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Rubella vaccine is a weakened (attenuated) form of the live rubella virus. Currently, there are three available vaccines for use in the U.S. Merck's MMRII and GlaxoSmithKline’s ProQuad both contain measles, mumps and rubella vaccine, live. Merck's ProQuad (MMRV) contains measles, mumps, rubella and varicella vaccine, 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 mumps virus, 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 an aborted three-month human female embryo. The growth medium used was salt solution and ten percent calf (bovine) serum.
Merck's ProQuad is licensed and recommended for individuals aged 12 months to 12 years of age. ProQuad (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 that was developed in 1966 from lung tissue taken from a 14-week aborted fetus and contains viral antigens.
MMRII and ProQuad Rubella Vaccine Ingredients
The growth medium for measles and mumps for both MMRII and ProQuad is a buffered salt solution containing vitamins and amino acids and supplemented with fetal bovine serum containing sucrose, phosphate, glutamate, and 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 finally propagated in aborted human diploid cell cultures (WI-38) is 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 package insert states that the MMRII vaccine should be given one month before or one month after any other live viral vaccines. The ProQuad vaccine package 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.
Rubella Vaccine Administration Recommendations
Currently, the CDC recommends that children receive two doses of a rubella containing vaccine, with the first dose administered between the ages of 12-15 months, and the second dose administered between the ages of 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 recommended for healthcare personnel, students entering college and other post-high school educational institutions, and anyone traveling internationally.
The CDC also recommends MMR vaccination for infants between 6 and 12 months of age who may be traveling internationally; however, ProQuad, MMRII, and PRIORIX are only FDA approved for use in children older than 12 months of age. The MMRII vaccine package insert states that the effectiveness and safety of administration of MMRII has not been established in children between the ages of 6 and 12 months of age and if administered to this population, antibodies may not develop. According to the CDC, an infant vaccinated prior to 12 months of age would still require two additional doses of MMR vaccine.
IMPORTANT NOTE: NVIC encourages you to become fully informed about Rubella and the Rubella 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.