established Safety and efficacy in HIV-infected children have not been established Vaccination should be deferred in individuals with a family history of congenital or hereditary immunodeficiency until the individual’s immune status has been evaluated and the individual has been found to be immunocompetent Postmarketing reports suggest transmission of vaccine virus may occur to high-risk individuals (eg, immunocompromised, pregnant women without positive varicella history or vaccination, or newborn infants of mothers without positive varicella history) Contains albumin; theoretical risk for transmission Creutzfeldt-Jacob disease Febrile seizures There is a risk of fever and associated febrile seizure in first 2 weeks following immunization with M-M-RII vaccine; for children who have experienced a previous febrile seizure (from any cause) and those with a family history of febrile seizures there is a small increase in risk of febrile seizure following receipt of M-M-RII vaccine Administration of MMRV (dose 1) to children aged 12-23 months who have not been previously vaccinated against measles, mumps, rubella, or varicella, nor had a history of the wild-type infections, is associated with higher rates of fever and febrile seizures at 5-12 days after vaccination when compared with children vaccinated with dose 1 of both MMR and varicella vaccine administered separately Drug interactions overview Immune globulins and transfusion Immune globulins (IG) and other blood products coadministered with MMRV contain antibodies that may interfere with vaccine virus replication and decrease the expected immune response Defer vaccination; appropriate suggested interval between transfusion or IG administration and vaccination will vary with the type of transfusion or indication for, and dose of, IG (eg, 5 months for varicella zoster immune globulin) Refer to prescribing information for specific recommendations Salicylates Reye syndrome reported following salicylate administration during wild-type varicella infection Avoid salicylates for 6 weeks after vaccination Corticosteroids and immunosuppressive drugs Do not administer to individuals receiving immunosuppressive doses of corticosteroids or other immunosuppressive drugs Can result in a more extensive vaccine-associated rash or disseminated disease in individuals on immunosuppressive drugs (see Contraindications) Use with other vaccines At least 1 month should elapse between a dose of a measles-containing vaccine (eg, MMR) and a dose of MMRV, and at least 3 months should elapse between administration of 2 doses of MMRV or varicella-containing vaccines Lab tests MMR vaccine given individually may result in a temporary depression of tuberculin skin sensitivity Therefore, if a tuberculin test is to be done, it should be administered either any time before, simultaneously with, or at least 4 to 6 weeks after MMRV Pregnancy Contraindicated during pregnancy; avoid pregnancy for 3 months following vaccination In a 10-year survey involving over 700 pregnant women who received rubella vaccine within 3 months before or after conception (of whom 189 received the Wistar RA 27/3 strain), none of the newborns had abnormalities compatible with congenital rubella syndrome Mumps infection during the first trimester of pregnancy may increase the rate of spontaneous abortion Although mumps vaccine virus has been shown to infect the placenta and fetus, there is no evidence that it causes congenital malformations in humans Reports have indicated that contracting wild-type measles during pregnancy enhances fetal risk; increased rates of spontaneous abortion, stillbirth, congenital defects and prematurity have been observed subsequent to infection with wild-type measles during pregnancy There are no adequate studies of the attenuated (vaccine) strain of measles virus in pregnancy; however, it would be prudent to assume that the vaccine strain of virus is also capable of inducing adverse fetal effects Lactation Unknown if measles or mumps vaccine is secreted in human milk The prescribing information describes studies that have shown lactating postpartum women immunized with live attenuated rubella vaccine may secrete the virus in breast milk and transmit it to breastfed infantsPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Live, attenuated viruses stimulate active immunity to disease caused by measles, rubella, and mumps viruses Pharmacokinetics Duration: >15 years after 2 doses Onset: Active immunity detected after 1 dose Pharmacogenomics HLA-B7, HLA-B51, HLA-DRB1*13, and HLADQA1*01 is associated with a measles vaccine response Homozygosity at HLA-B, HLA-DR, and HLA-DQA1 has been associated with a measles vaccine nonresponse SC or IM Preparation Single-dose vial M-M-R II Withdraw entire volume of supplied diluent (vial) into the syringe to be used for reconstitution Inject all the diluent into the vial of lyophilized vaccine, and agitate to mix thoroughly Discard if lyophilized vaccine cannot be dissolved Resulting suspension should appear clear yellow Withdraw entire vial contents into syringe Priorix Hold prefilled syringe by barrel and unscrew syringe cap by twisting it counterclockwise Align needle to axis of syringe and attach by gently connecting needle hub into Luer Lock adaptor and rotate a quarter turn clockwise until you feel it lock Cleanse vial stopper and transfer entire contents of prefilled syringe into lyophilized vaccine Without inverting vial, shake vial well until powder is completely dissolved Resulting suspension should appear clear peach-to-fuchsia pink-colored Discard if contains particulate matter or discolored After reconstitution, withdraw entire vial contents of reconstituted vaccine into same syringe after changing needle SC or IM Administration 25 gauge, 5/8-inch needle recommended Inject SC into outer aspect of upper arm Storage Unopened vials M-M-R II Store frozen/refrigerated at -58°F to +46°F (-50°C to +8°C) Protect from light at all times, since light exposure may inactivate the viruses Before reconstitution, refrigerate lyophilized vaccine at 36-46°F (2-8°C) Store the diluent refrigerated or separately at room temperature; do not freeze diluent Priorix Vials of lyophilized vaccine: Refrigerate at 36-46ºF (2-8ºC); protect from light Prefilled ungraduated syringes of sterile water diluent: Refrigerate at 36-46ºF (2-8ºC) or store at controlled room temperature up to 77ºF (25ºC) Do not freeze lyophilized antigen component or sterile water diluent Reconstituted vials Use as soon as possible after reconstitution M-M-R II 36-46°F (2-8°C) for up to 8 hr; discard if not used within 8 hr Protect from light Priorix 36-46ºF (2-8ºC) for up to 8 hr; discard if not used within 8 hr Do not freeze; discard if reconstituted vaccine has been frozen No images available for this drug. No images available for this drug.A Patient Handout is not currently available for this monograph.Print FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. 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