ProQuad
ProQuad (MMRV vaccine) is a combination live-attenuated vaccine. It offers protection against measles, mumps, rubella, and varicella (MMRV) in children age 1 through 12 years old. ProQuad (MMRV vaccine) is given as an injection under the skin or into the muscle. The dosing schedule is made up of 2 injections at specific ages. Common side effects include pain, tenderness, and soreness at the injection site and fever.
What is ProQuad (MMRV vaccine)?
What is ProQuad (MMRV vaccine) used for?
Prevention of measles, mumps, rubella, and varicella (MMRV) in children age 1 to 12 years old
How ProQuad (MMRV vaccine) works
ProQuad (MMRV vaccine) is a live-attenuated vaccine. It's made from weakened versions of the measles, mumps, rubella, and varicella (MMRV) viruses. The vaccine helps your body's immune system make antibodies against the viruses. These antibodies attack the viruses if they get into the body to help protect against severe illness.
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What are the side effects of ProQuad (MMRV vaccine)?
Common Side Effects
- Pain, tenderness, or soreness at the injection site (up to 21%)
- Fever (up to 20%)
- Redness at the injection site (up to 12%)
- Swelling at the injection site (up to 9%)
Other Side Effects
- Bruising at the injection site
- Feeling irritable
- Rash
- Diarrhea
- Upper respiratory infection
Serious Side Effects
- Serious allergic reaction: hives, rash, shaking, itching, nausea, flushing, dizziness, shortness of breath, chest pain
- Febrile seizure (fever with seizures): eye rolling, stiff arms and legs, passing out, shaking of arms and legs
Source: DailyMed
More on ProQuad (MMRV vaccine) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Feeling faint or lightheaded
- Seizures
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Fever
- General discomfort and fatigue
- Headache
- Irritability
- Muscle pain
- Pain, redness, or irritation at injection site
- Skin rash
Pros and cons of ProQuad (MMRV vaccine)
Pros
Combination vaccine that protects against 4 viruses
Full vaccination requires just 2 injections
Protection lasts for life for most people
Cons
Must be given by a healthcare professional as an injection under the skin or into the muscle
Not recommended by CDC as the vaccine of choice for the first dose of the series to protect against MMRV in children age 1 to under 4 years
Might not be a safe choice for people with an allergy to eggs
Pharmacist tips for ProQuad (MMRV vaccine)
Read the vaccine information statement for more information on ProQuad (MMRV vaccine). Keep in mind that ProQuad (MMRV vaccine) might not guarantee 100% protection from measles, mumps, rubella, and varicella infection, but it helps prevent severe illness. Ask a healthcare professional (HCP) if you have any questions.
Side effects like pain, tenderness, and soreness at the injection site are common within a few hours after your child gets vaccinated with ProQuad (MMRV vaccine). Try using warm compresses or ice packs or moving the limb around to help with these side effects. They typically go away in 1 to 2 days. But contact an HCP if the side effects last longer or if they're severe.
Don't give your child aspirin to help with fever or pain for at least 6 weeks after they get vaccinated with ProQuad (MMRV vaccine). It's best not to give them aspirin even after this time, unless recommended by an HCP. Aspirin raises the risk for Reye's syndrome in children under 18 years of age.
You should reschedule your child's vaccination with ProQuad (MMRV vaccine) if your child is sick with a fever that's higher than 101.3 degrees Fahrenheit. Wait until they recover so that their immune system can work its best to provide protection against MMRV. Ask your child's HCP if it's okay to get the vaccine if your child is mildly sick, such as with a cold or low-grade fever.
Make sure to keep a record of all your child's immunizations and show it to their HCP before they receive any vaccine, including ProQuad (MMRV vaccine). The HCP can make sure your child is getting all their vaccinations on schedule.
It's okay for your child to get ProQuad (MMRV vaccine) at the same time as most other vaccines. But your child shouldn't get ProQuad (MMRV vaccine) within 1 month of the MMR vaccine or within 3 months of Varivax (varicella vaccine).
You can report any severe reactions to ProQuad (MMRV vaccine) to the vaccine adverse event reporting system (VAERS) by visiting their website or by calling 1-800-822-7967.
Frequently asked questions about ProQuad (MMRV vaccine)
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What are the risks and warnings for ProQuad (MMRV vaccine)?
ProQuad (MMRV vaccine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of severe allergic reaction if allergic to eggs
Risk factors: Severe allergy to eggs or egg products
Let the healthcare professional (HCP) know if your child has a severe allergy to eggs. ProQuad (MMRV vaccine) contains egg protein. People with a severe allergy to eggs or egg products might be at higher risk of an allergic reaction to this vaccine. The HCP will weigh the risks and benefits for your child to get ProQuad (MMRV vaccine).
Call 911 right away if you notice symptoms of a severe allergic reaction, like feeling faint, swelling of the face, closing of the throat, difficulty breathing, hives or rash, dizziness, shaking, nausea, or chest pain.
Risk of fever and febrile seizure
Risk factors: Personal or family history of febrile seizure | Children age 1 to 2 years old who haven't been vaccinated against MMRV or who haven't had these infections
Although rare, children age 1 to 2 years old might be at risk for fever with or without seizures (febrile seizures) within the first 2 weeks after they've gotten the first dose of ProQuad (MMRV vaccine). Let your child's pediatrician, primary care provider, or HCP know if your child has ever had a febrile seizure before they get vaccinated with ProQuad (MMRV vaccine). If so, the HCP might recommend that your child get the MMR vaccine and Varivax (varicella vaccine) as separate vaccines to lower the risk of fever with or without seizures.
Avoid use in people with a weakened immune system
Risk factors: Weakened immune system from medical conditions or medications
Let the HCP know if your child has a weakened immune system, like from a genetic condition or from human immunodeficiency virus (HIV). In general, the CDC's immunization guidelines don't recommend ProQuad (MMRV vaccine) for these immunocompromised people. People with a weakened immune system might get seriously sick from the weakened viruses in the vaccine. Talk with your child's pediatrician or primary care provider if you're not sure whether your child can get vaccinated with ProQuad (MMRV vaccine).
Rare risk of spreading varicella (chickenpox) virus to others
Although rare, it's possible for your child to spread MMRV (particularly varicella, the chickenpox virus) to other people after they get vaccinated with ProQuad (MMRV vaccine). This typically isn't a concerning problem for most people. But some people, like pregnant people who've never had chickenpox, premature newborns, and people with a weak immune system, might be at higher risk for infection. If this happens, though, most cases are mild without any complications.
To be safe, children who get ProQuad (MMRV vaccine) should try to avoid close contact with high-risk people for up to 6 weeks after vaccination. Talk with your child's healthcare team about your options if avoiding close contact with high-risk people isn't possible.
Low platelet count
Risk factors: History of having a low platelet count | Previously had a drop in platelet levels after receiving a dose of a measles, mumps, and rubella-containing vaccine
Some people have had low platelet counts within 4 to 6 weeks after they've gotten a measles, mumps, and rubella vaccine. Typically, this drop in platelet count is temporary.
For most people, the brief drop in platelet count won't cause problems. But let the HCP if your child has a medical condition that causes them to have a low platelet count. The healthcare professional can weigh the risks and benefits of using ProQuad (MMRV vaccine) for your child's vaccination.
Call your child's pediatrician or primary care provider if you notice that your child has bleeding that's difficult to stop, bruises that don't go away, dizziness, or confusion. These can be symptoms of a low platelet count.
Specific spacing needed between immune globulin therapy or blood transfusions and ProQuad (MMRV vaccine)
Let the HCP know whether your child has gotten a blood transfusion or received other blood products like immune globulins recently. These products can affect your child's immune response to ProQuad (MMRV vaccine). The HCP will follow specific guidelines on when it's safe for your child to get ProQuad (MMRV vaccine) before or after immune globulin therapy or a blood transfusion.
ProQuad (MMRV vaccine) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 0.5ml | 1 dose | $282.55 | $282.55 |
Typical dosing for ProQuad (MMRV vaccine)
Each dose of the vaccine is 1 injection (0.5 mL) given under the skin or into the muscle. It's given by a trained healthcare professional (HCP).
Dose 1: The first dose is typically given between 12 and 15 months of age.
Dose 2: The second dose is typically given between 4 and 6 years of age.
How much does ProQuad (MMRV vaccine) cost?
ProQuad (MMRV vaccine) contraindications
History of allergy to previous dose of ProQuad; MMR II; Varivax; or any other vaccine against measles, mumps, rubella, or varicella
History of allergy to gelatin
History of anaphylaxis to neomycin
Have a weakened immune system due to medical conditions or medications
Sick with a fever greater than 101.3 degrees Fahrenheit
Active untreated tuberculosis (TB)
Currently pregnant or planning to become pregnant in the next 3 months
What are alternatives to ProQuad (MMRV vaccine)?
Prevention of measles, mumps, rubella, and varicella (MMRV) in children age 1 to 12 years old
Prevention of measles, mumps, and rubella (MMR) in adults and children 1 year of age and older
Prevention of chickenpox (varicella)
What is the latest news about ProQuad (MMRV vaccine)?
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References
Best studies we foundCenters for Disease Control and Prevention. (n.d.). Chickenpox (varicella).
Centers for Disease Control and Prevention. (2021). MMR & varicella vaccines or MMRV vaccine: Discussing options with parents.
Centers for Disease Control and Prevention. (2021). Q&As about vaccination options for preventing measles, mumps, rubella, and varicella.
Centers for Disease Control and Prevention. (2024). Measles, mumps, rubella, varicella (MMRV) vaccine safety.
Centers for Disease Control and Prevention. (2024). Recommended adult immunization schedule for ages 19 years or older.
Centers for Disease Control and Prevention. (2024). Recommended child and adolescent immunization schedule for ages 18 years or younger.
Centers for Disease Control and Prevention. (2024). Timing and spacing of immunobiologics.
Centers for Disease Control and Prevention. (2024). Vaccines when your child is sick.
Centers for Disease Control and Prevention. (2024). Varicella vaccination for specific groups.
Centers for Disease Control and Prevention. (2024). Varicella vaccine recommendations.
Centers for Disease Control and Prevention. (2025). MMRV vaccine VIS.
Immunize.org. (2023). Varicella (chickenpox): Questions and answers.
MedlinePlus. (2023). Platelet count.
Merck Sharp & Dohme LLC. (2024). Proquad- measles, mumps, rubella and varicella virus vaccine live injection, powder, lyophilized, for suspension [package insert]. DailyMed.
U.S. Department of Health and Human Services. (2022). Vaccine types.
U.S. Food and Drug Administration. (2024). Common ingredients in FDA-approved vaccines.
World Health Organization. (2020). How do vaccines work?
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