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Information on Measles, Mumps, Rubella & Varicella (MMRV) Vaccine / Measles, Mumps & Rubella (MMR) Vaccine

Information on Measles, Mumps, Rubella & Varicella (MMRV) Vaccine / Measles, Mumps & Rubella (MMR) Vaccine
2019-12-23

Measles, Mumps, Rubella and Chickenpox (Varicella) can all be effectively prevented by immunisation.


(I) Who should get MMRV/MMR vaccine?

Varicella vaccine has been incorporated into the Hong Kong Childhood Immunisation Programme and is applicable to children born on or after 1 Jan 2013.  The Department of Health provides three doses of vaccines to these children.  Details are as follows:

  1. MMR vaccine and varicella vaccine are given to all children at one year of age in Maternal and Child Health Centres.
  2. MMRV vaccine is given to all students at schools by the Department of Health.  A mop-up campaign is arranged for primary school students who have not completed the vaccination. 

For those born before 1 Jan 2013, the Department of Health provides two doses of MMR vaccine to children instead.

(II) Children with the following conditions should not receive MMRV/MMR vaccine

  1. Leukaemia, lymphoma or other forms of malignancies.
  2. Active untreated tuberculosis.
  3. Under treatment that will weaken immunity, such as steroids, irradiation or cytotoxic drugs.
  4. Immunodeficiency states, such as AIDS or hypogammaglobulinemia.
  5. Severe allergic reaction to neomycin, gelatin, sorbitol or any contents of this vaccine.
  6. Severe allergic reaction to MMR, varicella vaccine or any content of these vaccine.
  7. History of injection of immunoglobulin or blood transfusion within the past one year.
  8. History of injection of live vaccine within the past four weeks, including BCG vaccine, oral polio vaccine, live attenuated influenza vaccine (nasal spray).
  9. Pregnancy.

Apart from the above, students with history of injection of varicella vaccine within the past 3 months should not receive MMRV.

(III) Points to note before MMR/MMRV immunisation

  1. Student with a mild cold or cough on the day of vaccination can receive the vaccine. However, vaccination should be postponed until recovery if the student has a fever.
  2. Student with mild reaction (e.g. localised rash) after egg ingestion can be vaccinated in the usual manner.  Student with severe reaction after egg ingestion (e.g. difficulty in breathing or coma) should consult doctor before receiving this vaccination.
  3. Student with a history of cerebral injury, or with individual or family history of convulsions, should also consult doctor before receiving this vaccination. 
  4. Female recipients of MMR/MMRV vaccine should not get pregnant within three months after vaccination.  The Maternal and Child Health Centres of the Department of Health can provide contraceptive service if required.
Additional points to note before MMRV immunisation
  1. Students can receive MMRV according to the Hong Kong Childhood Immunisation Programme regardless of their history of varicella infection.  Prior history of varicella infection is not contraindication to MMRV or varicella vaccine.  Moreover, varicella disease at less than 12 months of age has been associated with an increased risk of a second episode of varicella.  If students have history of clinician diagnosed chickenpox or herpes zoster (shingles) and their parents do not wish these students to receive MMRV, parents should clearly document this medical history in the Immunisation Record (DH6).
  2. Eligible students aged 13 or above should receive MMR and Varicella Vaccine instead of MMRV.
  3. Students should avoid use of salicylates (such as aspirin) for 6 weeks after vaccination.
  4. Rarely, the varicella virus in the vaccine may transmit from vaccine recipients who develop a varicella-like rash to susceptible high-risk individuals (such as immunocompromised, pregnant women without immunity to chickenpox, newborn infants of mothers without immunity to chickenpox, all newborn infants born at less than 28 weeks gestation). However, it is not a contraindication for a child to receive varicella vaccine just because there is high risk individual in the same household. A pregnant mother or other household pregnant member is also not a contraindication for immunisation of a child in the household. No precautions are needed following immunisation of a child who does not develop a rash. However, if the child develops a rash post-vaccination, high risk individuals should avoid close contact with the child until the rash has resolved.

(IV) Possible reactions after immunisation

Some students may have the following adverse reactions after MMRV immunisation:

  1. Mild and short lasting conditions:
    • Injection site reactions including pain, redness, swelling or bruising. Parents may apply cold compress to relieve the symptoms.
    • Fever. Parents can provide the student with anti-fever medication to relieve the symptoms if indicated.
    • Irritability, vomiting and diarrhea
    • Upper respiratory infection.
    • Rash on face or body or at injection site, up to a month after vaccination.
    • Transient joint pain.
  1. Uncommon conditions:
    • Increased risk of febrile seizures has been reported in children under 2 years old receiving MMRV. However, there is no evidence on association between febrile seizure and MMRV vaccine among children aged 4-6 years old.
    • Herpes zoster (shingles) following varicella vaccination has been reported. The majorities of cases have been mild and without sequaelae. Current data suggests children vaccinated may have a lower risk of herpes zoster compared to those with natural varicella infection.
  1. Severe but extremely rare conditions:
    • Severe allergic reactions.
    • Infections of the brain or its coverings after receiving MMR-containing vaccine have been reported.  However these conditions are very rare and usually do not have long lasting ill effects on the students after recovery.

Some students may have the following adverse reactions within 2 weeks after MMR immunisation:

  1. Mild conditions:
    • Fever may last for 1-2 days. Parents can provide the student with anti-fever medication to relieve the symptoms if indicated.
    • Rash on face or body may last for 2 days.
    • Transient swelling of salivary glands or lymph nodes.
    • Transient joint pain.
  1. Severe but extremely rare conditions:
    • Severe allergic reactions.
    • Infections of the brain or its coverings after receiving MMR vaccine have been reported.  However these conditions are very rare and usually do not have long lasting ill effects on the students after recovery.