Measles, Mumps, Rubella and Varicella (MMR-Var) vaccine

Measles causes a rash, high fever, cough, runny nose and red eyes. In one out of every 1,000 cases of measles there may be inflammation of the brain (encephalitis) that can lead to convulsions, deafness or mental disability. Death occurs in about one out of every 3,000 cases of measles. Measles also causes serious illness in adults and increases the risk of miscarriage and premature delivery in pregnant women.

Mumps causes fever, headache and swollen glands around the jaw. In rare cases a child’s brain becomes severely inflamed (encephalitis). Mumps can also cause deafness. About one out of four men who get mumps have painfully swollen testicles that may lead to sterility in rare cases. For 1 out of 10 women who get mumps, the ovaries will be infected and painful.

Rubella, also called German measles, causes a slight fever, sore throat, rash and swelling of the neck glands that lasts about three days. Painful and swollen joints may occur in some people. In very rare cases rubella may cause inflammation of the brain (encephalitis) and a bleeding disorder. When a woman gets rubella in the first 20 weeks of pregnancy, there is a greater than 80% chance she may have a miscarriage or the baby will be born with a serious disability.

Varicella, also known as chickenpox, causes an itchy rash which looks like small water blisters. Most people who get varicella recover with no lasting effects. Occasionally it can lead to severe skin infections, pneumonia or problems with the brain, liver and heart. A pregnant woman with chickenpox can pass it to her baby before birth or can give it to her newborn baby.

• Chickenpox virus can reactivate later in life to cause shingles, a painful rash that can be very severe, especially in the elderly.

• All children should receive two doses of MMR and one dose of varicella vaccine.
• Children between the ages of one year up to and including 12 years of age who need both MMR and varicella vaccines during the same clinic visit should receive MMR-Var vaccine. The second dose of MMR is offered to children between 4–6 years of age.
• Individuals 13 years of age or older who need both MMR and varicella vaccine will receive them in 2 separate needles.

Yes, MMR-Var vaccine is safe. This vaccine contains a tiny amount of the virus that causes the disease. The virus has been weakened so it cannot give you the disease.

In Canada, a vaccine must go through a series of steps before it is approved for use. Once a vaccine has been approved, every lot is tested for safety and quality. In addition, side effects following immunization are constantly monitored.

There is no latex in the MMR-Var vaccine or its packaging, therefore a person with a latex allergy can still receive this vaccine.
What are possible side effects and risks of the MMR-Var vaccine?

Expected reactions –

• Redness, swelling, and tenderness in the area where the needle is given;
• Fever, and/or a rash can occur 4–12 days after getting the vaccine. The rash can be a blotchy red rash (measles-like) and/or spots that look like blisters (chickenpox).

Uncommon reactions –

• Swelling of the glands in the neck;
• Swelling of lymph glands;
• Diarrhea and/or vomiting;
• Tiredness, general malaise, irritability;
• Febrile convulsions.

Serious side effects are rare. However, with any immunization unexpected or unusual reactions can occur. Based on reactions reported following separate administration of MMR and varicella vaccine, the following may also be a risk with MMR-Var –

• Severe allergic reactions (anaphylaxis) occur in approximately one to three reports per 1,000,000 doses of vaccine distributed.
• Inflammation of the brain (encephalitis) or deafness. This occurs in approximately one case per ten million doses of MMR vaccine distributed.
• Thrombocytopenia (low platelet count in the blood that can cause a bleeding disorder) occurs in one per 30,000–40,000 doses of measles, rubella or varicella vaccine administered.

• For pain or swelling where the needle was given, place a cool damp towel on the area.
• For pain or fever, give acetaminophen (also called Tylenol^® or Tempra^®) as directed on the bottle. NOTE: Acetylsalicylic acid (ASA or Aspirin^®) is not recommended for persons less than 18 years of age because of the increased risk of Reye’s syndrome.
• Call your local public health nurse if you have questions or if there is an unusual reaction to the vaccine.

Talk to a public health nurse before getting this vaccine if the person who is to get the vaccine:

• Has any severe allergies,
• Has a lowered ability to fight infections due to cancer, other serious disease, or treatment (such as medications to fight cancer, radiation therapy or other drugs such as cortisone),
• Is sick now with something more serious than a cold,
• Has received immune globulin or other blood products within the past 12 months,
• Has been given a live vaccine, in the previous six weeks.