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Administering PCV7 and MMRV together appears safe
Leonardi M. Pediatrics. 2011;doi:10.1542/peds.2010-2132.
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Concomitant administration of the 7-valent pneumococcal conjugate vaccine and the measles-mumps-rubella-varicella vaccine appears to be safe for 1-year-old children, according to study results published online.
Michael Leonardi, MD, of Palmetto Pediatrics in North Charleston, S.C., and colleagues examined data on 1,027 children who were categorized into three groups: MMRV (ProQuad, Merck) and PCV7 (Prevnar, Wyeth) concomitantly (group 1); PCV7, then MMRV 6 weeks later (group 2); or MMRV, then PCV7 6 weeks later (group 3).
“For all three groups, the antibody response rate was ≥96.8% for measles, mumps, and rubella, ≥88% for varicella-zoster virus, and ≥98.3% for all of the seen Streptococcus pneumoniae serotypes,” Leonardi and colleagues wrote.
They said immune responses were also similar in all three groups. Adverse event rates were mostly comparable in the first group to the two other groups combined, but there were no serious adverse events.
“Concomitant administration of the MMRV and PCV7 is highly immunogenic and generally well tolerated,” the researchers concluded.
Disclosure: Several researchers disclosed financial ties to Merck and Co., which funded the study, and another researcher disclosed working for GlaxoSmithKline.
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This study adds to the large body of literature indicating that giving recommended vaccines at the same visit is safe and effective. Here, infants 12 through 15 months of age were randomized to receive either MMRV or PCV7 at the same visit; MMRV followed by PCV7 6 weeks later; or PCV7 followed by MMRV 6 weeks later. The antibody responses to each of the components in both vaccines and the adverse event profiles were the same in all three groups of subjects.
Numerous studies have shown that infants have the capacity to respond immunologically to multiple antigens given simultaneously. Administration of recommended vaccines at a single visit improves the likelihood that infants will be kept up-to-date with immunization recommendations and reduces the duration of time they remain susceptible to vaccine preventable diseases.
MMRV was licensed in the US in 2005. Two post-licensure studies indicated that children aged 12 through 23 months receiving MMRV had a slight increased risk for a febrile seizure 5 to 12 days after vaccination, compared with children who received MMR and varicella as separate vaccines at the same visit. The documented risk was one additional seizure per 2,300 to 2,600 vaccine recipients. The increased risk for seizures was not demonstrated after the second dose. The CDC’s Advisory Committee on Immunization Practices and the American Academy of Pediatrics adopted new recommendations for the use of MMRV based on this data.
The current recommendation is that either MMR vaccine and varicella vaccine or MMRV may be used for the first dose. A personal or family history of a seizure is now a precaution for use of MMRV vaccine. The risks and benefits of MMRV vs. administration of MMR and varicella vaccine should be discussed with parents if MMRV is considered for the first dose. MMRV is preferred for the second dose.
In 2010, PCV7 was replaced with PCV13. PCV13 has already been shown to be safe and to not interfere with antibody responses when administered along with DTaP, Hib, IPV, rotavirus, hepatitis B, MMR or varicella vaccines.
—Joseph A. Bocchini, MD
Infectious
Diseases in Children Editorial Board
Disclosure: Dr. Bocchini reports no relevant financial disclosures.
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