How does this medication work? What will it do for me?

This medication belongs to a group of medications known as vaccines. It is used in children to prevent measles, mumps, rubella, and chicken pox by increasing your defenses against the viruses that cause these illnesses. Vaccines do not cause the illness they are protecting against. This vaccine works by introducing very small amounts of weakened versions of the viruses. The weakened viruses stimulate the production of a person's own antibodies (molecules designed to attack that particular virus or toxin). The cells that produce antibodies remain in the body, ready to attack any future viruses that cause infection.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each glass vial of whitish powder contains a single dose of MMR-Varicella vaccine. When reconstituted with a clear, colourless, sterile liquid, each 0.5 mL dose contains not less than 3.00 log10 TCID50 (50% tissue culture infectious dose) of measles virus; 4.30 log10 TCID50 of mumps virus; 3.00 log10 TCID50 of rubella virus; and a minimum of 3.99 log10 PFU (plaque-forming units) of Oka/Merck varicella virus. Nonmedicinal ingredients: sucrose, hydrolyzed gelatin, urea, sodium chloride, sorbitol, monosodium L-glutamate, sodium phosphate, recombinant human albumin, sodium bicarbonate, potassium phosphate, potassium chloride, residual components of MRC-5 cells including DNA and protein, neomycin, bovine serum albumin, and other buffer and media ingredients.

How should I use this medication?

This medication may be administered to children 12 months through 12 years of age. It is usually given as a single dose, with the first dose given at 12 to 15 months of age, although it may be given at any time up to 12 years of age. This medication is given as an injection under the skin (subcutaneously) of the upper arm or upper thigh, usually in a doctor's office.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment for your child to receive the MMR-varicella vaccine, contact your doctor as soon as possible to reschedule your appointment.

This medication should be refrigerated. It may also be stored in a freezer at temperatures above -50ºC.  Protect it from light and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

The MMR-varicella vaccine should not be received by anyone who:

  • is allergic to measles, mumps, rubella, or varicella vaccines, or any ingredients of the medication
  • is allergic to neomycin
  • is pregnant or plans to become pregnant within the next 3 months
  • has a condition or is taking medication that reduces the ability of the immune system to fight infection
  • have active, untreated tuberculosis

This medication is not for children older than 12 years of age, adolescents, or adults.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • cold symptoms (e.g., runny nose, stuffy nose)
  • diarrhea
  • fatigue
  • fever up to 39°C
  • generally feeling unwell
  • irritability
  • loss of appetite
  • pain, redness, or swelling at the injection site
  • swollen cheek glands
  • trouble sleeping
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • coughing
  • ear pain
  • joint and muscle pain
  • rash
  • swollen glands in the armpit, neck, and groin
  • tingling and numbness in the arms, hands, feet, and legs
  • unexplained bruising or bleeding
  • unsteadiness with walking

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of Kawasaki syndrome (e.g., fever lasting more than 5 days; rash on the trunk; peeling skin on hands and fingers; red eyes, lips, throat, and tongue)
  • seizures
  • symptoms of a severe allergic reaction (e.g., difficulty in breathing or swallowing; hives; swelling of the mouth, throat, or face)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: The measles and mumps components of this vaccine are produced in chick embryo cell culture and may contain traces of egg protein. If your child has had an allergic reaction to egg in the past, be sure to tell your child’s doctor.

Your doctor may ask you and your child to stay in the office for about 30 minutes after having the vaccine so you can receive medical care if an allergic reaction occurs. If you notice signs of a severe allergic reaction in your child (hives; trouble breathing or swallowing; or swelling of the lips, face, throat, or tongue), get medical attention immediately.

Immune system: As with any vaccine, this vaccine may not be as effective for people with a weakened immune system (such as people who are on chemotherapy, have had an organ transplant, or have HIV).

If your child has a weakened immune system for any reason, discuss with your doctor how this medication may affect your child's medical condition, how your child's medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infection: Your child’s doctor may decide to delay this vaccine if your child has an acute infection or fever. Mild infections without fever, such as colds, usually do not require delay of the vaccine.

Medical conditions: Varicella vaccine should not be given for at least 3 months following a blood or plasma transfusion or human immunoglobulin therapy.

Seizures: There is an increased risk of seizures due to fever after receiving a vaccine for measles. Fever is a common side effect of this vaccine. Discuss appropriate treatment of fever with your doctor and make sure you know when it is necessary to get medical help for your child. Your child's doctor may suggest that you give your child a dose of medication to prevent fever.

Vaccine protection: As with any vaccine, this vaccine may not protect all people who receive it.

Pregnancy: This medication should not be used by women who are or may be pregnant. Pregnancy should be avoided for three months following vaccination.

Breast-feeding: This medication is intended for children under the age of 12 years. As such, it should not be used by women who are breast-feeding.

What other drugs could interact with this medication?

There may be an interaction between this medication and any of the following:

  • acetaminophen
  • acetylsalicylic acid (ASA)
  • anti-cancer medications (e.g., cyclophosphamide, methotrexate, vincristine)
  • azathioprine
  • belimumab
  • biologic therapies (e.g., infliximab, rituximab)
  • corticosteroids (e.g., budesonide, dexamethasone, prednisone)
  • dimethyl fumarate
  • fingolimod
  • hydroxychloroquine
  • immune globulins
  • leflunomide
  • medications that reduce the effectiveness of the immune system (e.g., cyclosporine, mycophenolate, tacrolimus)
  • mesalamine
  • methyl salicylate
  • sulfasalazine
  • tuberculin skin tests
  • vaccines

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.