Vaccines by disease: Learning more about the measles, mumps rubella & varicella (MMRV) vaccine

MMRV vaccine protects against four serious illnesses: measles, mumps, rubella and varicella (chickenpox). These infections have become uncommon in the United States since vaccination was introduced, but outbreaks still occur and are common in some parts of the world.

Measles is a severe illness that can lead to ear infections, brain damage, pneumonia and seizures. One to three of every 1,000 children who contract measles in the United States dies. Deaths are more common in children less than 5 years of age or in those who have immune systems problems. In rare cases, children who recover from measles develop a severe and fatal neurological illness called subacute sclerosing panencephalitits (SSPE) many years later. Pregnant women who develop measles may miscarry or have premature births.

Mumps causes swelling of the parotid glands and may include complications including deafness, meningitis or inflammation of the testicles, ovaries or pancreas. Pregnant women who develop mumps early in pregnancy may miscarry.

Rubella may cause fever, rash, swollen glands, joint pain, low platelet count, encephalitis and temporary arthritis. Pregnant women who contract rubella may miscarry, or the fetus may develop congenital rubella syndrome, which includes defects of the eyes, ears, heart and nervous system.

Varicella causes chickenpox, a mild illness with fever and rash in most children. However, in some people, it can cause serious complications such as severe skin infections that may leave permanent scars, pneumonia, brain infection (rare) or even death. Patients who have chickenpox also become predisposed to infection with group A Streptococcus (GAS) and Staphylococcus aureus bacteria, each of which can be life threatening. Chickenpox is more likely to be severe in adolescents, adults and anyone who has an abnormal immune system or is taking medicines that affect the immune system. Pregnant women who get chickenpox for the first time may develop severe illness or miscarry, or there may be abnormalities in the fetus such as congenital varicella syndrome. Even when people recover from chickenpox, painful shingles can develop later in life.

Prevention is the key to not contracting measles, mumps, rubella and varicella, and one of the most effective preventive methods is the MMRV vaccine.

Who should receive the MMRV vaccine? In order for the MMRV vaccine to be fully effective, two doses should be given to children when they are the following ages: 12 to 15 months; and 4 to 6 years. The preferred interval between dose one and two of MMRV is three months. However, dose two may be given as early as 28 days after dose one. Some people should not be inoculated with the MMRV vaccine including those who: Are severely allergic to gelatin or the antibiotic neomycin or have had a reaction to a previous dose of the MMRV vaccine HIV/AIDS, weakened immune systems, cancer or low platelet counts; who are being treated for another condition with steroids; have recently received a blood transfusion. These people should speak with their primary health care provider about this vaccine. Review the vaccination schedule for those who start late on a vaccine or are more than one month behind.

When did the MMRV vaccine become available?
Vaccines for measles, mumps and rubella have been available since the 1960s, and a combination vaccine called MMR is available. A vaccine against varicella has been available since 1995.

In 2006, a vaccine called MMRV that combines MMR and varicella vaccines was licensed in the United States for use in children 1 to 12 years of age.

How does someone become infected with measles, mumps, rubella and varicella?
All four infections are caused by viruses that are spread through person-to-person contact or rarely are airborne spread.

How effective is the MMRV vaccine?
When both doses of the MMRV vaccine are given, the immunized recipient is thought to be at least 95 percent protected from measles, mumps, rubella and varicella.

Since the measles vaccine was licensed, there has been a 99 percent reduction in measles cases in the United States.

With the introduction of the mumps vaccine, the annual number of mumps cases has fallen from approximately 200,000 cases to 600 cases. However, in 2006 outbreaks of mumps in adolescents and adults were reported from several states.

Before a vaccine was developed for rubella, there was a rubella outbreak in the United States from 1963 to 1964, and 12 million people contracted the disease. More than 11,000 fetuses died, and 20,000 babies were born with birth defects. Today, fewer than 25 cases of rubella are reported in the United States each year.

Before the varicella vaccine was available, 3 million to 4 million cases were reported in the United States each year with 10,000 hospitalizations and 100 deaths.

However, outbreaks of measles, mumps, rubella and varicella still occur in the United States so it is important to keep vaccination rates high in the community.

What are the possible side effects of the MMRV vaccine?
Mild side effects may include:

• fever
• mild rash
• swelling of cheek or neck glands

Rare moderate side effects may include:

• seizures brought on by a high fever
• temporary joint pain or stiffness
• temporary lowering of the patient’s platelet count

Very rare severe problems may include:

• serious allergic reaction
• pneumonia

There is no evidence that MMRV causes autism or bowel disorders. Learn more about vaccines and autism

How do I learn more about this vaccine?
The best person to ask about this or any vaccine is a child’s pediatrician or primary health care provider.

Immunization is the best thing you do for your child to protect against measles, mumps, rubella and varicella.