Frequently asked questions about ProQuad® (Measles, Mumps, Rubella and Varicella Virus Vaccine Live)
Given CDC recommended dosing for ProQuad differs from the FDA-approved recommended dosing, any cost or coverage information may be out of date. As always, please contact your patient’s insurance provider for specific information about your patient’s cost or coverage.
What is the indication and usage for ProQuad?
Indications
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.
What is the dosing for ProQuad?
The first dose is administered at 12 to 15 months of age but may be given anytime through 12 years of age.
The second dose is administered at 4 to 6 years of age. At least 1 month should elapse between a dose of a measles-containing vaccine and a dose of ProQuad. At least 3 months should elapse between a dose of varicella-containing vaccine and ProQuad.
Given CDC recommended dosing for ProQuad differs from the FDA-approved recommended dosing, any cost or coverage information may be out of date. As always, please contact your patient’s insurance provider for specific information about your patient’s cost or coverage.
What is the Selected Safety Information (SSI) for ProQuad, VARIVAX, and M-M-R®II?
Selected Safety Information
- Hypersensitivity: ProQuad, M-M-R®II, and VARIVAX are contraindicated in patients with a history of anaphylactic reaction or hypersensitivity to any component of the vaccine (including gelatin or neomycin) or to a prior dose of measles, mumps, rubella, or varicella-containing vaccine. Use caution when administering ProQuad and M-M-R®II to individuals with anaphylaxis or immediate hypersensitivity to eggs.
- ProQuad, M-M-R®II, and VARIVAX are contraindicated in certain individuals, including those with: immunodeficiency or who are immunosuppressed; an active febrile illness; untreated tuberculosis.
- Pregnancy: ProQuad, M-M-R®II, and VARIVAX are contraindicated for use in pregnant women. Do not administer ProQuad or VARIVAX to individuals who are planning to become pregnant in the next 3 months. Do not administer M-M-R®II to individuals who are planning to become pregnant in the next month.
- Febrile Seizures: 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 a first dose of both M-M-R®II and VARIVAX administered concomitantly.
- Febrile Seizures: Use caution when administering ProQuad and M-M-R®II to individuals with a history of febrile seizures.
- Family History of Immunodeficiency: Vaccination with ProQuad, M-M-R®II, and VARIVAX should be deferred in individuals with a family history of congenital or hereditary immunodeficiency until the individual’s immune status has been evaluated and the individual has been found to be immunocompetent.
- Thrombocytopenia: Transient thrombocytopenia has been reported within 4-6 weeks following vaccination with measles, mumps, and rubella vaccine. Carefully evaluate the potential risk and benefit of vaccination in children with thrombocytopenia or in those who experienced thrombocytopenia after vaccination with a previous dose of a measles, mumps, and rubella-containing vaccine.
- Varicella Transmission and Precautions: Advise vaccinees administered ProQuad or VARIVAX to avoid: close contact with high-risk individuals susceptible to varicella for up to 6 weeks following vaccination since transmission of varicella vaccine virus to susceptible contacts has been reported. Varicella vaccine virus transmission may occur between vaccine recipients and contacts susceptible to varicella including healthy individuals.
- Immune Globulins and Other Blood Products: Immune Globulins and other blood products should not be given concomitantly with ProQuad, M-M-R®II, or VARIVAX.
- Use of Salicylates: Avoid use of salicylates in children and adolescents administered ProQuad or VARIVAX for 6 weeks following vaccination due to the association of Reye Syndrome with salicylate therapy and wild-type varicella infection.
- Adverse Events: The following adverse events have been reported for both subcutaneous and intramuscular injections of ProQuad, M-M-R®II, and VARIVAX: fever, injection-site reactions (pain/tenderness/soreness, erythema, and swelling); and rash on the body or at the injection site. Additionally, irritability has been reported for the subcutaneous injections of ProQuad, M-M-R®II, and VARIVAX.
- ProQuad Systemic Vaccine-Related Adverse Events: Systemic vaccine-related adverse events that were reported at a significantly greater rate in recipients of subcutaneous ProQuad than in recipients of the component vaccines administered concomitantly were fever and measles-like rash.
- VARIVAX Dose-related Adverse Events: In a clinical trial involving children who received 2 doses of VARIVAX 3 months apart, the incidence of injection-site clinical complaints observed in the first 4 days following vaccination was slightly higher post-dose 2 (overall incidence 25.4%) than post-dose 1 (overall incidence 21.7%), whereas the incidence of systemic clinical complaints in the 42-day follow-up period was lower post-dose 2 (66.3%) than post-dose 1 (85.8%).
- Concomitant Vaccines With ProQuad: ProQuad may be administered concomitantly with diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed (DTaP), Haemophilus influenzae type b conjugate (meningococcal protein conjugate) and hepatitis B (recombinant) vaccine. It may also be administered concomitantly with pneumococcal 7-valent conjugate vaccine and/or hepatitis A vaccine (inactivated) at separate injection sites.
- Concomitant Vaccines With VARIVAX: VARIVAX can be administered with other live viral vaccines. If not given concurrently, at least 1 month should elapse between a dose of a live attenuated measles virus-containing vaccine and a dose of VARIVAX. In children, at least 3 months should elapse between administration of 2 doses of a live attenuated varicella virus-containing vaccine.
- Tuberculin Testing: If a tuberculin test is to be done with M-M-R®II and ProQuad, it should be administered either any time before, simultaneously with, or at least 4 to 6 weeks after vaccination. With VARIVAX, tuberculin testing may be performed before the vaccine is administered or at least 4 weeks following vaccination.
- Additional M-M-R®II Precautions: Additional adverse reactions, which have been reported without regard to causality, include febrile convulsions, arthritis, thrombocytopenia, anaphylaxis, anaphylactoid reactions, arthritis, encephalitis and encephalopathy in their diverse clinical presentations.
- Additional VARIVAX Precautions: It is not known if varicella vaccine virus is excreted in human milk. A boost in antibody levels has been observed in vaccinees following exposure to wild-type varicella, which could account for the apparent long-term persistence of antibody levels in studies. The duration of protection from varicella infection after vaccination is unknown.
- ProQuad/VARIVAX and Herpes Zoster: The long-term effect of VARIVAX on the incidence of herpes zoster, particularly in those vaccinees exposed to wild-type varicella, is unknown at present.
- Efficacy: Vaccination with ProQuad, VARIVAX, or M-M-R®II may not result in protection in 100% of vaccinees.
Before administering VARIVAX® (Varicella Virus Vaccine Live), M-M-R®II (Measles, Mumps, and Rubella Virus Vaccine Live), or ProQuad®(Measles, Mumps, Rubella and Varicella Virus Vaccine Live), please read the accompanying Prescribing Information. The Patient Information also is available for VARIVAX, M-M-R®II, and ProQuad.
How is ProQuad administered?
A single dose of ProQuad is approximately 0.5 mL. It can be administered subcutaneously or intramuscularly.
What is the CPT code for ProQuad?
The CPT Code for ProQuad is 907101.
Given CDC recommended dosing for ProQuad differs from the FDA-approved recommended dosing, any cost or coverage information may be out of date. As always, please contact your patient’s insurance provider for specific information about your patient’s cost or coverage.
What are the storage guidelines for ProQuad?
Storage temperature range
To maintain potency, ProQuad must be stored frozen between -58°F and +5°F (-50°C to -15°C). Use of dry ice may subject ProQuad to temperatures colder than -58°F (-50°C).
Before reconstitution, store the lyophilized vaccine in a freezer at a temperature between −58°F and +5°F (−50°C and −15°C) for up to 18 months. Any freezer (eg, chest, frost-free) that reliably maintains an average temperature between −58°F and +5°F (−50°C and −15°C) and has a separate sealed freezer door is acceptable for storing ProQuad. Routine defrost cycling of a frost-free freezer is acceptable.
Temperature range prior to reconstitution
ProQuad may be stored at refrigerator temperature (36° to 46°F, 2° to 8°C) for up to 72 hours prior to reconstitution. Discard any ProQuad vaccine stored at 36° to 46°F which is not used within 72 hours of removal from 5°F (-15°C) storage.
Light exposure
Protect the vaccine from light at all times since such exposure may inactivate the vaccine viruses.
Guidelines for reconstituted vaccine
- If not used immediately, the reconstituted vaccine may be stored at room temperature, protected from light, for up to 30 minutes.
- Discard reconstituted vaccine if it is not used within 30 minutes.
- Do not freeze reconstituted vaccine.
Diluent storage temperature
Diluent should be stored separately at room temperature (68° to 77°F, 20° to 25°C), or in a refrigerator (36° to 46°F, 2° to 8°C).
For information regarding the product or questions regarding storage conditions, call 1-800-MERCK-90.
Can ProQuad be given to adults?
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.
What are the CDC recommendations for routine measles, mumps, rubella, and varicella vaccinations?
CDC recommends the 2-dose series to be given at 12-15 months and then at 4-6 years.2
MMRV is not CDC recommended for ages 12-47 months (administer MMR and varicella vaccines separately for this age group).2
What is the CDC recommended catch-up schedule for measles, mumps, rubella, and varicella vaccinations?
The CDC Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger specifies catch-up vaccination for measles, mumps, rubella and varicella is for unvaccinated children and adolescents to receive a 2-dose series:2
- MMR: at least 4 weeks apart
- Varicella:
- Age 7-12 years: Routine interval: 3 months (a dose inadvertently administered after at least 4 weeks may be counted as valid)
- Age 13 years and older: Routine interval: 4-8 weeks (min. interval: 4 weeks)
MMRV (ProQuad) not recommended for ages 12-47 months or 13-18 years (administer MMR and varicella vaccines separately for these age groups). Minimum interval between MMRV doses is 3 months.2
What is the difference between the MMR and MMRV vaccines?
A MMR vaccine is a vaccine that helps prevent measles, mumps and rubella in ages 12 months and older.
MMRV vaccine is a vaccine that helps prevent measles, mumps, rubella and varicella (chickenpox). ProQuad is the only MMRV vaccine currently approved in ages 12 months through 12 years.
Is ProQuad available for children through the Vaccines For Children (VFC) Program?
Yes, in most states, ProQuad is available through the Vaccines for Children (VFC) Program for children who qualify. Check with your state or local VFC Program to learn more about the specific products available to your practice.
Given CDC recommended dosing for ProQuad differs from the FDA-approved recommended dosing, any cost or coverage information may be out of date. As always, please contact your patient’s insurance provider for specific information about your patient’s cost or coverage.
How can I order ProQuad for my practice?
ProQuad can be ordered via ordering.merckvaccines.com, by calling into the Merck Vaccines Customer Care line 877.VAX.MERCK (877.829.6372), or through your preferred wholesaler/distributor. For a list of Merck authorized distributors please go to Authorized distributors – Merck.com.
References
- American Academy of Pediatrics. AAP Immunization Coding Table. Updated October 2025. Accessed November 6, 2025. https://downloads.aap.org/AAP/PDF/coding_vaccine_coding_table.pdf
- Advisory Committee on Immunization Practices (ACIP). Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2025. Last reviewed October 7, 2025. Accessed November 6, 2025. https://www.cdc.gov/vaccines/hcp/imz-schedules/downloads/child/0-18yrs-child-combined-schedule.pdf