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Risk outcomes comparable after MMRV, MMR plus varicella vaccines
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SAN FRANCISCO —Young children who received the measles-mumps-rubella-varicella vaccine experienced similar outcomes compared with children who received a measles-mumps-rubella vaccine with separate varicella, according to study results presented at ID Week 2013.
“Among toddlers, measles-containing vaccines increase risk of seizure and fever during the 7 to 10 days after immunization,” study researcher Nicola P. Klein, MD, PhD, of the Kaiser Permanente Vaccine Study Center in Oakland, Calif., told Infectious Diseases in Children. “The aim of this study was to evaluate the risk of seven additional serious outcomes, as well as seizure and fever, following combination MMRV and separately administered MMR and varicella vaccines.”
Nicola P. Klein
The analysis included children aged 12 to 23 months who were enrolled in the Vaccine Safety Datalink from 2000 to 2012. Klein and colleagues assessed 123,200 doses of MMRV and 584,987 doses of separately administered MMR plus varicella.
The seven outcomes assessed for post-vaccine risk intervals were:
- Anaphylaxis (day 0);
- Immune thrombocytopenia purpura (ITP; days 14-28; 1-42);
- Ataxia (days 14-28; 1-42);
- Arthritis (days 1-42);
- Encephalitis/meningitis/encephalopathy (days 3-21; 1-42);
- Acute disseminated encephalomyelitis (days 3-21; 1-41); and
- Kawasaki disease (days 1-28; 1-56).
Overall, results indicated that the outcomes were not statistically different in terms of risk intervals.
Researchers observed no or few events of acute disseminated encephalomyelitis, arthritis, Kawasaki disease, encephalitis/meningitis and anaphylaxis.
There was an increased risk for ITP with the MMRV vaccine (OR=11.13; 95% CI, 1.9-68.2) and MMR plus varicella (OR=10; 95% CI, 4.5-22.5) when comparing the risk and control intervals.
After two cases, MMRV was associated with an increased risk for anaphylaxis (OR=15.3; 95% CI, 2.2-108.9).
However, there was a decreased risk for ataxia after MMRV (OR=0.8; 95% CI, 0.5-1) and MMR plus varicella (OR=0.8: 96% CI, 0.7-0.9).
“This study observed an increased risk for anaphylaxis after MMRV and a reduced risk for ataxia after MMRV and MMR plus varicella, both of which require further investigation,” Klein said. “Power was limited in this study for outcomes other than seizure and fever. In addition, ongoing monitoring for anaphylaxis and other outcomes after these vaccines is warranted.”
For more information:
Klein NP. Abstract #144. Presented at: ID Week 2013; Oct. 2-6, 2013; San Francisco.
Disclosure: One of the researchers reports research funding from and investigator roles with GlaxoSmithKline.