title: Immunogenicity and reactogenicity of tetravalent vaccine for measles, mumps, rubella and varicella (MMRV) in healthy children: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Varicella is a highly infectious childhood disease. Tetravalent measles-mumps-rubella-varicella (MMRV) vaccine was introduced as one-syringe dose.
  
  
  OBJECTIVE
  To evaluate the immunogenicity and reactogenicity of MMRV vaccine versus trivalent MMR with varicella (V) vaccines in healthy children and to assess the respective safety issue.
  
  
  METHODS
  Randomized controlled trials (RCTs) were searched from the OVID databases. Trials were eligible if healthy children were randomized to receive MMRV or MMR+V vaccine. Seroconversions in serum antibody titers were the primary outcomes; adverse events were the secondary outcomes.
  
  
  RESULTS
  Ten RCTs with 8961 healthy children were identified. MMRV and MMR+V vaccines showed comparable immunogenicity against measles (relative risk [RR] = 0.99, 95% CI = 0.98-1.00), mumps (RR = 0.99, 95% CI = 0.97-1.00), rubella (RR = 1.00, 95% CI = 1.00-1.01) and varicella (RR = 0.98, 95% CI = 0.95-1.01). At least 93% of children in both groups had seroconverted within 6 weeks. MMRV group showed significantly higher incidences of fever (RR = 1.19, 95% CI = 1.09-1.31) and rash (RR = 1.23, 95% CI = 1.06-1.43).
  
  
  CONCLUSIONS
  The immunogenicities of MMRV and MMR+V vaccines were comparable in healthy children; however, MMRV vaccination showed higher incidences of fever and rash.
authors.affiliation: School of Public Health and Primary Care, China.
authors.forename: Julia Hy
authors.initials: JH
authors.lastname: Leung
authors.forename: Hoyee W
authors.initials: HW
authors.lastname: Hirai
authors.forename: Kelvin Kf
authors.initials: KK
authors.lastname: Tsoi
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D002644:Chickenpox / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D005076:Exanthema / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000453:epidemiology; D064368:Healthy Volunteers; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000517:prevention & control*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D009107:Mumps / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012409:Rubella / Q000517:prevention & control*; D016896:Treatment Outcome; D017778:Vaccines, Combined / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D019433:Chickenpox Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D017778:Vaccines, Combined; C050102:measles, mumps, rubella, varicella vaccine
keywords: immunogenicity; measles–mumps–rubella; reactogenicity; tetravalent vaccine; varicella