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Pain response to M-M-R vaccination in 4-6 year old children
Moshe Ipp1, Eyal Cohen, Morton Goldbach
1The Hospital for Sick Children, and Department of Paediatrics, University of Toronto, Faculty of Medicine, Toronto, Canada.
Insights
Priorix-TM- against Measles, Mumps, and Rubella (MMR) vaccine was associated with significantly less pain compared to MMR-II-TM- in children aged 4-6 years. This study found Priorix-TM- led to lower pain scores and less crying post-injection.
Area of Science:
- Pediatric Pain Management
- Vaccine Efficacy and Safety
- Immunization Practices
Background:
- Previous studies indicated differing pain responses to MMR vaccines in infants and young children.
- Understanding acute pain responses in children is crucial for improving vaccination experiences.
Purpose of the Study:
- To compare the acute and immediate pain response to two licensed MMR vaccine products in children aged 4-6 years.
- To determine if pain responses in this age group mirror findings in younger infants.
Main Methods:
- A randomized, double-blind study involving 60 children aged 4-6 years.
- Participants received either Priorix-TM- or MMR-II-TM-.
- Pain was assessed using self-report (OUCHER scale), proxy-report (physician/parent VAS), and cry duration.
Main Results:
- Children receiving MMR-II-TM- reported higher pain scores on VAS and OUCHER scales compared to those receiving Priorix-TM-.
- Physician-reported VAS scores were significantly higher for MMR-II-TM- (p=0.017).
- Median crying duration post-vaccination was significantly longer for MMR-II-TM- (p=0.020).
Conclusions:
- Priorix-TM- was associated with significantly less pain during vaccination compared to MMR-II-TM- in children aged 4-6 years.
- These findings suggest a difference in immediate pain perception between the two MMR vaccine products.
Background:
Differences in pain response to two different M-M-R products have previously been demonstrated in 12-month old infants and in 4 â 6 year old children. Objective To determine if the acute and immediate pain response to two licensed M-M-R vaccine products (using a self-report measure) in children 4-6 years of age was similar to that demonstrated in younger infants.
Methods:
Randomized, double blind, study. Subjects were randomly allocated to PriorixA (SmithKline Beecham) or M-M-R IIA (Merck Frosst). The primary outcome measure was pain response to vaccination quantified using a self-report OUCHER pain scale. Secondary outcome measures included pain measurement by proxy (physician and parent) using a visual analog scale (VAS) and measurement of cry and cry duration immediately post-vaccination.
Results:
Of the 60 subjects enrolled, 30 received PriorixA and 30 received M-M-R IIA. There were no significant differences between the two groups on age, sex, or previous painful procedure. Post-vaccination, children in the M-M-R IIA group had higher median pain scores compared with children in the PriorixA group for VAS (12.5 vs. 2.0, respectively by paediatricians, p=0.017; 18.5 vs. 5.0, respectively by parents, p=0.235), OUCHER (20 vs. 0.00, respectively, p=0.047). The median duration of crying post M-M-R IIA was higher compared with PriorixA (6 vs. 0 seconds, respectively, p=0.020). Conclusion PriorixA was associated with significantly less pain compared with M-M-R IIA, at the time of injection.
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