Core Characteristics

• Live-attenuated viral vaccine.
• Derived from Wistar RA 27/3 vaccine strain.
• Grown in human diploid or chick embryo cell cultures.
• Formulated commonly as combination Measles-Rubella or Measles-Mumps-Rubella vaccine.

Administration Details

Storage And Handling

• Available in freeze-dried (lyophilized) form.
• Requires reconstitution with sterile diluent prior to use.
• Store frozen or at 2°C to 8°C.
• Highly sensitive to heat and light.
• Protect reconstituted vaccine from light.
• Discard unused reconstituted vaccine within 4 to 6 hours to prevent toxic shock syndrome.

Immunization Schedule

Universal Immunization Programme

• Administered as Measles-Rubella vaccine.
• First dose given at 9 to 12 months.
• Second dose given at 16 to 24 months.

Indian Academy Of Pediatrics Guidelines

• Recommends Measles-Mumps-Rubella vaccine over Measles-Rubella vaccine.
• First dose at 9 months.
• Second dose at 15 to 18 months.
• Third dose at 4 to 6 years to boost anamnestic response.

Efficacy And Immunogenicity

• Single dose provides lifelong protection in over 95% of vaccinees.
• Primary goal prevents Congenital Rubella Syndrome.
• Suboptimal coverage shifts disease epidemiology to older age groups, paradoxically increasing Congenital Rubella Syndrome incidence.
• Maternal antibodies interfere with vaccine response before 9 months.

Adverse Reactions

• Mild rash develops in 5% of vaccinees.
• Joint symptoms including arthralgia and arthritis occur 1 to 3 weeks post-vaccination.
• Joint symptoms predominantly affect susceptible post-pubertal females.
• Immune thrombocytopenic purpura occurs at frequency of 1 per 30,000 vaccinations.
• Chronic arthritis lasting less than 6 weeks constitutes notable serious adverse event.

Contraindications And Precautions

• Strictly contraindicated in severely immunocompromised states, including high-dose corticosteroid therapy exceeding 14 days and severe human immunodeficiency virus.
• Contraindicated during pregnancy.
• Avoid pregnancy for 4 weeks following vaccination.
• Accidental vaccination during pregnancy does not increase risk of congenital malformations.
• Accidental vaccination in pregnancy does not warrant medical termination.
• Delay vaccination 3 to 11 months following administration of antibody-containing blood products.
• Routine pregnancy testing prior to immunization remains unnecessary.