ProQuad Combination Vaccine

Vaxopedia

A child with measles.
ProQuad helps prevent measles, mumps, rubella, and chicken pox. Photo courtesy of the CDC

ProQuad is a newer vaccine, but unlike most other new vaccines, this one can mean fewer shots for your kids.

ProQuad

Proquad is indicated for use in children 12 months to 12 years of age who need to be vaccinated against the measles, mumps, rubella, and varicella viruses. This used to mean getting two separate shots, the MMR and Varivax (chicken pox) vaccines, which according to the latest immunization schedule, most kids get when they are about 12 to 15 months old, with boosters at age 4 years.

Like the separate MMR and Varivax vaccines, ProQuad is an attenuated live virus vaccine.

Other facts about ProQuad include that:

  • ProQuad is made by Merck
  • You must wait at least 1 month between getting a regular MMR vaccine and ProQuad
  • ProQuad may be given at the same time as the Hib and HepB vaccines
  • ProQuad may be used as the first dose of MMR and Varivax
  • ProQuad may be used as the second dose of MMR, if the child also needs a chicken pox shot

With the combination vaccines ProQuad and Kinrix (IPV plus DTaP), most preschoolers can now get away with just two shots (still getting four vaccines) before they start kindergarten.

ProQuad Warnings and Side Effects

ProQuad should not be given to certain children, including children:

  • who have had anaphylactic reactions to neomycin or a hypersensitivity to gelatin or other components of ProQuad
  • with malignant neoplasms, such as leukemia and lymphoma
  • on immunosuppressive therapy
  • who have immunodeficiencies
  • who have a family history of congenital or hereditary immunodeficiency, until testing is completed

Children should also not get ProQuad if they:

  • have active untreated tuberculosis
  • have an active febrile illness and the fever is above 101.3 degrees
  • are pregnant

Your pediatrician will likely also be cautious before giving ProQuad to your child if he has a history of cerebral injury, seizures, a family history of seizures, egg allergy, contact dermatitis from neomycin, thrombocytopenia, or if he is supposed to avoid the stress from a fever.

The safety profile of ProQuad is similar to that of the separate MMR and Varivax vaccines. Children were more likely to have fever, a rash at the injection site, and a measles-like rash after getting ProQuad, but were less likely to have pain, tenderness, and soreness at the injection site, than if they got separate MMR and Varivax shots.

Post-marketing studies have found an increased rate of fever and febrile seizures in kids getting ProQuad vs. those getting separate MMR and Varivax shots.

The most common side effects of ProQuad include injection site reactions:

  • pain/tenderness/soreness
  • erythema (redness)
  • swelling
  • ecchymosis (bruising)
  • rash

and systemic reactions:

  • fever greater or equal to 102 degrees
  • irritability
  • measles like rash
  • chicken pox like rash
  • rash
  • upper respiratory infection
  • viral exanthema
  • diarrhea

What You Need To Know About the ProQuad Vaccine

Other things to know about ProQuad include that:

  • Unlike other combination vaccines, the Advisory Committee on Immunization Practices (ACIP) does not recommend ProQuad vs. the separate MMR and chicken pox vaccines for the first dose of the vaccines in young children. Because of the increased risk of fever and febrile seizures, unless a parent prefers ProQuad, they do not "express a preference for use of MMRV vaccine over separate injections of equivalent component vaccines".
  • ProQuad is still preferred for the second dose of measles, mumps, rubella, and varicella vaccines and for kids over 47 months getting their first doses.

Whichever vaccines you choose, ProQuad for separate MMR and chicken pox vaccines, get educated and get your kids vaccinated and protected.

Sources

CDC. Use of Combination Measles, Mumps, Rubella, and Varicella Vaccine. MMWR. May 7, 2010 / 59(RR03);1-12

Klein NP, et al. Measles-containing vaccines and febrile seizures in children age 4 to 6 years. Pediatrics. 2012 May;129(5):809 -814.

MMWR, March 14, 2008, Vol 57, #10. Update: Recommendations from the ACIP Regarding Administration of Combination MMRV Vaccine

ProQuad Product Label. August 2005.

Continue Reading