Combination MMRV vaccine associated with greater febrile seizure risk

The CDC’s Advisory Committee on Immunization Practices (ACIP) has updated its recommendations on the use of the combination measles, mumps, rubella and chickenpox (MMRV) vaccine. The ACIP is recommending that either MMR or MMRV vaccine may be used for first dose for 1–2 year olds. However, families without a strong preference for MMRV should receive separate MMR + varicella vaccines.

This recommendation is based on a study by the Kaiser Permanente Division of Research that analyzed 459,000 children 12–23 months old receiving their first dose of a measles-containing vaccine and found the MMRV vaccine to be associated with a two-fold increased risk of fever and febrile seizures 7–10 days after vaccination compared with same-day administration of a separate shot for MMR and the varicella vaccine. Data showed that the risk for a febrile seizure after the first dose of MMRV vaccine is low, although it is higher than after MMR vaccine and varicella vaccine administered as separate injections.

Providers who consider using MMRV should discuss with families and caregivers the risk and benefits.

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