Applies to measles virus vaccine / mumps virus vaccine / rubella virus vaccine / varicella virus vaccine: parenteral for injection for sub-q use.
Side effects include:
MMR: Fever, transient rash, injection site reactions (pain, induration, edema).
MMRV (ProQuad®): Adverse effects similar to those reported when varicella vaccine and MMR are administered simultaneously at separate sites, but higher incidence of fever (≥38.9°), febrile seizures, and measles-like rash.
For Healthcare Professionals
Applies to measles virus vaccine/mumps virus vaccine/rubella virus vaccine/varicella virus vaccine: injectable powder for injection, subcutaneous powder for injection.
General
The most common adverse events were injection site reactions and fever.[Ref]
Other
Deaths have been reported following vaccination with measles, mumps, and rubella vaccines; however, a causal relationship has not been established in healthy individuals. Death as a direct consequence of disseminated measles vaccine virus infection has been reported in severely immunocompromised individuals in whom a measles-containing vaccine is contraindicated and who were inadvertently vaccinated.[Ref]
Very common (10% or more): Fever (up to 61.2%)
Common (1% to 10%): Viral infection
Uncommon (0.1% to 1%): Malaise, fatigue
Rare (0.01% to 0.1%): Otitis media
Very rare (less than 0.01%): Kawasaki syndrome
Postmarketing reports: Candidiasis, infection, ear pain, trauma, death[Ref]
Local
Very common (10% or more): Injection site pain/tenderness/soreness (up to 41.1%), injection site erythema (27%), injection site swelling (15.6%)
Common (1% to 10%): Injection site bruising, injection site rash, injection site pruritus
Postmarketing reports: Extravasation, injection-site complaints (burning and/or stinging of short duration, eczema, edema/swelling, hive-like rash, discoloration, hematoma, induration, lump, vesicles, wheal and flare), inflammation, venipuncture site hemorrhage, warm sensation, warm to touch[Ref]
Dermatologic
Very common (10% or more): Rash (up to 20.3%)
Common (1% to 10%): Measles-like rash, varicella-like rash, viral exanthema
Very rare (less than 0.01%): Erythema multiforme
Postmarketing reports: Atypical measles, cellulitis, herpes zoster, measles, skin infection, varicella (vaccine strain), Henoch-Schonlein purpura, herpes simplex, impetigo, panniculitis, pruritus, purpura, skin induration, Stevens-Johnson syndrome, sunburn, varicella-like rash, roughness/dryness[Ref]
Respiratory
Common (1% to 10%): Rhinorrhea, cough, upper respiratory infection
Uncommon (0.1% to 1%): Nasopharyngitis, rhinitis
Rare (less than 0.1%): Cough, bronchitis
Postmarketing reports: Influenza, respiratory infection, bronchial spasm, epistaxis, pneumonitis, pneumonia, pulmonary congestion, sinusitis, sneezing, sore throat, wheezing[Ref]
Nervous system
Uncommon (0.1% to 1%): Somnolence, lethargy
Rare (0.01% to 0.1%): Febrile seizures
Very rare (less than 0.01%): Meningitis, encephalitis, cerebrovascular accident, cerebellitis, cerebellitis like symptoms, Guillain Barré syndrome, transverse myelitis, peripheral neuritis
Postmarketing reports: Acute disseminated encephalomyelitis (ADEM), afebrile convulsions or seizures, aseptic meningitis, ataxia, Bell's palsy, convulsion, dizziness, dream abnormality, encephalitis, encephalopathy, febrile seizure, headache, hypersomnia, measles inclusion body encephalitis, ocular palsies, paresthesia, polyneuritis, polyneuropathy, subacute sclerosing panencephalitis, syncope, transverse myelitis, tremor, nerve deafness[Ref]
Encephalitis and encephalopathy have been reported approximately once for every 3 million doses of the combination of measles, mumps, and rubella vaccine. Some of these cases may have been caused by measles vaccines. The risk of serious neurological disorders for encephalitis and encephalopathy with wild-type measles is 1 per 2000 reported cases.
There have been reports of subacute sclerosing panencephalitis (SSPE) in children with no history of infection with wild-type measles but who did receive measles vaccine. Some of these cases may have resulted from unrecognized measles in the first year of life or possibly from the measles vaccination.
Based on estimated measles vaccine distribution in the United States (US), the association of SSPE cases to measles vaccination is about one case per million vaccine doses distributed. The association with wild-type measles virus infection is 6 to 22 cases of SSPE per million cases of measles.
Cases of aseptic meningitis have been reported following measles, mumps, and rubella vaccination. Although a causal relationship between other strains of mumps vaccine and aseptic meningitis has been shown, there is no evidence to link Jeryl Lynn (TM) mumps vaccine to aseptic meningitis.[Ref]
Gastrointestinal
Common (1% to 10%): Diarrhea, vomiting
Uncommon (0.1% to 1%): Parotid swelling
Very rare (less than 0.01%): Mumps-like syndrome
Postmarketing reports: Parotitis, abdominal pain, flatulence, hematochezia, mouth ulcer, lip abnormality[Ref]
Psychiatric
Common (1% to 10%): Irritability
Uncommon (0.1% to 1%): Abnormal crying, nervousness, insomnia, somnolence
Postmarketing reports: Agitation, apathy, nervousness[Ref]
Hematologic
Uncommon (0.1% to 1%): Lymphadenopathy
Very rare (less than 0.01%): Thrombocytopenia, thrombocytopenic purpura
Postmarketing reports: Aplastic anemia, lymphadenitis, regional lymphadenopathy, thrombocytopenia[Ref]
Cases of thrombocytopenia have been reported after use of measles; measles, mumps, and rubella (MMR); and varicella vaccination. Individuals with current thrombocytopenia may develop more severe thrombocytopenia following vaccination. In addition, individuals who experienced thrombocytopenia following the first dose of MMR may develop thrombocytopenia with repeat doses.[Ref]
Hypersensitivity
Very rare (less than 0.01%): Allergic reactions (including anaphylactic and anaphylactoid reactions)
Postmarketing reports: Anaphylaxis and related phenomena such as angioneurotic edema, facial edema, and peripheral edema, anaphylaxis in individuals with or without an allergic history[Ref]
Metabolic
Uncommon (0.1% to 1%): Anorexia[Ref]
Musculoskeletal
Very rare (less than 0.01%): Arthralgia, arthritis
Postmarketing reports: Musculoskeletal pain, myalgia, pain of the hip, leg, or neck, swelling, stiffness[Ref]
Chronic arthritis has been associated with wild-type rubella infection and has been related to persistent virus and/or viral antigen isolated from body tissues. Recipients of rubella vaccine may develop chronic joint symptoms. Arthralgia and/or arthritis, and polyneuritis after wild-type rubella virus infection vary in frequency and severity with age and gender, being greatest in adult females and least in pre-pubertal children. Following vaccination in children, reactions in joints are uncommon (0 to 3%) and of brief duration. In women, incidence rates for arthritis and arthralgia are higher than those seen in children (12 to 26%), and the reactions tend to be more marked and of longer duration (e.g., months or years). In adolescent girls, the reactions appear to be intermediate in incidence between those seen in children and adult women.[Ref]
Genitourinary
Very rare (less than 0.01%): Orchitis, epididymitis[Ref]
Ocular
Postmarketing reports: Edema of the eyelid, irritation, necrotizing retinitis (reported only in immunocompromised individuals), optic neuritis, retinitis, retrobulbar neuritis[Ref]
