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Vaccine Safety

by Sue Hubbard, M.D.

The MMR (measles, mumps and rubella) vaccine and Varivax (chickenpox) vaccine have both been licensed and recommended for many years. These vaccines are typically given to children between the ages of 12-15 months, and then again between 4-5 years.

In 2005, a new vaccine was released which combined MMR and Varivax  (MMRV) which reduced the number of needle sticks a child would receive from their routine immunizations.

Vaccine safety is always a paramount concern and even after a vaccine is FDA approved there continues to be “post licensing” monitoring of the vaccine, looking for any reported adverse events. After the release of MMRV in 2005, there were noted to be an increase in the number of febrile seizures occurring within 10 days of receiving the combination vaccine.  As a result, the use of this combination vaccine was suspended in 2008 and then resumed in early 2010.

A study released in the July issue of Pediatrics now looks at the vaccine safety data that was accumulated on MMRV post licensure,  and analyzed data on over 459,000 children who had been vaccinated between 2000 and 2008.

In the retrospective study, 83,000 children received MMRV and 376,000 with separate MMR and Varivax vaccines. The study found that children between the ages of 12–23 months have about double the risk of developing a febrile seizure 10 days after receiving MMRV than those children that received separate MMR and Varicella vaccines. MMRV vaccination was associated with an estimated 4.3 additional seizures per 10,000 doses during the 7–10 days post vaccine.

As discussed in previous blogs, febrile seizures are fairly common and are typically harmless to a child, but cause a lot of anxiety and fear for parents.  (my own son had a febrile seizure as a toddler).  The American Academy of Pediatrics endorses the use of single or combination vaccine for MMR and Varivax.

The fact that there may be a greater likelihood (albeit small) for a child to develop a febrile seizure post MMRV vaccination needs to be discussed with parents as there is not going to be a “right” answer as to vaccine preference. Some parents would prefer minimize needle sticks and would opt to receive MMRV, while others would prefer to have MMR and Varivax given separately to minimize any risk of  an adverse event.

Due to the fact that the increased seizure risk was seen in children between 12-23 months, one might advocate to use the separate vaccines for the initial series and the combination vaccine in the older child (who would probably vote to get one less STICK).

Protecting against measles, mumps, rubella and chickenpox is the most important issue at hand.  Discuss the pros and cons of the combination vaccine with your own doctor, but be reassured that vaccines are continually being monitored for safety as well as efficacy.

That’s your daily dose for today.  We’ll chat again tomorrow.

Send your question to Dr. Sue.

Related Posts on www.kidsdr.com

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