Condition on Arrival

• Should be below 10°C (50°F); do not use warm vaccine; refrigerate on arrival.

Storage

• Protect vaccine from light at all times, since such exposure may inactivate the viruses.
• Before reconstitution, store vaccine at 2°C to 8°C (36°F to 46°F) or colder.
• The diluent may be stored in the refrigerator with the lyophilized vaccine or separately at room temperature. Do not freeze the diluent.
• For storage following reconstitution, see “Handling” below.

Handling

• To reconstitute, use only diluent supplied, since it is free of preservatives or other antiviral substances that might inactivate the vaccine.
• It is recommended that the vaccine be used as soon as possible after reconstitution. Store reconstituted vaccine in the vaccine vial in a dark place at 2°C to 8°C (36°F to 46°F) and discard if not used within 8 hours.
• First withdraw the entire volume of diluent into the syringe to be used for reconstitution. Inject all the diluent in syringe into the vial of lyophilized vaccine, and agitate to mix thoroughly. If the lyophilized vaccine cannot be dissolved, discard. Withdraw the entire contents into a syringe and inject the total volume of restored vaccine subcutaneously.
• Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. The vaccine, when reconstituted, is clear yellow.

General Tips

• If you have questions about the condition of the vaccine at the time of delivery, you should immediately place vaccine in recommended storage; and call the Merck Vaccine Customer Center at 1-877-VAX-MERCK (1-877-829-6372), or call the CDC at 1-800-CDC-INFO (1-800-232-4636).
• When supplied, diluent should be stored separately at room temperature (20°C to 25°C,
  68°F to 77°F) or in the refrigerator.
• Rotate stock so that the earliest-dated vaccine is used first.¹
• Ensure that the refrigerator is plugged into an outlet in a protected area where it cannot be disconnected accidentally.¹
• It is important to use a separate sterile syringe and needle for each individual patient to prevent transmission of hepatitis and other infectious agents from one person to another.
• Needles should be disposed of properly and should not be recapped.²
• All vaccines must be discarded after the expiration date; expired or damaged Vaccines for Children (VFC) vaccines must be returned to your State Immunization Program.
• For vaccines that require reconstitution with diluent, use only the diluent supplied. Click here for a demonstration of reconstitution with diluent.
• For general questions concerning the proper storage and handling of Merck vaccines, please contact the Merck Vaccine Customer Center at 1-800-MERCK-90 (1-800-637-2590), Monday through Friday, 8:00 am–7:00 pm ET.
• Before administering M-M-R^®_II, please read the Prescribing Information.

M-M-R^®_II is indicated for simultaneous vaccination against measles, mumps, and rubella in individuals 12 months of age or older.

—M-M-R^®_II should be given 1 month before or after administration of other live viral vaccines.

Select Safety Information

M-M-R^®_II is contraindicated in certain individuals, including those with: a history of hypersensitivity to any component of the vaccine, including gelatin; a history of anaphylactic or anaphylactoid reaction to neomycin; blood dyscrasias, leukemia, lymphomas of any type, or other malignant neoplasms affecting the bone marrow or lymphatic systems; an immunodeficient condition or receiving immunosuppressive therapy; an active febrile illness; or those who are pregnant.

Due caution should be employed in administration of M-M-R^®_II to persons with a history of cerebral injury, individual or family histories of convulsions, or any other condition in which stress due to fever should be avoided.

The following adverse reactions have been reported with M-M-R^®_II without regard to causality: fever, headache, dizziness, rash, injection-site reactions, febrile convulsions, anaphylaxis and anaphylactoid reactions, arthritis, and thrombocytopenia.

As for any vaccine, vaccination with M-M-R^®_II may not result in protection in 100% of vaccinees.

Before administering M-M-R^®_II, please read the Prescribing Information.

Reference: 1. Centers for Disease Control and Prevention. Vaccine management: Recommendations for storage and handling selected biologicals. In: Atkinson W, Wolfe C, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 9th ed. Atlanta, Ga: Dept of Health and Human Services; 2006: Appendix C. 2. Centers for Disease Control and Prevention. National Immunization Program. Vaccine storage and handling. http://www2a.cdc.gov/nip/isd/shtoolkit/splash.html. Accessed November 20, 2007.

M-M-R^®_II is a registered trademark of Merck & Co., Inc.