Version June 2024
| Contraindications |
| Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component |
| Pregnancy or possibility of pregnancy within 4 weeks |
| Immunosuppression |
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| PrecautionsΔ |
| Receipt of antibody-containing blood product within past 3 to 11 months◊ |
| History of thrombocytopenia or thrombocytopenic purpura |
| Need for tuberculosis testing§ |
| Moderate or severe illness with or without fever (ie, illness more severe than upper respiratory infection, otitis media, gastroenteritis) |
| For MMRV only: Personal history of seizures or seizures in sibling or parent |
| For MMRV only: Concurrent use of an antiviral agent with activity against herpes viruses (eg, acyclovir, valacyclovir)¥ |
| MMR or MMRV may be given to patients with the following conditions that are incorrectly perceived as contraindications or precautions to MMR or MMRV |
| Egg allergy |
| HIV infection without severe immune compromise¶ is not a contraindication to MMR; MMRV is not recommended for children with HIV infection because it has not been studied in this population |
| Positive TST |
| Simultaneous tuberculosis testing (either TST or IGRA)§ |
| Breastfeeding |
| Pregnant contact |
| Child-bearing age, but not trying to become pregnant |
| Immune-deficient family member or household contact |
| MMR or MMRV may be given to patients with the following conditions that are incorrectly perceived as contraindications or precautions to immunization |
| Mild acute illness with or without fever (eg, upper respiratory infection, otitis media, gastroenteritis) |
| Mild-to-moderate local reaction (eg, swelling, redness, soreness) after previous dose |
| Low-grade or moderate fever after previous dose |
| Current antimicrobial therapy |
| Convalescent phase of illness |
| Preterm birth (except for hepatitis B vaccine in infants who weigh <2000 g and whose mother is hepatitis B surface antigen negative at the time of birth) |
| Recent exposure to infectious disease |
| History of penicillin allergy, other nonvaccine allergies, relatives with allergies, or receiving allergen extract immunotherapy |
MMR: measles, mumps, rubella combination vaccine; MMRV: measles, mumps, rubella, varicella combination vaccine; TST: tuberculin skin test; IGRA: interferon gamma release assay.
* MMR and varicella vaccines can be administered on the same day. If not administered on the same day, they should be separated by ≥28 days.
¶ Refer to UpToDate topic on measles, mumps, and rubella vaccines for definition of severe immunosuppression in HIV infection.
Δ Precautions should be reviewed with respect to potential benefits and risks. If the benefit of vaccination is believed to outweigh the risk, the vaccine should be administered; if the risk from the vaccine is believed to outweigh the benefit, the vaccine should not be administered.
◊ The specific interval depends upon the product. Refer to UpToDate topic on measles, mumps, and rubella vaccines for children for details.
§ Measles vaccination may suppress temporarily tuberculin reactivity. Measles-containing vaccine can be administered on the same day or 4 to 6 weeks after TST. The effect of live virus vaccination on IGRA is uncertain. Pending additional information, the Advisory Committee on Immunization Practices suggests that IGRA testing be performed on the same day or 4 to 6 weeks after administration of MMR.
¥ Antiviral drugs active against herpes viruses (eg, acyclovir, valacyclovir) may interfere with varicella-containing vaccines and should be discontinued ≥24 hours before administration of varicella vaccines and avoided for 14 days after vaccination.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
