at all:

  • thrombocytopenia purpura (easy bruising or bleeding);
  • a history of seizures;
  • a neurologic disorder or disease affecting the brain (or if this was a reaction to a previous vaccine);
  • a weak immune system caused by disease, bone marrow transplant, or by using certain medicines or receiving cancer treatments;
  • if the child has received an immune globulin or other blood product within the past year; or
  • if the child has received a measles, mumps, and rubella (MMR) vaccine within the past 28 days (4 weeks).

Your child can still receive a vaccine if he or she has a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until the child gets better before receiving this vaccine.

Pregnant women should wait to get this vaccine until after they have given birth. Women should not get pregnant for 3 months after getting the vaccine.

A woman should not receive this vaccine without telling the doctor if she is breast-feeding a baby.

Publications

Measles-Mumps-Rubella-Varicella (MMRV) Vaccine

Immunization is one of the most effective ways to protect yourself and your family against vaccine preventable diseases.

What is measles?

Measles is a highly contagious viral infection that is spread through the air from person to person.

Measles lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing. Also, measles virus can remain for up to two hours on a surface or in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected.

Symptoms of measles begin seven to 21 days, usually 10 to 14 days, after exposure to a case of measles and include fever, runny nose, cough, drowsiness, irritability and red eyes. Small white spots (known as “Koplik’s spots”) can appear on the inside of the mouth and throat, but are not always present. Then, three to seven days after the start of the symptoms, a red blotchy rash appears on the face and then progresses down the body. Measles is contagious one day before fever develops and usually 4 days before the rash appears. Measles remains contagious until four days after the appearance of the rash.

Most people fully recover from measles within two to three weeks. But measles can cause complications in up to 25 per cent of people, such as pneumonia, ear infections, diarrhea, hearing loss, encephalitis (brain swelling), seizures, or, rarely, even death. Measles can be especially dangerous for infants, those with weakened immune systems and pregnant women.

What is mumps?

Mumps is a contagious disease that is caused by the mumps virus. Mumps is spread by droplets of saliva or mucus from the mouth, nose, or throat of an infected person, usually when the person coughs or sneezes. Items used by an infected person, such as cups or utensils can also be contaminated with the virus, which may spread to others if those items are shared. In addition, the virus may spread when someone with mumps touches items or surfaces without washing their hands and someone else then touches the same surface and rubs their mouth or nose.

Symptoms typically appear 16 to 18 days after infection, but this period can range from 12 to 25 days after infection. Mumps is best known for the swelling of the cheeks and jaw that it causes, which is a result of parotitis (inflammation of the salivary glands). Mumps also causes fever and headache. Mumps can be contagious from seven days before and up to five days after the salivary glands begin to swell. Up to half of people who get mumps have very mild or no symptoms, and therefore do not know they were infected with mumps.

People who show symptoms usually recover after a week or two, but mumps can occasionally cause serious complications. The most common complication is orchitis (swelling of the testicles) in males who have reached puberty; rarely does this lead to fertility problems. Other rare complications include encephalitis (swelling of the brain) and/or meningitis (swelling of the tissue covering the brain and spinal cord) and oophoritis (swelling of the ovaries) in females who have reached puberty and deafness. Mumps infection during the first trimester of pregnancy may increase the risk of a miscarriage.

What is rubella?

Rubella is a contagious disease caused by a virus. Rubella is spread by contact with an infected person, through coughing and sneezing.

Symptoms typically appear about 14 to 21 days after being exposed to someone who was contagious.

The infection is usually mild with fever, rash, headache, malaise, mild runny nose (coryza) and red eyes (conjunctivitis). The rash usually starts on the face and spreads to the rest of the body. These symptoms last approximately three days. Rubella is contagious one week before and at least four days after the appearance of the rash. About half of the people who get rubella do not have symptoms.

Complications are not common, but they occur more often in adults. Aching joints occur in many cases, especially among young women. In rare cases, rubella can cause serious problems, including encephalitis (swelling of the brain). Rubella is most dangerous for a pregnant woman’s unborn baby. Infection during pregnancy can cause miscarriage, or birth defects like deafness, blindness, intellectual disability, and heart defects.

What is varicella (chickenpox)?

Chickenpox is a contagious disease caused by a virus. Chickenpox spreads very easily from person to person. It is passed from an infected person to others through coughing or sneezing. A person can also get chickenpox after touching a blister or the liquid from a blister.

Symptoms typically appear 10 to 21 days after infection, usually 14 to 16 days after infection. The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs. The rash may first show up on the face, chest, and back then spread to the rest of the body. In children, the first sign of disease is often rash, while in adults, mild fever and malaise may occur one to two days before the rash. Some people who have been immunized against chickenpox can still get the disease. However, the symptoms are usually milder with fewer blisters and mild or no fever. Chickenpox is contagious as long as five days but usually one to two days before the rash and until all blisters have formed scabs, usually about five days after the rash.

Complications of chickenpox can include dehydration, pneumonia, encephalitis and blood stream infections (sepsis). The risk of these complications increases with age. Chickenpox infection during pregnancy can cause miscarriage, congenital varicella syndrome (CVS) and other complications.

Why is the MMRV vaccine important?

The MMRV vaccine offers parents an option to have their child immunized against four diseases in one vaccine. This vaccine reduces the number of injections for children.

In Ontario, measles, mumps, rubella, and varicella vaccination is required for school attendance under the Immunization of School Pupils Act (ISPA). Parents are required to provide a record of immunization or a valid exemption before their child attends school.

How well does the MMRV protect against measles, mumps, rubella and/or chickenpox?

Almost all children who receive two doses of vaccine against these four diseases are protected against all of them. Protection from measles, mumps and rubella after getting the vaccine is life-long.

Who is eligible to receive the publicly funded vaccine?

In Ontario, children are eligible to receive the publicly funded MMRV vaccine from four to 12 years of age to protect against measles, mumps, rubella and chickenpox.

At what age should the MMRV vaccine be given?

The MMRV vaccine is offered to children between four to six years of age as part of their routine immunization schedule. The vaccine is currently approved for children up to 12 years of age.

Who should not get the MMRV vaccine?

Children should not receive the vaccine if they have:

  • allergies to the vaccine or any component of the vaccine;
  • known allergies to neomycin; or
  • previously experienced an allergic reaction to any measles, mumps, rubella and/or varicella vaccines.

Please consult with your health care provider if you have:

  • a weakened immune system or take medications that suppress the immune system;
  • a personal or family history of febrile seizures;
  • previously had a severe allergic reaction to eggs, or anything that contained eggs;
  • received blood or blood products; or
  • a severe infection with a high fever greater than 38.5°C.

You should always discuss the benefits and risks of any vaccine with your health care provider or local public health unit prior to receiving the vaccine.

Is the MMRV vaccine safe?

The MMRV vaccine is safe and effective; most children will have no reaction. Some common side effects from the MMRV include redness, swelling and tenderness in the area where the needle is given. Fever, and/or a rash can occur four to 12 days after getting the vaccine. The rash can be a blotchy red rash (measles-like) and/or spots that look like blisters (chickenpox). Severe reactions are rare.

There have been studies that showed a possible increased risk of febrile seizures in children who received the MMRV vaccine as a first dose when younger than two years of age. These studies were conducted in the United States for the MMRV vaccine ProQuad™. The rate of febrile seizures in Priorix-Tetra™ has not been reported to be higher than if MMR and varicella vaccines are given separately. As children get older their risk for febrile seizures lessens. Children who are four to six years of age do not experience febrile seizures as often as children less than four years of age.

Please report any side effects or severe vaccine reaction to your health care provider or local public health unit.

When should I call my health care provider?

Call your health care provider or go to the nearest hospital emergency department if your child has any of the following reactions within three days of receiving the vaccine:

Who should I talk to if I have any questions?

Talk to your health care provider or call your local public health unit.

How should my child’s immunization be recorded?

After you or your child receives any immunization, make sure the health care provider updates the personal immunization record (the “Yellow Card”). This will be your record to keep so that you know what immunizations you have received.

Measles, mumps, rubella and chickenpox (varicella) vaccine (MMR-Var)

Tips to follow immediately following vaccination

Wait 15 minutes before leaving premises where vaccine is received. If an allergic reaction occurs, the symptoms will appear a few minutes after the vaccination.

If you feel side effects, immediately inform the person giving the vaccine. That person will be able to treat you immediately.

Tips to follow at home

If you experience redness, pain or swelling at the injection site, apply a cold, damp compress on it.

Use medication for fever or discomfort if needed.

Do not give medication containing aspirin (acetylsalicylic acid) to people under age 18 for 6 weeks following their vaccination.

Cover the blisters. If this is not possible, contacts with premature newborns and people with weakened immune system should be avoided as long as these blisters are present.

When to seek medical help

See a doctor if one of the following applies to you:

  • You experience serious and unusual symptoms

  • Your symptoms get worse instead of improving

  • Your symptoms last over 48 hours

MMR vaccine side effects

The MMR vaccine is very safe and most side effects are mild and shortlived.

Because the MMR vaccine combines 3 separate vaccines in 1 injection, each vaccine can cause different side effects that can happen at different times.

There’s less chance of side effects after the second dose of MMR than the first.

Common side effects of the MMR vaccine

About a week to 11 days after the MMR injection, some children get mild symptoms, including a rash, high temperature, loss of appetite and a general feeling of being unwell for about 2 or 3 days.

Find out how to treat a high temperature in a child

About 3 to 4 weeks after having the MMR injection, 1 in 50 children develop mild symptoms of mumps.

These include swelling of the glands in the cheek, neck or under the jaw, and lasts for a day or 2.

One to 3 weeks after receiving the rubella vaccine component of MMR vaccine, some adult women experience painful, stiff or swollen joints, which can last for around 3 days.

Rare side effects of the MMR vaccine

Bruise-like spots

In rare cases, a child may get a small rash of bruise-like spots about 2 weeks after having the MMR vaccine.

This side effect is linked to the rubella vaccine and is known as idiopathic thrombocytopenic purpura (ITP).

It’s been estimated that ITP develops in 1 in every 24,000 doses of the MMR vaccine given.

There’s a greater risk of developing ITP from measles or rubella infection than there is from having the vaccine.

ITP usually gets better without treatment but, as with any rash, you should seek advice from a GP as soon as possible.

Seizures (fits)

There’s a small chance of having a seizure (fit) 6 to 11 days after having the MMR vaccine.

It sounds alarming, but it’s rare and happens in only about 1 in every 1,000 doses.

In fact, MMR-related seizures are less frequent than seizures that occur as a direct result of a measles infection.

Allergic reaction to the MMR vaccine

In extremely rare cases, a child can have a severe allergic reaction (known medically as anaphylaxis) immediately after having the MMR vaccine.

It’s an alarming prospect, but if the child is treated quickly, they make a full recovery. Medical staff who give vaccines are trained to deal with allergic reactions.

This NHS leaflet tells you about the common side effects of vaccinations that may occur in babies and children under 5 (PDF, 118kb).

Monitoring safety and side effects of the MMR vaccine

The Yellow Card Scheme allows you to report suspected side effects from any medicine you’re taking.

It’s run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).

Find out how to report a vaccine side effect

Immunization Reactions

Is this your child’s symptom?

  • Reactions to a recent immunization (vaccine)
  • Most are reactions at the shot site (such as pain, swelling, redness)
  • General reactions (such as a fever or being fussy) may also occur

Reactions to These Vaccines are Covered:

  • Chickenpox (varicella) virus
  • DTaP (Diphtheria, Tetanus, Pertussis)
  • Hemophilus influenzae type b
  • Hepatitis A virus
  • Hepatitis B virus
  • Human Papilloma virus
  • Influenza virus
  • MMR (Measles, Mumps, Rubella)
  • Meningococcal
  • Polio virus
  • Pneumococcal
  • Rotavirus
  • Tuberculosis (BCG vaccine)

Symptoms of Vaccine Reactions

  • Local Reactions. Shot sites can have swelling, redness and pain. Most often, these symptoms start within 24 hours of the shot. They most often last 3 to 5 days. With the DTaP vaccine, they can last up to 7 days.
  • Fever. Fever with most vaccines begins within 24 hours and lasts 1 to 2 days.
  • Delayed Reactions. With the MMR and chickenpox shots, fever and rash can occur. These symptoms start later. They usually begin between 1 and 4 weeks.
  • Anaphylaxis. Severe allergic reactions are very rare, but can occur with any vaccine. They start within 2 hours.

Vaccine Free App

  • Vaccines on the Go app from Children’s Hospital of Philadelphia
  • This free app can answer any vaccine questions you may have
  • It is fact-based and up-to-date

When to Call for Immunization Reactions

Call 911 Now

  • Trouble breathing or swallowing
  • Not moving or very weak
  • Can’t wake up
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Age less than 12 weeks old with fever. Caution: do NOT give your baby any fever medicine before being seen.
  • Fever over 104° F (40° C)
  • High-pitched crying lasts more than 1 hour
  • Crying nonstop lasts more than 3 hours
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Redness or red streak starts more than 48 hours (2 days) after the shot
  • Redness around the shot becomes larger than 3 inches (7.5 cm)
  • Fever lasts more than 3 days
  • Fever returns after being gone more than 24 hours
  • Measles vaccine rash (starts day 6 to 12 after shot) lasts more than 4 days
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Redness or red streak around shot is larger than 1 inch (2.5 cm)
  • Redness, swelling or pain is getting worse after 3 days
  • Fussiness from vaccine lasts more than 3 days
  • You have other questions or concerns

Self Care at Home

  • Normal immunization reaction

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Immunization Reactions

Treatment for Common Immunization Reactions

  1. What You Should Know About Common Shot Reactions:
    • Immunizations (vaccines) protect your child against serious diseases.
    • Pain, redness and swelling are normal where the shot was given. Most symptoms start within the first 12 hours after the shot was given. Redness and fever starting on day 1 of the shot is always normal.
    • All of these reactions mean the vaccine is working.
    • Your child’s body is making new antibodies to protect against the real disease.
    • Most of these symptoms will only last 2 or 3 days.
    • There is no need to see your doctor for normal reactions, such as redness or fever.
    • Medicine is only needed if your child has pain. Also, use a fever medicine for fever over 102° F (39 ° C).
    • Here is some care advice that should help.
  2. Reaction at Shot Site:
    • Cold Pack: For pain at the shot site, use a cold pack. You can also use put ice in a wet washcloth on the sore shot site. Use for 20 minutes as needed.
    • Pain Medicine: To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed.
    • Hives at the Shot Site: If itchy, can put on 1% hydrocortisone cream (such as Cortaid). No prescription is needed. Use twice daily as needed.
  3. Fever Medicine:
    • Fever with most vaccines begins within 12 hours and lasts 2 to 3 days. This is normal, harmless and possibly helpful.
    • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
    • If over 6 months old, can give an ibuprofen product (such as Advil).
    • For all fevers: Give extra fluids. Do not use too many clothes or blankets on your child.
  4. General Symptoms From Vaccines:
    • All vaccines can cause mild fussiness, crying and restless sleep. This is usually due to a sore shot site.
    • Some children sleep more than usual. A decreased appetite and activity level are also common.
    • These symptoms are normal. They do not need any treatment.
    • They will usually go away in 24-48 hours.
  5. Call Your Doctor If:
    • Redness starts after 2 days (48 hours)
    • Redness becomes larger than 2 inches (5 cm)
    • Pain or redness gets worse after 3 days (or lasts more than 7 days)
    • Fever starts after 2 days (or lasts more than 3 days)
    • You think your child needs to be seen
    • Your child becomes worse

Specific Immunization Reactions

  1. Chickenpox Vaccine:
    • Pain or swelling at the shot site for 1 to 2 days. (20% of children)
    • Mild fever lasting 1 to 3 days begins 14 to 28 days after the shot (10%). Give acetaminophen or ibuprofen for fever over 102° F (39°C).
    • Never give aspirin for fever, pain or within 6 weeks of getting the shot. Reason: Risk of Reye syndrome, a rare but serious brain disease.
    • Chickenpox-like rash (usually 2 red bumps) at the shot site (3%)
    • Chickenpox-like rash (usually 5 red bumps) scattered over the body (4%)
    • This mild rash begins 5 to 26 days after the shot. Most often, it lasts a few days.
    • Children with these rashes can go to child care or school. Reason: For practical purposes, vaccine rashes are not spread to others.
    • Exception: Do not go to school if red bumps drain fluid and are widespread. Reason: can be actual chickenpox.
    • Caution: If vaccine rash contains fluid, cover it with clothing. You can also use a bandage (such as Band-Aid).
  2. Diphtheria, Tetanus, Pertussis (DTaP) Vaccine:
    • The following harmless reactions to DTaP can occur:
    • Pain, tenderness, swelling and redness at the shot site are the main side effects. This happens in 25% of children. It usually starts within the first 12 hours. Redness and fever starting on day 1 of the shot is always normal. It lasts for 3 to 7 days.
    • Fever (in 25% of children) and lasts for 24 to 48 hours
    • Mild drowsiness (30%), fretfulness (30%) or poor appetite (10%) and lasts for 24 to 48 hours.
    • Large swelling over 4 inches (10 cm) can follow the later doses of DTaP. The area of redness is smaller. This usually occurs with the 4th or 5th dose. It occurs in 5% of children. Most children can still move the leg or arm normally.
    • The large thigh or upper arm swelling goes away without treatment by day 3 (60%) to day 7 (90%).
    • This is not an allergy. Future DTaP vaccines are safe to give.
  3. Hemophilus Influenza Type B Vaccine (Hib):
    • No serious reactions reported.
    • Sore injection site or mild fever only occurs in 2% of children.
  4. Hepatitis A Vaccine:
    • No serious reactions reported.
    • Sore injection occurs in 20% of children.
    • Loss of appetite occurs in 10% of children.
    • Headache occurs in 5% of children.
    • Most often, no fever is present.
    • If these symptoms occur, they most often last 1-2 days.
  5. Hepatitis B Virus Vaccine (HBV):
    • No serious reactions reported.
    • Sore shot site occurs in 30% of children and mild fever in 3% of children.
    • Fever from the vaccine is rare. Any baby under 2 months with a fever after this shot should be examined.
  6. Influenza Virus Vaccine:
    • Pain, tenderness or swelling at the injection site occurs within 6 to 8 hours. This happens in 10% of children.
    • Mild fever under 103° F (39.5° C) occurs in 20% of children. Fevers mainly occur in young children.
    • Nasal Influenza Vaccine: Congested or runny nose, mild fever.
  7. Measles Vaccine (part of MMR):
    • The measles shot can cause a fever (10% of children) and rash (5% of children). This occurs about 6 to 12 days after the shot.
    • Mild fever under 103° F (39.5°C) in 10% and lasts 2 or 3 days.
    • The mild pink rash is mainly on the trunk and lasts 2 or 3 days.
    • No treatment is needed. The rash cannot be spread to others. Your child can go to child care or to school with the rash.
    • Call Your Doctor If:
      • Rash changes to blood-colored spots
      • Rash lasts more than 3 days
  8. Meningococcal Vaccine:
    • No serious reactions.
    • Sore shot site for 1 to 2 days occurs in 50%. Limited use of the arm occurs in 15% of children.
    • Mild fever occurs in 5%, headache in 40% and joint pain in 20%
    • The vaccine never causes meningitis.
  9. Mumps or Rubella Vaccine (part of MMR):
    • There are no serious reactions.
    • Sometimes, a sore shot site can occur.
  10. Papillomavirus Vaccine:
    • No serious reactions.
    • Sore injection site for few days in 90%.
    • Mild redness and swelling at the shot site (in 50%).
    • Fever over 100.4° F (38.0° C) in 10% and fever over 102° F (39° C) in 2%.
    • Headache in 30%.
  11. Pneumococcal Vaccine:
    • No serious reactions.
    • Pain, tenderness, swelling or redness at the injection site in 20%.
    • Mild fever under 102° F (39° C) in 15% for 1-2 days.
  12. Polio Vaccine:
    • Polio vaccine given by shot sometimes causes some muscle soreness.
    • Polio vaccine given by mouth is no longer used in the U.S.
  13. Rotavirus Vaccine:
    • No serious reactions to this vaccine given by mouth.
    • Mild diarrhea or vomiting for 1 to 2 days in 3%.
    • No fever.
  14. BCG Vaccine for Tuberculosis (TB):
    • Vaccine used to prevent TB in high-risk groups or countries. It is not used in the US or most of Canada. Note: This is different than the skin test placed on the forearm to detect TB.
    • BCG vaccine is given into the skin of the right shoulder area.
    • Timing: Mainly given to infants and young children.
    • Normal reaction: After 6 to 8 weeks, a blister forms. It gradually enlarges and eventually drains a whitish yellow liquid. The blister then heals over leaving a scar. The raised scar is proof of BCG protection against TB.
    • Abnormal reaction: Abscess (infected lump) occurs in the shoulder or under the arm. Occurs in 1% of patients.
    • Call Your Doctor If:
      • Blister turns into a large red lump
      • Lymph node in the armpit becomes large

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 02/01/2020

Last Revised: 03/14/2019

Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.

Measles, Mumps, Rubella (MMR) Vaccine

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CDC Warns that MMRV Vaccine Doubles Seizure Risk

The CDC (Centers for Disease Control) reports that their ongoing study reveals that children who get an MMRV vaccine are “twice as likely to have a febrile seizure 7-10 days after getting the shot than children who get MMR and varicella vaccines (2 shots) at the same health care visit.” These concerns affect doctors and nurses concerning publich health and education policies. The MMRV shot is the measles-mumps-rubella-chickenpox combination vaccine and febrile means “relating to fever.”
MMRV vs. MMR Safety
The MMRV vaccine caused 77 febrile seizures out of a sample size of 63,000 children. That is a rate of approximately 1.2 children out of every 1,000 who will have seizures due to the vaccine. The study also looked at children who received the MMR vaccine and a separate V vaccine on the same day instead of the four-in-one combination vaccine. The MMR + V two-shot combination caused 174 febrile seizures out of a sample size of 376,000 children. This is approximately 1 child out of every 2,000 who experience this adverse side effect. The four-in-one MMRV has approximately doubled the chance that a child will have a febrile seizure compared with the two shot combination of MMR + V. The CDC also notes that “children who receive the MMR vaccine are more likely to have febrile seizures 8-14 days after vaccination than children who are not vaccinated at all.”
ProQuad is the trade name for the MMRV vaccine produced by Merk pharmaceuticals. It is licensed for use in children from the ages of 12 months to 12 years old. One in five children have the following side effects from the vaccine: soreness or swelling at the injection site, fever, and rash. The MMRV four-in-one combination shot has a higher incidence of fever and rash compared with using 2 separate shots (MMR + V) to achieve the same level of vaccination protection. The CDC notes that “febrile seizures cannot be prevented” due to the MMRV vaccine.
MMRV Side-Effects
MMRV vaccine combines the attenuated MMR (measles, mumps, rubella) with the chickenpox vaccine (varicella). It is often given to children between 1 and 2 years of age. ProQuad side effects are rare but include allergic reactions, difficulty breathing and closing of the throat, hives, weakness, paleness, dizziness, a rapid heart beat, deafness, long-term seizures, coma, brain damage, febrile seizures, acute and chronic arthritis, and a temporarily low platelet count.
MMR Vaccine Development
The measles and mumps component of the vaccine are grown in hens’ eggs and from chicken embryo cell cultures. These strains of the virus are less virulent than those affecting human cells and are therefore called attenuated strains. The rubella (German measles) component of the vaccine is propagated using a cell line developed from human embryonic lung tissue originally from aborted human fetuses.
Chickenpox-Only Vaccine
The chickenpox component of the vaccine (varicella) contains live attenuated virus. In the US, 9.7 million doses of the chickenpox-only vaccine were distributed between 1995 and 1998. 6,580 reports of adverse effects were reported and only 4% were determined to be serious side effects. About ⅔ of the side effects occurred in children under the age of 10. Rashes were the most commonly reported side effect. Serious side effects were rare but included encephalitis, ataxia, erythema multiforme, Stevens-Johnson syndrome, pneumonia, thrombocytopenia, seizures, neuropathy, and herpes zoster.
Public Health Policy
Public health policy weighs the risks of contracting measles, mumps, rubella, and chickenpox against the risks of adverse effects due to vaccinations. The CDC opines that the dangers of illness due contracting the live diseases is greater than the risk of side effects due to vaccinations. The FDA is responsible for approving the types of vaccines made available to the US public. Evidence suggests that separate vaccines for each disease may be safer than combination vaccines. In Japan, MMR vaccination has been discontinued and has been replaced with single vaccines for each disease. Many healthcare professionals in the US are concerned that if individual vaccines are made available that many children will not receive immunizations for all four diseases. Therefore, a combination vaccine ensures that children are protected from measles, mumps, rubella, and chickenpox simultaneously without any risk that they may not receive all of these shots individually. However, this also increases the risk of side effects due to the vaccination process. Nursing professionals and doctors can base their educational recommendations on balance between broader public health concerns and the individual health concerns of each patient.

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