title: Immunogenicity and safety of two doses of tetravalent measles-mumps-rubella-varicella vaccine in healthy children.
abstract: BACKGROUND
  Combination vaccines against common childhood diseases are widely used, provide an improved coverage, are more convenient and are more cost-effective than multiple injections. We conducted a study to evaluate the safety and immunogenicity of a combined measles-mumps-rubella-varicella (MMRV) candidate vaccine in comparison with the separate administration of licensed measles-mumps-rubella (MMR; Priorix) and varicella (V; Varilrix) vaccines.
  
  
  METHODS
  Healthy children 12-18 months of age received 2 doses of MMRV vaccine (3 lots) 6-8 weeks apart (MMRV group) or 1 dose of MMR vaccine administered concomitantly with 1 dose of varicella vaccine, followed by a second dose of MMR at 6-8 weeks later (MMR+V group). Local symptoms (redness, pain and swelling) were recorded for 4 days after vaccination, and fever (any, axillary temperature > or =37.5 degrees C or rectal temperature > or =38.0 degrees C; grade 3, axillary temperature >39.0 degrees C or rectal temperature >39.5 degrees C) was monitored daily for 15 days. Other adverse events were monitored for 6 weeks.
  
  
  RESULTS
  A total of 494 children were vaccinated (371 in the MMRV group and 123 in the MMR+V group. Two doses of MMRV vaccine were at least as immunogenic as 2 doses of MMR and 1 dose of varicella vaccine. After the second dose, all children had seroconverted to measles, rubella and varicella in both vaccine groups, and 98% versus 99% had seroconverted to mumps in the MMRV versus the MMR+V group, respectively. The MMRV vaccine did not induce an increased local or general reactogenicity compared with the separate administration, although a higher incidence of low grade fever was seen after the first dose in the MMRV group (67.7% after MMRV versus 48.8% after MMR+V; P < 0.05), this was not observed for grade 3 fever (11.6% after MMRV versus 10.6% after MMR+V; P = 0.87). After the second dose, no differences in incidence of fever were found in either MMRV or MMR+V groups.
  
  
  CONCLUSIONS
  Administration of 2 doses of the combined MMRV vaccine was as immunogenic and well-tolerated as separate injections of MMR and varicella vaccine.
authors.affiliation: Childrens Hospital, Johannes Gutenberg-University Hospital, Mainz, Germany. knuf@kinder.klinik.uni-mainz.de
authors.forename: Markus
authors.initials: M
authors.lastname: Knuf
authors.forename: Pirmin
authors.initials: P
authors.lastname: Habermehl
authors.forename: Fred
authors.initials: F
authors.lastname: Zepp
authors.forename: Wilma
authors.initials: W
authors.lastname: Mannhardt
authors.forename: Martin
authors.initials: M
authors.lastname: Kuttnig
authors.forename: Pekka
authors.initials: P
authors.lastname: Muttonen
authors.forename: Albrecht
authors.initials: A
authors.lastname: Prieler
authors.forename: Hartwig
authors.initials: H
authors.lastname: Maurer
authors.forename: Helmtrud
authors.initials: H
authors.lastname: Bisanz
authors.forename: Nadia
authors.initials: N
authors.lastname: Tornieporth
authors.forename: Dominique
authors.initials: D
authors.lastname: Descamps
authors.forename: Paul
authors.initials: P
authors.lastname: Willems
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D019433:Chickenpox Vaccine / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D005260:Female; D005334:Fever; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D006940:Hyperemia; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D008459:Measles virus / Q000276:immunology; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D009109:Mumps virus / Q000276:immunology; D010146:Pain; D017778:Vaccines, Combined / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D019433:Chickenpox Vaccine; D007074:Immunoglobulin G; D022542:Measles-Mumps-Rubella Vaccine; D017778:Vaccines, Combined; C050102:measles, mumps, rubella, varicella vaccine; C040901:rubella antibodies