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Dose-Response Study of a Quadrivalent Measles, Mumps, Rubella and Varicella Vaccine in Healthy Children

2005; Lippincott Williams & Wilkins; Volume: 24; Issue: 8 Linguagem: Inglês

10.1097/01.inf.0000172901.29621.e9

1532-0987

Henry R. Shinefield, Wendy R. Williams, Colin D. Marchant, Keith S. Reisinger, Tracy Stewart, H. Cody Meissner, Juan Guerrero, Stephanie O. Klopfer, F. Schödel, Barbara J. Kuter,

Animal Virus Infections Studies

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-R®II 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-R®II. Recipients of MMRV received a second injection of MMRV ∼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-R®II and VARIVAX (93.1%). The second injection of MMRV boosted VZV antibody titers. Antibody responses to measles, mumps and rubella were ≥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-R®II 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.