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Image source: CDC PHIL

Measles vaccine is a weakened (attenuated) form of the live measles virus. There are three vaccines currently available for use in the U.S. Two vaccines, Merck's MMRII and GlaxoSmithKline’s PRIORIX, contains Measles, Mumps and Rubella Vaccine, Live.    Merck's ProQuad (MMRV) contains Measles, Mumps, Rubella and Varicella, Live. 

Merck’s MMRII is licensed and recommended for individuals aged 12 months or older. It is a live attenuated virus vaccine propagated in chick embryo cells and cultured with Jeryl Lynn live attenuated virus mumps and Meruvax II, a live attenuated rubella virus vaccine propagated in WI-38 human diploid lung fibroblasts.  The WI-38 human diploid cell line was derived from the lung tissue of a three-month human female embryo.  The growth medium used was salt solution and 10 percent calf (bovine) serum. 

Merck's ProQuad is licensed and recommended for individuals aged 12 months to 12 years of age. ProQuad (MMR-V -Measles, Mumps, Rubella and Varicella Virus Vaccine Live) is a combined, attenuated, live virus vaccine containing measles, mumps, rubella, and varicella viruses. ProQuad is a sterile lyophilized preparation of the components of M-M-R II (Measles, Mumps, and Rubella Virus Vaccine Live): Measles Virus Vaccine Live, and Varicella Virus Vaccine Live (Oka/Merck), the Oka/Merck strain of varicella-zoster virus propagated in MRC-5 cells. MRC-5 cells are derived from a cell line developed in 1966 from lung tissue of a 14-week aborted fetus and contains viral antigens. 

The growth medium for measles and mumps in both MMRII  and ProQuad  is a buffered salt solution containing vitamins and amino acids and it is supplemented with fetal bovine serum containing sucrose, phosphate, glutamate, recombinant human albumin, and neomycin. The growth medium for rubella is a buffered salt solution containing vitamins and amino acids and supplemented with fetal bovine serum containing recombinant human albumin and neomycin. Sorbitol and hydrolyzed gelatin stabilizer are added to the individual virus harvests. In the ProQuad vaccine,  the Oka/Merck strain of the live attenuated varicella virus, initially obtained from a child with wild-type varicella, introduced into human embryonic lung cell cultures, adapted to and propagated in embryonic guinea pig cell cultures and human diploid cell cultures (WI-38), is then added to the MMRII component.

According to Merck, both MMRII and ProQuad vaccines are screened for adventitious agents. Each dose of MMRII contains sorbitol, sodium phosphate, sucrose, sodium chloride, hydrolyzed gelatin, recombinant human albumin, fetal bovine serum, other buffer and media ingredients and neomycin.  Each dose of ProQuad contains sucrose, hydrolyzed gelatin, sorbitol, MSG, sodium phosphate, human albumin, sodium bicarbonate, potassium phosphate and chloride, neomycin, bovine calf serum, chick embryo cell culture, WI-38 human diploid lung fibroblasts and MRC-5 cells.   

The MMRII vaccine product information insert states that the MMRII vaccine should be given one month before or one month after any other live viral vaccines.  The ProQuad vaccine product information insert states that one month should lapse between administration of ProQuad and another measles containing vaccine such as MMRII and at least three months should lapse between ProQuad and any varicella containing vaccine. 

GlaxoSmithKline’s PRIORIX is licensed and recommended for individuals aged 12 months or older. PRIORIX is made up of the Schwarz strain of live attenuated measles virus and the RIT 4385 strain of live attenuated mumps virus, derived from the Jeryl Lynn mumps strain, both propagated in chick-embryo fibroblasts. It also contains the Wistar RA 27/3 strain of live attenuated rubella virus propagated in MRC-5 human diploid cells. 

These three virus strains are cultured in media containing amino acids, neomycin sulfate and bovine serum albumin. Multiple washings are done to remove the antibiotic and albumin from the media. The attenuated measles, mumps and rubella viruses are then mixed with a stabilizer before lyophilization. After reconstitution, the vaccine is a clear peach- to fuchsia pink-colored suspension. In addition to the measles, mumps, and rubella viruses, each 0.5ml dose also contains amino acids, mannitol, anhydrous lactose, and sorbitol. Each dose may also contain residual amounts of ovalbumin, bovine serum albumin and neomycin sulphate.

The tip caps of the prefilled syringes of diluent for PRIORIX contain natural rubber latex. 

The CDC currently recommends that children receive two doses of a measles containing vaccine, with the first dose administered between 12-15 months, and the second dose between 4-6 years.  The CDC also recommends that individuals born after 1957 and have no laboratory evidence of immunity or documentation of vaccination should receive at least one dose of MMR vaccine.  Two doses of MMR vaccine are also recommended for healthcare personnel, students entering college and other post-high school educational institutions, and international travelers. 

MMR vaccination is recommended by the CDC for infants between 6 and 11 months of age who may be traveling internationally;  however, ProQuad  MMRII  and PRIORIX  are only FDA approved for use in children 12 months and older. Both the MMRII  and PRIORIX  vaccine package insert states that the effectiveness and safety of the vaccines have not been established in children under 12 months. The MMRII package insert states that if administered to children 6 through 11 months, antibodies may not develop.  According to the CDC, an infant vaccinated prior to 12 months of age will still require two additional doses of MMR vaccine. 

IMPORTANT NOTE: NVIC encourages you to become fully informed about measles and the measles vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.



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