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Combination measles, mumps, rubella and varicella vaccine
Insights
The investigational measles, mumps, rubella, varicella (MMRV) vaccine demonstrated comparable immunogenicity and safety to the standard measles, mumps, rubella (MMR) vaccine plus varicella (V) vaccine. Both schedules achieved high seroconversion rates and similar antibody persistence for measles, mumps, and rubella.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Immunology
Background:
- Standard immunization schedules involve separate vaccines for measles, mumps, rubella, and varicella.
- Combination vaccines offer potential benefits in terms of administration and cost-effectiveness.
Purpose of the Study:
- To compare the immunogenicity, safety, and antibody persistence of a novel combination measles, mumps, rubella, varicella (MMRV) vaccine against the standard measles, mumps, rubella (MMR) vaccine followed by varicella (V) vaccine.
Main Methods:
- A comparative clinical trial involving healthy children aged 15–17 months.
- Administration of either the investigational MMRV vaccine or the MMR vaccine followed by the V vaccine 6 weeks later.
- Assessment of seroconversion rates, mean antibody titers, clinical reactivity, and antibody persistence at 1 year post-vaccination.
Main Results:
- Both MMRV and MMR + V schedules induced nearly 100% seroconversion for all vaccine components.
- Similar mean antibody titers were observed between the two groups for each virus.
- Comparable clinical reactogenicity, including rashes and fever, was noted.
- Antibodies to measles, mumps, and rubella were persistent at 1 year.
- Varicella antibody persistence was observed in 80% of MMRV recipients and 100% of MMR + V recipients.
Conclusions:
- The combination MMRV vaccine is immunogenic and safe for healthy children.
- It presents a cost-effective alternative for varicella immunization.
- Further research is needed to optimize the varicella component dosage and enhance antibody persistence.
Abstract:
A comparative clinical trial was conducted in 15- to 17-month-old healthy children to compare an investigational combination measles, mumps, rubella, varicella (MMRV) vaccine v standard measles, mumps, rubella vaccine followed 6 weeks later with the varicella (MMR + V) vaccine. Both the MMRV and MMR + V vaccine schedules stimulated virtually 100% seroconversion for all component viruses. Mean antibody titers were similar for each virus component in the two vaccine groups. Clinical reactivity postimmunization was also similar with 25% to 29% morbilliform rashes, 12% to 25% mild papulovesicular (varicella) rashes, and 12.5% to 18% temperature elevations above 38.3 degrees C (101 degrees F). Antibodies to measles, mumps, and rubella viruses were persistent at 1 year of follow-up in both groups. Varicella antibody was persistent in 8/10 originally seronegative MMRV vaccinees and 5/5 MMR + V vaccine recipients tested. One MMRV vaccine recipient had a household exposure to chickenpox during the year postvaccination that resulted in a subclinical boost in varicella antibody titer. Two children in the MMR + V vaccine group had close varicella exposures; mild varicella (20 lesions) developed in one. There were no known exposures to natural measles, mumps, or rubella. Three of four MMRV vaccinees with low titer antibody to varicella prior to immunization had greater than fourfold increases in antibodies after vaccination. The combination MMRV vaccine is an immunogenic, safe, and cost-effective approach to varicella immunization of healthy children. Continued work is needed to select the appropriate dose of varicella component, to assure higher persistence rate of varicella antibody.