{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:48:18Z","timestamp":1793296098620,"version":"4.5.0"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>In February 2008, we alerted the Advisory Committee on Immunization Practices to preliminary evidence of a twofold increased risk of febrile seizures after the combination measles-mumps-rubella-varicella (MMRV) vaccine when compared with separate measles-mumps-rubella (MMR) and varicella vaccines. Now with data on twice as many vaccine recipients, our goal was to reexamine seizure risk after MMRV vaccine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Using 2000\u20132008 Vaccine Safety Datalink data, we assessed seizures and fever visits among children aged 12 to 23 months after MMRV and separate MMR + varicella vaccines. We compared seizure risk after MMRV vaccine to that after MMR + varicella vaccines by using Poisson regression as well as with supplementary regressions that incorporated chart-review results and self-controlled analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>MMRV vaccine recipients (83 107) were compared with recipients of MMR + varicella vaccines (376 354). Seizure and fever significantly clustered 7 to 10 days after vaccination with all measles-containing vaccines but not after varicella vaccination alone. Seizure risk during days 7 to 10 was higher after MMRV than after MMR + varicella vaccination (relative risk: 1.98 [95% confidence interval: 1.43\u20132.73]). Supplementary analyses yielded similar results. The excess risk for febrile seizures 7 to 10 days after MMRV compared with separate MMR + varicella vaccination was 4.3 per 10 000 doses (95% confidence interval: 2.6\u20135.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Among 12- to 23-month-olds who received their first dose of measles-containing vaccine, fever and seizure were elevated 7 to 10 days after vaccination. Vaccination with MMRV results in 1 additional febrile seizure for every 2300 doses given instead of separate MMR + varicella vaccines. Providers who recommend MMRV should communicate to parents that it increases the risk of fever and seizure over that already associated with measles-containing vaccines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2010-0665","type":"journal-article","created":{"date-parts":[[2010,6,29]],"date-time":"2010-06-29T22:03:18Z","timestamp":1277848998000},"page":"e1-e8","source":"Crossref","is-referenced-by-count":270,"title":["Measles-Mumps-Rubella-Varicella Combination Vaccine and the Risk of Febrile Seizures"],"prefix":"10.1542","volume":"126","author":[{"given":"Nicola P.","family":"Klein","sequence":"first","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Fireman","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Katherine","family":"Yih","sequence":"additional","affiliation":[{"name":"Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Lewis","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kulldorff","sequence":"additional","affiliation":[{"name":"Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Ray","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Baxter","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vaccine Study Center, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Hambidge","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Nordin","sequence":"additional","affiliation":[{"name":"HealthPartners Research Foundation, Minneapolis, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Naleway","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northwest, Portland, Oregon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward A.","family":"Belongia","sequence":"additional","affiliation":[{"name":"Marshfield Clinic Research Foundation, Marshfield, Wisconsin; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Lieu","sequence":"additional","affiliation":[{"name":"Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Baggs","sequence":"additional","affiliation":[{"name":"Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Weintraub","sequence":"additional","affiliation":[{"name":"Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Vaccine Safety Datalink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,7,1]]},"reference":[{"issue":"5","key":"2021120820011212500_B1","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1542\/peds.88.5.881","article-title":"Risk of seizures after measles-mumps-rubella immunization","volume":"88","author":"Griffin","year":"1991","journal-title":"Pediatrics"},{"issue":"8949","key":"2021120820011212500_B2","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/S0140-6736(95)90471-9","article-title":"A new method for active surveillance of adverse events from diphtheria\/tetanus\/pertussis and measles\/mumps\/rubella vaccines","volume":"345","author":"Farrington","year":"1995","journal-title":"Lancet"},{"issue":"9","key":"2021120820011212500_B3","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1056\/NEJMoa003077","article-title":"The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine","volume":"345","author":"Barlow","year":"2001","journal-title":"N Engl J Med"},{"issue":"3","key":"2021120820011212500_B4","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1001\/jama.292.3.351","article-title":"MMR vaccination and febrile seizures: evaluation of susceptible subgroups and long-term prognosis","volume":"292","author":"Vestergaard","year":"2004","journal-title":"JAMA"},{"issue":"8","key":"2021120820011212500_B5","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/01.inf.0000172902.25009.a1","article-title":"Evaluation of a quadrivalent measles, mumps, rubella and varicella vaccine in healthy children","volume":"24","author":"Shinefield","year":"2005","journal-title":"Pediatr Infect Dis J"},{"issue":"7","key":"2021120820011212500_B6","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/01.inf.0000220209.35074.0b","article-title":"The safety and immunogenicity of a quadrivalent measles, mumps, rubella and varicella vaccine in healthy children: a study of manufacturing consistency and persistence of antibody","volume":"25","author":"Lieberman","year":"2006","journal-title":"Pediatr Infect Dis J"},{"issue":"4","key":"2021120820011212500_B7","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/01.inf.0000207857.10947.1f","article-title":"Safety and immunogenicity of a measles, mumps, rubella and varicella vaccine given with combined Haemophilus influenzae type b conjugate\/hepatitis B vaccines and combined diphtheria-tetanus-acellular pertussis vaccines","volume":"25","author":"Shinefield","year":"2006","journal-title":"Pediatr Infect Dis J"},{"key":"2021120820011212500_B8","doi-asserted-by":"crossref","first-page":"S89","DOI":"10.1097\/MLR.0b013e3180616c0a","article-title":"Real-time vaccine safety surveillance for the early detection of adverse events","volume":"45","author":"Lieu","year":"2007","journal-title":"Med Care"},{"issue":"32","key":"2021120820011212500_B9","doi-asserted-by":"crossref","first-page":"4257","DOI":"10.1016\/j.vaccine.2009.05.036","article-title":"An assessment of the safety of adolescent and adult tetanus-diphtheria-acellular pertussis (Tdap) vaccine, using active surveillance for adverse events in the Vaccine Safety Datalink","volume":"27","author":"Yih","year":"2009","journal-title":"Vaccine"},{"issue":"1","key":"2021120820011212500_B10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/INF.0b013e3181af8605","article-title":"Real-time surveillance to assess risk of intussusception and other adverse events after pentavalent, bovine-derived rotavirus vaccine","volume":"29","author":"Belongia","year":"2010","journal-title":"Pediatr Infect Dis J"},{"key":"2021120820011212500_B11","unstructured":"Kulldorff\u2008M, Davis\u2008RL, Kolczak\u2008M, Lewis\u2008E, Lieu\u2008T, Platt\u2008R. 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