The World Health Organization recommends vaccinating against measles, mumps, rubella, and varicella because the risks of these diseases far outweigh the risks of vaccinating against them. In particular, the World Health Organization recommends varicella vaccination in countries where the vaccine is affordable, the disease is a relatively important problem, and high and sustained vaccine coverage can be achieved. The United States and a few other countries have widely implemented this. MMR and varicella vaccine are given at roughly the same time and a booster injection is recommended for both. The MMRV vaccine, a combined MMR and varicella vaccine, simplifies administration of the vaccines.
Contraindications
For individuals who are moderately or severely ill, it is generally recommended that they wait until after recovery before getting ProQuad. No such precautions are recommended for minor illnesses, such as a cold.
It is recommended that aspirin or aspirin containing products be avoided for at least six weeks after receiving ProQuad vaccine. A serious condition called Reye's syndrome has been reported in patients with chicken pox and influenza.
Individuals should not receive ProQuad without first consulting their doctor if there is a history of a life-threatening allergic reaction to gelatin, eggs, the antibiotic neomycin, or a previous MMR or chicken pox vaccine.
Doctors are advised to be aware of whether or not a patient has HIV/AIDS or another disease that affects the immune system, is taking a medication that affects the immune system, has cancer, a fever or active untreated tuberculosis, is receiving cancer treatment, or has ever had a low platelet count.
Adverse events
Rare but serious adverse events reported following ProQuad vaccination include allergic reactions, including swelling of the lips, tongue, or face; difficulty breathing or closing of the throat; hives; paleness; weakness; dizziness; a fast heart beat; deafness; long-term seizures, coma, or lowered consciousness; seizures caused by fever; or temporary low platelet count. For children age two and younger, the MMRV vaccine is associated with more adverse events compared to separate administration of MMR and varicella vaccinations on the same day. There are 4.3 additional febrile seizures per 10,000 vaccinated children, 7.5 additional mostly mild fever episodes per 100 vaccinated children and 1.1 additional measles-like rash per 100 children. Febrile seizures caused by the MMRV vaccine occur 7 to 10 days after vaccination. In children age 4–6, there is no evidence for an increased risk in febrile seizures after MMRV compared to the separate administration of MMR and Varicella vaccines.
