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Illness after measles-mumps-rubella vaccination
T R Freeman1, M A Stewart, L Turner
1Department of Family Medicine, University of Western Ontario, London.
Insights
Measles-mumps-rubella (MMR) vaccination can cause temporary side effects like fever and rash. These post-vaccine symptoms do not differ between infants vaccinated at 13 or 15 months old.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health
Background:
- Measles-mumps-rubella (MMR) vaccination is a critical public health intervention.
- Understanding potential post-vaccine sequelae is important for parental counseling and vaccine policy.
- Previous studies have investigated MMR vaccine side effects, but comparisons of different administration ages are valuable.
Purpose of the Study:
- To document common sequelae following measles-mumps-rubella (MMR) vaccination.
- To compare post-vaccine symptoms in children receiving the MMR vaccine at 13 months versus 15 months of age.
Main Methods:
- A prospective cluster randomized controlled trial was conducted across 22 family practices.
- 253 infants completed the study, with half receiving the MMR vaccine at 13 months and the other half at 15 months.
- Outcomes included physician-assessed physical findings, maternal diaries of illnesses, and medical record reviews for hospital admissions.
Main Results:
- Increased rates of lymphadenopathy (23.8%), fever (16.8%), and rash (26.9%) were observed in the weeks following MMR vaccination.
- Fewer health problems were reported in the weeks after vaccination compared to the pre-vaccination period.
- No significant difference in adverse events or hospital admissions was found between the 13-month and 15-month vaccination groups.
Conclusions:
- Parents should be informed about potential transient side effects of MMR vaccination, including lymphadenopathy, nasal discharge, and rash.
- The timing of MMR vaccination (13 vs. 15 months) does not appear to significantly influence the occurrence of common sequelae.
- These findings support current vaccination schedules and aid in informed parental decision-making regarding MMR vaccine administration.
Objectives:
To provide accurate information on the common sequelae of measles-mumps-rubella (MMR) vaccination and to compare post-vaccine symptoms in children vaccinated at 13 and 15 months.
Design:
Prospective cluster randomized controlled trial.
Setting:
Twenty-two family practices in southwestern Ontario.
Patients:
All 376 infants who were due to receive MMR vaccine in the next year, 253 (67.3%) successfully completed the study.
Intervention:
MMR vaccine administered at 13 months by half of the family physicians and at 15 months by the remaining half.
Outcome Measures:
Family physician's physical findings in children 7 days and 30 days after vaccine; reported illnesses by mothers in a daily diary in the month before and after vaccination and medical records of visits to family physicians and hospital admissions in the month before and after vaccination.
Results:
Compared with the incidence rates in the corresponding weeks before vaccination, the rates of lymphadenopathy (23.8%) and fever (16.8%) were higher 1 week afterward and the rate of rash (26.9%) was higher 7 to 14 days afterward. Fewer health problems were reported in the third and fourth weeks after vaccination than in the corresponding weeks beforehand. Hospital admissions after vaccination were no more frequent than those before once cause and time of admission were taken into account. The two age groups did not differ in any of the outcomes.
Conclusions:
Mothers should be informed about the possibility of increased physical findings in the weeks after MMR vaccination, especially lymphadenopathy, nasal discharge and rash. Since the occurrence of sequelae does not seem to differ significantly between 13-month-old recipients and 15-month-old recipients, it should not influence the decision of when to administer the vaccine.