1.  Centers for Disease Control and Prevention (CDC). Use of combination measles, mumps, rubella, and varicella vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010;59(RR-3):1–12.
2.  Centers for Disease Control and Prevention (CDC). Home. Vaccines for Children Program (VFC)
Web site. http://www.cdc.gov/vaccines/programs/
vfc/index.html. Updated April 24, 2014. Accessed
March 2, 2016.
3.  Centers for Disease Control and Prevention (CDC).
About VFC. Vaccines for Children Program (VFC)
Web site. http://www.cdc.gov/vaccines/programs/
vfc/about/index.html. Updated February 14, 2014. Accessed March 2, 2016.
4.  Centers for Disease Control and Prevention (CDC). VFC Detailed Questions and Answers for Parents. Vaccines for Children Program (VFC) Web site. http://www.cdc.gov/vaccines/programs/vfc/parents/
qa-detailed.html. Updated February 19, 2013. Accessed March 2, 2016.

Indication for ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live)

ProQuad is a vaccine indicated for active immunization for the prevention of measles, mumps, rubella, and varicella in children 12 months through 12 years of age.

Selected Safety Information for ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live)

ProQuad is contraindicated in individuals with any of the following: history of anaphylactic reaction to neomycin or hypersensitivity to gelatin or any other component of the vaccine; primary or acquired immunodeficiency states; family history of congenital or hereditary immunodeficiency; immunosuppressive therapy; active untreated tuberculosis or febrile illness (>101.3°F or >38.5°C); or those who are pregnant. If vaccination of post-pubertal females is undertaken, pregnancy should be avoided for 3 months following vaccination.

Administration of ProQuad (dose 1) to children 12 to 23 months old who have not been previously vaccinated against measles, mumps, rubella, or varicella, nor had a history of the wild-type infections, is associated with higher rates of fever and febrile seizures at 5 to 12 days after vaccination when compared to children vaccinated with dose 1 of both M-M-R®II (Measles, Mumps, and Rubella Virus Vaccine Live) and VARIVAX® (Varicella Virus Vaccine Live) administered separately.

Use caution when administering ProQuad to children with: a history of cerebral injury or seizures or any other condition in which stress due to fever should be avoided; anaphylaxis or immediate hypersensitivity to eggs; contact hypersensitivity to neomycin; thrombocytopenia. Children with immediate hypersensitivity to eggs may be vaccinated with extreme caution; adequate treatment should be readily available should a reaction occur.

Advise vaccinees to avoid: close contact with high-risk individuals susceptible to varicella for up to 6 weeks following vaccination since transmission of varicella vaccine virus may occur between vaccinees and susceptible contacts; pregnancy for 3 months after vaccination; using salicylates for 6 weeks after vaccination. Defer vaccination for at least 3 months following blood or plasma transfusions, or administration of immune globulins (IG). The appropriate suggested interval between transfusion or IG administration and vaccination will vary with the type of transfusion or indication for, and dose of, IG.

Following administration of ProQuad, any immune globulin (IG), including VZIG, should not be given for 1 month thereafter unless its use outweighs the benefits of vaccination.

The most frequent vaccine-related adverse events reported in ≥5% of subjects vaccinated with ProQuad were: injection-site reactions (pain/tenderness/soreness, erythema, and swelling); fever; and irritability. Systemic vaccine-related adverse events that were reported at a significantly greater rate in recipients of ProQuad than in recipients of the component vaccines administered concomitantly were fever and measles-like rash. In children 12 to 23 months of age, the only vaccine-related injection-site adverse reaction that was more frequent among recipients of ProQuad than recipients of M-M-R®II (Measles, Mumps, and Rubella Virus Vaccine, Live) and VARIVAX® (Varicella Virus Vaccine Live) was rash at the injection site (2.4% versus 1.6%, respectively).

Dosage and Administration for ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live)

Each 0.5 mL dose of ProQuad is administered subcutaneously.

  • The first dose is usually administered at 12 to 15 months of age.
  • A second dose, if needed, is usually administered at 4 to 6 years of age.

At least 1 month should elapse between a dose of a measles-containing vaccine such as M-M-R®II and a dose of ProQuad. At least 3 months should elapse between a dose of varicella-containing vaccine and ProQuad.

No clinical data are available regarding the development or worsening of thrombocytopenia in individuals vaccinated with ProQuad. Cases of thrombocytopenia have been reported after primary vaccination with measles vaccine; measles, mumps, rubella vaccine; after varicella vaccination; and following revaccination with measles vaccine or M-M-R®II.

The safety and efficacy of ProQuad for use after exposure to measles, mumps, rubella or varicella have not been established.

The safety and efficacy of ProQuad for use in children known to be infected with human immunodeficiency viruses have not been established.

In severely immunocompromised individuals who have been inadvertently vaccinated with measles containing vaccine, measles inclusion body encephalitis, pneumonitis and fatal outcome as a direct consequence of disseminated measles vaccine virus infection have been reported. In this population, disseminated mumps and rubella vaccine virus infection have also been reported.

Tuberculin testing should be administered anytime before, simultaneously with, or at least 4 to 6 weeks after ProQuad.

ProQuad may be administered concomitantly with pneumococcal 7-valent conjugate vaccine and/or hepatitis A vaccine (inactivated) at separate injection sites.

ProQuad may be administered concomitantly with Haemophilus influenzae type b conjugate (meningococcal protein conjugate) and hepatitis B (recombinant) vaccine. Additionally, ProQuad may be administered concomitantly with pneumococcal 7-valent conjugate vaccine, and/or hepatitis A (inactivated) vaccines.

There are no data regarding the administration of ProQuad with inactivated poliovirus vaccine or with other live virus vaccines.

There are insufficient data to support concomitant vaccination with diphtheria, tetanus, and acellular pertussis vaccine adsorbed.

The duration of protection from measles, mumps, rubella, and varicella infections after vaccination with ProQuad is unknown.

Before administering ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live), please read the Prescribing Information.

Selected Safety Information for ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live)

Selected Safety Information for ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live)

ProQuad is contraindicated in individuals with any of the following: history of anaphylactic reaction to neomycin or hypersensitivity to gelatin or any other component of the vaccine; primary or acquired immunodeficiency states; family history of congenital or hereditary immunodeficiency; immunosuppressive therapy; active untreated tuberculosis or febrile illness (>101.3°F or >38.5°C); or those who are pregnant. If vaccination of post-pubertal females is undertaken, pregnancy should be avoided for 3 months following vaccination.

Administration of ProQuad (dose 1) to children 12 to 23 months old who have not been previously vaccinated against measles, mumps, rubella, or varicella, nor had a history of the wild-type infections, is associated with higher rates of fever and febrile seizures at 5 to 12 days after vaccination when compared to children vaccinated with dose 1 of both M-M-R®II (Measles, Mumps, and Rubella Virus Vaccine Live) and VARIVAX® (Varicella Virus Vaccine Live) administered separately.

Use caution when administering ProQuad to children with: a history of cerebral injury or seizures or any other condition in which stress due to fever should be avoided; anaphylaxis or immediate hypersensitivity to eggs; contact hypersensitivity to neomycin; thrombocytopenia. Children with immediate hypersensitivity to eggs may be vaccinated with extreme caution; adequate treatment should be readily available should a reaction occur.

Advise vaccinees to avoid: close contact with high-risk individuals susceptible to varicella for up to 6 weeks following vaccination since transmission of varicella vaccine virus may occur between vaccinees and susceptible contacts; pregnancy for 3 months after vaccination; using salicylates for 6 weeks after vaccination. Defer vaccination for at least 3 months following blood or plasma transfusions, or administration of immune globulins (IG). The appropriate suggested interval between transfusion or IG administration and vaccination will vary with the type of transfusion or indication for, and dose of, IG.

Following administration of ProQuad, any immune globulin (IG), including VZIG, should not be given for 1 month thereafter unless its use outweighs the benefits of vaccination.

The most frequent vaccine-related adverse events reported in ≥5% of subjects vaccinated with ProQuad were: injection-site reactions (pain/tenderness/soreness, erythema, and swelling); fever; and irritability. Systemic vaccine-related adverse events that were reported at a significantly greater rate in recipients of ProQuad than in recipients of the component vaccines administered concomitantly were fever and measles-like rash. In children 12 to 23 months of age, the only vaccine-related injection-site adverse reaction that was more frequent among recipients of ProQuad than recipients of M-M-R®II (Measles, Mumps, and Rubella Virus Vaccine, Live) and VARIVAX® (Varicella Virus Vaccine Live) was rash at the injection site (2.4% versus 1.6%, respectively).

Dosage and Administration for ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live)

Each 0.5 mL dose of ProQuad is administered subcutaneously.

  • The first dose is usually administered at 12 to 15 months of age.
  • A second dose, if needed, is usually administered at 4 to 6 years of age.

At least 1 month should elapse between a dose of a measles-containing vaccine such as M-M-R®II and a dose of ProQuad. At least 3 months should elapse between a dose of varicella-containing vaccine and ProQuad.

No clinical data are available regarding the development or worsening of thrombocytopenia in individuals vaccinated with ProQuad. Cases of thrombocytopenia have been reported after primary vaccination with measles vaccine; measles, mumps, rubella vaccine; after varicella vaccination; and following revaccination with measles vaccine or M-M-R®II.

The safety and efficacy of ProQuad for use after exposure to measles, mumps, rubella or varicella have not been established.

The safety and efficacy of ProQuad for use in children known to be infected with human immunodeficiency viruses have not been established.

In severely immunocompromised individuals who have been inadvertently vaccinated with measles containing vaccine, measles inclusion body encephalitis, pneumonitis and fatal outcome as a direct consequence of disseminated measles vaccine virus infection have been reported. In this population, disseminated mumps and rubella vaccine virus infection have also been reported.

Tuberculin testing should be administered anytime before, simultaneously with, or at least 4 to 6 weeks after ProQuad.

ProQuad may be administered concomitantly with pneumococcal 7-valent conjugate vaccine and/or hepatitis A vaccine (inactivated) at separate injection sites.

ProQuad may be administered concomitantly with Haemophilus influenzae type b conjugate (meningococcal protein conjugate) and hepatitis B (recombinant) vaccine. Additionally, ProQuad may be administered concomitantly with pneumococcal 7-valent conjugate vaccine, and/or hepatitis A (inactivated) vaccines.

There are no data regarding the administration of ProQuad with inactivated poliovirus vaccine or with other live virus vaccines.

There are insufficient data to support concomitant vaccination with diphtheria, tetanus, and acellular pertussis vaccine adsorbed.

The duration of protection from measles, mumps, rubella, and varicella infections after vaccination with ProQuad is unknown.

Before administering ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live), please read the Prescribing Information.

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