Dose-response study of a quadrivalent measles, mumps, rubella and varicella vaccine in healthy children.

Abstract

BACKGROUND:

A combined measles, mumps, rubella and varicella (MMRV) vaccine would facilitate universal immunization against 4 diseases by decreasing the number of injections and thus enhancing compliance and coverage rates. If a second dose of varicella vaccine were to be recommended, MMRV could be used to administer a routine second dose of M-M-RII with the added advantage of boosting varicella-zoster virus (VZV) antibody titers.

METHODS:

Subjects 12-23 months of age received a single injection of 1 of 3 lots of an MMRV vaccine (ProQuad) containing high, middle or low VZV potency, or VARIVAX given concomitantly with M-M-RII. Recipients of MMRV received a second injection of MMRV approximately 90 days later.

RESULTS:

We enrolled 1559 subjects in the study. Antibody response rates to VZV 6 weeks after 1 injection of high potency MMRV (88.6%) or 2 injections of MMRV of any varicella potency (99.7-100%) were similar to the response rates after concomitant administration of M-M-RII and VARIVAX (93.1%). The second injection of MMRV boosted VZV antibody titers. Antibody responses to measles, mumps and rubella were >or=98%, similar to the control, after 1 or 2 injections of MMRV. MMRV was generally well-tolerated during the 42 days after vaccination.

CONCLUSIONS:

One injection of high potency MMRV resulted in antibody responses to the 4 vaccine components equivalent to those found after concomitant administration of M-M-RII and VARIVAX. A second injection of MMRV resulted in a significant boost in VZV antibody. This boost may translate into enhanced immunogenicity against varicella, which is known to correlate with increased protection.

• Authors: Henry Shinefield, Steve Black, Wendy R Williams, Colin Marchant, Keith Reisinger, Tracy Stewart, H Cody Meissner, Juan Guerrero, Stephanie Olsen Klopfer, Jin Xu, Florian Schödel, Barbara J Kuter, Dose Selection Study Group for Proquad
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 24 Issue 8 Pg. 670-5 (Aug 2005) ISSN: 0891-3668 [Print] United States
• PMID: 16094218 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Viral
• Chickenpox Vaccine
• Measles-Mumps-Rubella Vaccine
• Vaccines, Combined
• measles, mumps, rubella, varicella vaccine

Topics

• Antibodies, Viral (blood)
• Chickenpox Vaccine (administration & dosage, adverse effects, immunology)
• Dose-Response Relationship, Immunologic
• Female
• Humans
• Infant
• Male
• Measles-Mumps-Rubella Vaccine (administration & dosage, adverse effects, immunology)
• Vaccines, Combined (administration & dosage, adverse effects, immunology)