Proquad Vaccine: MMRV (MMR+Chickenpox) live Quadrivalent Vaccine

Proquad Vaccine: MMRV (MMR+CHICKENPOX) live Quadrivalent Vaccine

Proquad vaccine is a brand of MMR Vaccine combination with varicella (Chickenpox vaccine) by Merck Vaccins. Proquad vaccine is a sterile lyophilised mixed preparation containing the attenuated strain of measles, mumps and rubella virus and also live attenuated chichkenpox (Varicella virus)

How is Proquad vaccine available?

Proquad vaccine is available as lyophilized powder is available in a separate vial. Other vial contains sterile water to be mixed with lyophilized powder. The vaccine is in opaque paper packet. It should be stored in the packaging it comes with.

How is Proquad vaccine stored?

The vial containing lyophilized powder should be stored in frozen and the sterile water for dilution is stored at 2-8 degree Celsius. The manufacturer’s guidelines about storage should be followed at all stages of transport and storage.

How is Proquad vaccine prepared?

Proquad vaccine sterile water for injection is mixed with lyophilized powder. The needle should be attached to the syringe of sterile water. The water is pushed into the vial of lyophilized powder. The mixture is agitated gently to mix the content. The care should be taken while doing the procedure that sterilizers and disinfectant should not touch the vial. The care should be taken to avoid the needle prick while mixing the contents. The mixture is sucked buck into the syringe.

How the Proquad vaccine can be given?

Proquad vaccine can be given either by subcutaneous route. All the safety injection precautions need to be taken while giving injection. The disinfectant applied to skin should be evaporated completely before giving the injection. The disposables after use of injection should be discarded as per biomedical waste management protocols. The vaccine if expired should be discarded and not used. The expired vaccines need to be discarded as per biomedical waste management protocols.

At what age Proquad vaccine is given?

Proquad vaccine is given at age 15 months followed by at 5 years of age in routine immunization schedule.

What if someone has missed Proquad vaccine dose?

If unvaccinated person above 9 months comes to OPD, Proquad vaccine is the priority vaccine to be given. The missed dose should be given as early as possible. The opinion of pediatrician is to be taken before vaccination. In adults the side effects are comparatively more like fever and bilateral parotid swelling.

How does Proquad vaccine works?

Proquad vaccine contains live attenuated viruses of measles, mumps and rubella, varicella. Live attenuated means these are live virus but they lack capacity to cause disease though they have capacity to infect. When these viruses are injected by vaccine they infect the person who got the injection. They multiply in the body of the host. The immunity of the host recognizes these viruses. The immunity develops mechanism to fight these viruses. In this process the body also develops the memory immunity. When the real infection of these diseases occur the body rapidly increases the immune response and the disease is prevented. This is active form of immunization.

What are the side effects of the Proquad vaccine?

Side effects of Proquad vaccine are usually milder when compared to the diseases it cause. Common side effects are:

· Fever may come and usually lasts for 1-3 days and it can be easily controlled by oral medications like paracetamol at home.

· Skin rash which looks like measles disease can appear in few days after vaccination. This rash is usually milder and short lasting than measles disease.

· Pain, swelling and redness at injection site. This may come after injection and may last for 1-3 days. It usually subsides by its own or by simple measures like local cold fomentation.

· Symptoms of upper respiratory tract infection like cold and running nose.

· Nervousness and crying.

· Lymphadenopathy: Uncommon.

· Conjuctivitis, bronchitis, parotid gland swelling, diarrhea and vomiting are uncommon side effects. These are usually milder and are generally manageable on OPD basis at home.

· In adults the reactions like bilateral parotid swelling and fever reactions are common to children.

· Thrombocytopenia is rare side effects and if occurs it usually resolves by its own.

· There is an increased risk of fever and febrile convulsions 5 to 12 days after Proquad vaccine when used as the first measles-containing vaccination, as compared with 2 separate injections of MMR and varicella vaccines (see Adverse Effects). There was no indication of an increased risk when used as the second measles-containing vaccination.

· Like all other vaccine anaphylaxis reaction may come after this vaccination though it is very rare. The facility at which vaccination is given should be ready to manage the anaphylaxis with necessary equipments and skilled personnel.

What cautions are needed with Proquad vaccine?

· The facility to management anaphylaxis should be ready while giving this injection.

· The caution should be taken in those who are allergic egg proteins.

· The vaccine should not be given to those who are allergic to any of its components.

· This is live vaccine so cannot be used in pregnancy.

· The pregnancy should be avoided till after 3 months of giving this vaccine, though this vaccine is not valid indication for abortion.

· The caution should be taken in immmunocompromised patients. The vaccine is used in them if benefit outweighs the risks.

· In infants of HIV mothers this vaccine should be given as early as after 6 months of age.

· The vaccine is avoided in those with active TB disease or those in intensive phase of the TB-treatment.

· The vaccine should be given after one month to those who got measles as the natural disease does not given immunity.

· Biomedical waste management guidelines are to be followed like all other vaccinations.

· The vaccine is stored as per mentioned on packet by the manufacturer.

To whom Proquad vaccine is contraindicated?

· This vaccine is contraindicated in those with stage 3 or stage 4 HIV AIDS disease.

· this is contraindicated those who are severely immunocompromized.

· Those who are pregnant.

· Those who are allergic to any of its component.

· Those who got anaphylaxis at the time of this in past.

· Those who are allergic to egg protein.

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