CDC MMRV Vaccine Data Safety Link Slides

7/30/2019 CDC MMRV Vaccine Data Safety Link Slides

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Very Few Countries Recommend

Universal Varicella Vaccination


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Data

Natural Chicken Pox in the Netherlands results in 1 to 2

Hospital Admissions per 100,000 infections.

Only 253.5 General Practioner Outpatient visits.

Contrast these numbers with the Vaccine-

When Varicella is administered as directed with the MMR

Outpatient Fever Visits- 3,000 per 100,000

Febrile Seizures requiring Emergency Room Treatment-

28 to 80 per 100,000 depending on how the vaccine is

administered.

ResultVaricella Vaccine is Not on the

Netherlands' Schedule

This study was performed to determine if the Netherlands

should follow the US with Universal Varicella vaccination.


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Chicken Pox was a routine childhood illnessbefore a $75 per dose vaccine was developed.

http://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/index.html


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The following slides look at seizure rates of the MMR alone, th

alone, the MMR and Chicken Pox in separate injections in th

using the MMRV Pro-Quad 4 in 1 Combo injec


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Which vaccine would you choose for your

Keeping the MMR and delaying or skippi

Chicken Pox dramatically reduces the poss

a febrile seizure without affecting Public H

Excess

Chicken

PoxVaccine

Seizures

Over

MMR

Alone

MMRV---------- , MMR+V-------------, MMR alone -------------------, VZV Chicken PoYellow-----


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189 / 83,107 = 1 / 439 598 / 376,354 = 1 / 629


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3000 / 100k = 3 / 100 Vaccinated C

Require Outpatient Fever Vis

Excess

Chicken

Pox Fever

Visits

OverMMR

Alone

MMRV---------- , MMR+V-------------, MMR alone -------------------, VZV Chicken PoYellow-----


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Vaccines and Immunizations

Vaccines and Preventable Diseases:

Q&As About the Options for Protecting Your Child AgainstMeasles, Mumps, Rubella, and Varicella

To be protected against measles, mumps, rubella (German measles), and varicella (chickenpox),children need to be vaccinated twice: once when they are 12 through 15 months old, and again whenthey are 4 through 6 years old.

To prevent these diseases, two vaccination options are available. A child can receive two shots: themeasles, mumps, and rubella (MMR) vaccine and the varicella vaccine, or one shot: the measles,mumps, rubella, and varicella (MMRV) vaccine.

Questions and Answers:

How do I decide which option to use for my childs first vaccination against measles, mumps, rubella, andvaricella?

Your doctor can discuss using MMR and varicella vaccines or MMRV vaccine with you

to help you make an informed decision for your child. There are risks and benefits witheach option. For a 12- through 47-month-old childs first vaccination against thesediseases, there is one major trade-off to consider.

Using the MMRV vaccine means that a child will only have to have one shot to provideprotection against the four diseases (measles, mumps, rubella and varicella). However,the MMRV vaccine has been associated with a higher risk of two side effects that youshould know about when it is used for the first vaccination among children who are 12through 47 months old.

First, children who get the MMRV vaccine for their first vaccinations are more likely to

have fever of 102F or higher within 42 days of being vaccinated than those who get theMMR and varicella vaccines at the same visit for their first vaccinations. Studies haveshown that out of every 100 children who are 12 through 23 months old and get theMMRV vaccine for their first vaccinations, about 22 have fever of 102F or higherwithin the 42 days following vaccination compared with 15 out of every 100 who get theMMR and varicella vaccines at the same visit. Most of this increase in fever occursduring the 5 to 12 days after vaccination only.

Second, two studies have shown that children who get the MMRV vaccine for their first

Page 1 of 4Vaccines: VDP-VAC/combo/MMRV/FAQs Options for Parents and Caregivers

3/23/2011http://www.cdc.gov/print.do?url=http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/m...


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vaccinations when they are 12 through 23 months old are about twice as likely to have afebrile seizure in the 5 to 12 days following vaccination compared with those whoreceive the MMR and varicella vaccines at the same visit. However, its important toremember that the overall risk of febrile seizures is very low for both options (about 8out of every 10,000 children who get the MMRV vaccine for their first vaccinationswhen they are 12 through 23 months old, and about 4 out of every 10,000 children whoget the MMR and varicella vaccines at the same visit for their first vaccinations whenthey are 12 through 23 months old).

Studies of febrile seizures after vaccination with first dose of MMRV vaccine have notbeen done in older children, but experts agree that this increased risk of febrile seizuresduring the 5 to 12 days after the first vaccination with MMRV vaccine likely also occursin children aged 24 through 47 months, but not in children who are 48 months or olderbecause febrile seizures are uncommon after this age.

For the first dose of measles, mumps, rubella, and varicella vaccines given at ages 48months and older, using the MMRV vaccine is generally preferred over using the MMR

and varicella vaccines because it requires one less injection to provide similar protectionwith no known additional risks of side effects. See the ACIP Recommendations.

Is there an increased risk of febrile seizures after vaccination with the MMR vaccine?

Among children who are younger than 7 years old, approximately one additional febrileseizure occurs in the 8 to 14 days after vaccination for every 3,000-4,000 childrenvaccinated with the MMR vaccine, compared with children not vaccinated during thepreceding 30 days.

Is there an increased risk of febrile seizures after vaccination with the varicella vaccine?

Studies have not shown an increased risk of febrile seizure after varicella vaccine.

What is the risk of febrile seizures after the first dose of MMRV vaccine compared with the first dose of MMR andvaricella vaccines administered at the same doctor visit?

Its important to understand that both options have a very small risk of febrile seizure asa side effect. For children who get the MMRV vaccine for their first vaccinations whenthey are 12 through 23 months old, about 8 out of every 10,000 will have a febrileseizure. For children who get the MMR and

varicella vaccines at the same visit for their first vaccinations when they are 12 through23 months old, about 4 out of every 10,000 will have a febrile seizure.

What is a febrile seizure?

"Febrile" means "relating to a fever." In some children, having a fever can bring on a




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seizure. During a febrile seizure, a child often has spasms or jerking movementslargeor smalland may lose consciousness. Febrile seizures usually last only a minute ortwo. They are most common with fevers reaching 102F (38.9C) or higher, but can alsooccur at lower temperatures or when a fever is going back down.

What kinds of things can cause febrile seizures?

Febrile seizures may happen with any condition that causes a fever, including typicalchildhood illnesses like ear infections or even the common cold. Measles was a commoncause of febrile seizures in the U.S. before it became a rare disease due to the success ofthe vaccination program.

Who is most at risk for febrile seizures?

Febrile seizures are not uncommon. About 2-5% of young children will have at least onefebrile seizure. Most febrile seizures occur in children between the ages of 6 months and5 years. The peak age is 14 through18 months, which overlaps with the ages when first

doses of the MMRV, MMR, and varicella vaccines are recommended. A child who hasalready had a febrile seizure is more likely to have another one. Also if a member of achild's immediate family (a brother, sister, or parent) has had febrile seizures, that childis more likely to have a febrile seizure.

How serious is a febrile seizure?

Most children who have febrile seizures recover quickly and have no lasting effects.However, febrile seizures often result in a visit to an emergency room and can be veryfrightening for parents and caregivers.

About 1 in 3 children who have one febrile seizure will have at least one more febrileseizure. Most children (>90%) will not develop epilepsy. Genetic predisposition andother factors such as cerebral palsy, delayed development, or other neurologicalabnormalities increase the risk for future development of epilepsy after a febrile seizure.

Two studies have shown that children who have febrile seizures after receiving an MMRvaccine are no more likely to have epilepsy or learning or developmental problems thanchildren who have febrile seizures that are not associated with a vaccine. Experts believeit is likely that this finding for MMR vaccine applies to MMRV vaccine as well.

Is there an increased risk of fever or febrile seizures associated with the MMRV vaccine when it is used as asecond dose?

Studies do not suggest that children who are 4 through 6 years old and receive theMMRV vaccine have an increased risk of febrile seizures after vaccination whencompared with those who receive the MMR and varicella vaccines at the same doctorvisit. In addition, the second dose of MMRV vaccine is less likely to cause fever than thefirst dose.

How do I decide which option to use for my childs second vaccination against measles, mumps, rubella, and




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Page Located on the Web at http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/mmrv/vacopt-faqs-parent.htm

varicella?

For the second dose given at any age (15 months through 12 years), use of the MMRVvaccine is generally preferred over using the MMR and varicella vaccines because itrequires one less injection to provide similar protection with no known additional risksof side effects. See the ACIP Recommendations.

Why is it important that my child be fully vaccinated against measles, mumps, rubella, and varicella?

Measles, mumps, rubella, and varicella are all potentially serious diseases.

Measles causes rash, cough, runny nose, eye irritation, and fever. Complicationscan include ear infection, pneumonia, seizures (jerking or staring), brain damage,and death.Mumps causes fever, headache, and swollen glands. Complications can includedeafness, meningitis (infection of the brain and spinal cord covering), painfulswelling of the testicles or ovaries, and, rarely, death.

Rubella causes rash, mild fever, and arthritis (mostly in women). If a woman getsrubella while she is pregnant, she could have a miscarriage or her baby could beborn with serious birth defects.Varicella (chickenpox) causes rash, itching, fever, and tiredness. Complicationscan include severe skin infection, scars, pneumonia, brain damage, or death.

This page last modified on March 2, 2011Content last reviewed on May 7, 2010Content Source: National Center for Immunization and Respiratory Diseases


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CDC MMRV Vaccine Data Safety Link Slides

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