MMR and Varicella Vaccines Administration

Administration Options

The Centers for Disease Control and Prevention (CDC) recommends that MMR vaccine and varicella vaccine can be safely administered together at the same visit as separate injections 1, 2
Simultaneous administration of MMR vaccine and varicella vaccine produces seroconversion rates and adverse reaction rates similar to those observed when the vaccines are administered separately 2
Administering vaccines simultaneously increases the probability that a child will be fully immunized at the appropriate age 2
For children aged 12-47 months receiving their first dose, either MMR vaccine plus varicella vaccine or the combination MMRV vaccine may be used 1, 3
For the second dose at any age (15 months-12 years) or for the first dose at age ≥48 months, MMRV vaccine is generally preferred over separate injections 3, 4

For children receiving their first dose at 12-47 months of age, CDC recommends MMR vaccine and varicella vaccine as separate injections unless the parent or caregiver specifically requests MMRV 1, 5
This recommendation is based on evidence that MMRV is associated with a higher risk of fever and febrile seizures 5-12 days after the first dose in children 12-23 months (approximately one extra febrile seizure per 2,300-2,600 MMRV vaccine doses) 6, 5
For the second dose at any age or first dose at ≥48 months, MMRV vaccine is generally preferred over separate injections 3, 4

If not administered simultaneously, live vaccines (such as MMR and varicella) should be given at least 28 days apart 3, 7
Both vaccines can be administered at the routinely recommended ages: 12-15 months for the first dose and 4-6 years for the second dose 1, 8
A personal or family history (sibling or parent) of seizures of any etiology is a precaution for MMRV vaccination 9, 10
Children with such history should generally receive separate MMR and varicella vaccines rather than MMRV 9, 8

Studies have shown that response to MMR and varicella vaccines administered on the same day is identical to vaccines administered a month apart 2

Simultaneous administration of MMR and varicella vaccines is an effective strategy to ensure complete immunization 2