DOSAGE AND ADMINISTRATION
FOR SUBCUTANEOUS ADMINISTRATION
Do not inject intravenously
The dose for any age is 0.5 mL administered subcutaneously, preferably into
the outer aspect of the upper arm.
The recommended age for primary vaccination is 12 to 15 months.
Revaccination with M-M-R II is recommended prior to elementary school entry.
See also INDICATIONS AND USAGE, Recommended Vaccination Schedule.
Children first vaccinated when younger than 12 months of age should receive
another dose between 12 to 15 months of age followed by revaccination prior
to elementary school entry.35 See also INDICATIONS AND USAGE,
Measles Outbreak Schedule.
Immune Globulin (IG) is not to be given concurrently with ATTENUVAX (measles virus vaccine live) .
CAUTION: A sterile syringe free of preservatives, antiseptics, and detergents
should be used for each injection and/or reconstitution of the vaccine because
these substances may inactivate the live virus vaccine. A 25 gauge, 5/8“
needle is recommended.
To reconstitute, use only the diluent supplied, since it is free of preservatives
or other antiviral substances which might inactivate the vaccine.
Single Dose Vial - First withdraw the entire volume of diluent
into the syringe to be used for reconstitution. Inject all the diluent in the
syringe into the vial of lyophilized vaccine, and agitate to mix thoroughly.
If the lyophilized vaccine cannot be dissolved, discard. Withdraw the entire
contents into a syringe and inject the total volume of restored vaccine subcutaneously.
It is important to use a separate sterile syringe and needle for each individual
patient to prevent transmission of hepatitis B and other infectious agents from
one person to another.
Parenteral drug products should be inspected visually for particulate matter
and discoloration prior to administration whenever solution and container permit.
ATTENUVAX (measles virus vaccine live) , when reconstituted, is clear yellow.
Use With Other Vaccines
ATTENUVAX (measles virus vaccine live) should not be given less than one month before or after administration
of other live viral vaccines.
M-M-R II has been administered concurrently with VARIVAX* [Varicella Virus
Vaccine Live (Oka/Merck)], and PedvaxHIB* [Haemophilus b Conjugate Vaccine (Meningococcal
Protein Conjugate)] using separate sites and syringes. No impairment of immune
response to individually tested vaccine antigens was demonstrated. The type,
frequency, and severity of adverse experiences observed with M-M-R II were similar
to those seen when each vaccine was given alone.
Routine administration of DTP (diphtheria, tetanus, pertussis) and/or OPV (oral
poliovirus vaccine) concurrently with measles, mumps, and rubella vaccines is
not recommended because there are limited data relating to the simultaneous
administration of these antigens.
However, other schedules have been used. The ACIP has stated ”Although
data are limited concerning the simultaneous administration of the entire recommended
vaccine series (i.e., DTP, OPV, MMR, and Hib vaccines, with or without hepatitis
B vaccine), data from numerous studies have indicated no interference between
routinely recommended childhood vaccines (either live, attenuated, or killed).
These findings support the simultaneous use of all vaccines as recommended.“14
No. 4589X/4309 ATTENUVAX (measles virus vaccine live) is supplied as follows: (1) a box
of 10 single-dose vials of lyophilized vaccine (package A), NDC 0006-4589-00;
and (2) a box of 10 vials of diluent (package B). To conserve refrigerator space,
the diluent may be stored separately at room temperature.
During shipment, to ensure that there is no loss of potency, the vaccine must
be maintained at a temperature of 10°C (50°F) or colder. Freezing during
shipment will not affect potency.
Protect the vaccine from light at all times, since such exposure may inactivate
Before reconstitution, store the vial of lyophilized vaccine at 2-8°C (36-46°F)
or colder. The diluent may be stored in the refrigerator with the lyophilized
vaccine or separately at room temperature.
It is recommended that the vaccine be used as soon as possible after reconstitution.
Store reconstituted vaccine in the vaccine vial in a dark place at 2-8°C
(36-46°F) and discard if not used within 8 hours.
14. Centers for Disease Control and Prevention. Recommended
childhood immunization schedule — United States, January-June 1996, MMWR 44(51
& 52): 940-943, January 5, 1996.
15. Measles Prevention: Recommendations of the Immunization
Practices Advisory Committee (ACIP), MMWR 38(S-9): 5-22, December 29,
16. Jong, E.C.: The Travel and Tropical Medicine Manual, W.B.
Saunders Company, p. 12-16, 1987.
17. Committee on Immunization Council of Medical Societies,
American College of Physicians, Phila. PA, Guide for Adult Immunization, First
18. King, G.E.; Markowitz, L.E.; Patriarca, P.A.; et al: Clinical
Efficacy of Measles Vaccine During the 1990 Measles Epidemic, Pediatr. Infect.
Dis. J. 10(12): 883-888, December 1991.
19. Krasinski, K.; Borkowski, W.: Measles and Measles Immunity
in Children Infected With Human Immunodeficiency Virus, JAMA 261(17):
35. Measles, Mumps, and Rubella — Vaccine Use and Strategies
for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control
of Mumps: Recommendations of the Advisory Committee on Immunization Practices
(ACIP), MMWR 47(RR-8): May 22, 1998.
Manuf. and Dist. by: Merck & Co. Inc., Whitehouse Station,
New Jersey, NJ 08889, USA. Issued February 2006. FDA revision date: n/a