M-M-R II

Uses

It is used for combined immunization against measles, mumps & rubella. As a general guide, the first dose of MMR vaccine is administered to children aged from 12 months. A second (booster) dose of MMR or monovalent measles vaccine is recommended before starting school at 3-6 years of age. Children presenting for their pre-school booster who have not received their first dose of MMR vaccine should be given a dose of MMR vaccine then followed by a second dose 3 months later.

MMR vaccine can be used in place of measles vaccine for children & should be given irrespective of previous measles, mumps or rubella infection.

To control outbreaks of measles and should be offered to susceptible children within 3 days of exposure to infection.

Dosage

M-M-R II dosage

Adults and Children: A single dose of 0.5 ml of the reconstituted vaccine given by deep subcutaneous injection. Do not give intravenously.

Expanded Program on Immunization schedule: After completion of 9 months, 1 dose of measles-rubella vaccine should be given. After completion of 15 months, 1 dose of only measles containing vaccine should be given.

Reconstitute vaccine with the provided diluent. Mix thoroughly. Discard if powder does not dissolve. Use immediately after reconstitution.

Side Effects

Common side-effects: Generally pain and tenderness at the injection site may occur within 24 hours after vaccination, which usually disappear by itself within 2-3 days.

Generally transient fever reaction may occur within 1 -2 weeks after vaccination. Rash: generally mild rash may occur within 12 days after vaccination, which generally lasts for no more than 2 days.

Rare side- effects: Severe fever reaction: physical methods and drugs should be used for symptomatic treatment to prevent febrile seizures.

Very rare side-effects:

• Allergic rash: generally urticaria may occur within 72 hours after vaccination, and if this reaction occurs, anti-allergy treatment should be timely given.
• Anaphylactic shock: generally occurs within 1 hour after vaccination. Injection of epinephrine and other emergency measures should be timely given for treatment.
• Anaphylactoid purpura: medical care should be timely given if anaphylactoid purpura occurs. Cortical steroids can be given for anti-allergy treatment. Improper or not timely treatment is likely to cause anaphylatic purpura nephritis. Thrombocytopenia purpura.
• Adults may develop arthritis, pain and swelling of large joints after vaccination

Precaution

Patients with history of cerebral injury or seizures. Patients with thrombocytopenia and those who develop thrombocytopenia after 1st dose. For patients with active tuberculosis, tuberculosis treatment should be started before using the vaccine. Vaccination may be deferred in patients with moderate or severe acute illness. Pregnancy should be avoided for 28 days after vaccination. Lactation.

Interaction

Immune globulins may reduce the efficacy of vaccines. May reduce the diagnostic effect of tuberculin tests.

Pregnancy & Breastfeeding use

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Contraindication

Current febrile respiratory illness or other febrile infection. Patients receiving immunosuppressive therapy; primary and acquired immunodeficiency states. Blood dyscrasias, cancers affecting the bone marrow or lymphatic systems. Pregnancy. Active untreated tuberculosis.

Storage Condition

Powder: Store at 2-8°C. Freezing does not affect potency.

Diluent: May store in refrigerator or at room temperature; do not freeze.

Reconstituted solution: Store at 2-8°C; protect from light; discard if not used within 8 hr.

Innovators Monograph

You find simplified version here M-M-R II