AAP Recommends Quadrivalent MMRV for Most Children

But separate MMR, varicella vaccines indicated for children with personal/family history of seizures

TUESDAY, Aug. 30 (HealthDay News) -- Use of measles-mumps-rubella-varicella vaccine (MMRV) is generally preferred over separate injections of measles-mumps-rubella (MMR) and varicella vaccines, unless there is a personal or family history of seizures, or difficulty communicating the risks involved to parents or caregivers, according to a policy statement by the American Academy of Pediatrics (AAP), published online Aug. 28 in Pediatrics.

Michael T. Brady, M.D., from the Committee on Infectious Diseases (AAP), and colleagues estimated the prevalence of febrile seizures after monovalent and quadrivalent varicella vaccination, and present updated recommendations for the use of these vaccines in children.

The investigators reported that at age 12 through 23 months, seven to nine and three to four febrile seizures occur per 10,000 children after MMRV and separate MMR and varicella vaccination, respectively. In this age group, MMRV results in one additional febrile seizure per approximately 2,300 to 2,600 children compared with those who undergo separate MMR and varicella vaccines. Children aged 4 to 6 years showed no increased risk of febrile seizures. The AAP recommends that either MMR and varicella or MMRV can be administered as first doses from age 12 months through 47 months. MMRV is generally preferred over MMR and varicella for first dose in children 48 months or older, and for the second dose at any age (15 months to 12 years). Health providers who face barriers in clearly communicating the benefits and risks of MMRV to parents and caregivers should administer MMR and varicella. Children with a personal or family history of seizures should generally be vaccinated with MMR and varicella.

"A personal or family (such as sibling or parent) history of seizures is now a precaution for MMRV vaccination," the authors write.

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