title: Pain response to M-M-R vaccination in 4-6 year old children.
abstract: BACKGROUND
  Differences in pain response to two different M-M-R products have previously been demonstrated in 12-month old infants and in 4 â 6 year old children. Objective To determine if the acute and immediate pain response to two licensed M-M-R vaccine products (using a self-report measure) in children 4-6 years of age was similar to that demonstrated in younger infants.
  
  
  METHODS
  Randomized, double blind, study. Subjects were randomly allocated to PriorixA (SmithKline Beecham) or M-M-R IIA (Merck Frosst). The primary outcome measure was pain response to vaccination quantified using a self-report OUCHER pain scale. Secondary outcome measures included pain measurement by proxy (physician and parent) using a visual analog scale (VAS) and measurement of cry and cry duration immediately post-vaccination.
  
  
  RESULTS
  Of the 60 subjects enrolled, 30 received PriorixA and 30 received M-M-R IIA. There were no significant differences between the two groups on age, sex, or previous painful procedure. Post-vaccination, children in the M-M-R IIA group had higher median pain scores compared with children in the PriorixA group for VAS (12.5 vs. 2.0, respectively by paediatricians, p=0.017; 18.5 vs. 5.0, respectively by parents, p=0.235), OUCHER (20 vs. 0.00, respectively, p=0.047). The median duration of crying post M-M-R IIA was higher compared with PriorixA (6 vs. 0 seconds, respectively, p=0.020). Conclusion PriorixA was associated with significantly less pain compared with M-M-R IIA, at the time of injection.
authors.affiliation: The Hospital for Sick Children, and Department of Paediatrics, University of Toronto, Faculty of Medicine, Toronto, Canada.
authors.forename: Moshe
authors.initials: M
authors.lastname: Ipp
authors.forename: Eyal
authors.initials: E
authors.lastname: Cohen
authors.forename: Morton
authors.initials: M
authors.lastname: Goldbach
authors.forename: Colin
authors.initials: C
authors.lastname: Macarthur
mesh_terms: D002648:Child; D002675:Child, Preschool; D003448:Crying; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D013997:Time Factors; D014611:Vaccination
chemical_list: D022542:Measles-Mumps-Rubella Vaccine