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Proquad Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

ProQuad [Measles, Mumps, Rubella and Varicella (Oka/Merck) Virus Vaccine Live] is a "live" vaccine used to prevent the diseases of measles, mumps, rubella and varicella. This medication is available in generic form. Common side effects include pain/redness/swelling at the injection site, fever, rash, and fussiness in children.

Individuals 12 months through 12 years of age should receive a single 0.5-mL dose of ProQuad administered subcutaneously. At least 1 month should elapse between a dose of a measles-containing vaccine such as M-M-R II, and a dose of ProQuad. ProQuad may interact with steroids, medicines to treat or prevent organ transplant rejection, medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders. Tell your doctor all medications and supplements you or your child use and vaccines recently received. ProQuad vaccine must not be used during pregnancy. It may harm a fetus. It is important to prevent pregnancy for at least 3 months after vaccination. This medication may pass into breast milk. However, it is unlikely to harm a nursing infant. Consult your doctor before breastfeeding.

Our ProQuad [Measles, Mumps, Rubella and Varicella (Oka/Merck) Virus Vaccine Live] Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Patient Information in Detail?

Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.

Proquad in Detail - Patient Information: Side Effects

Your child should not receive a booster vaccine if he or she had a life-threatening allergic reaction after the first shot.

Keep track of any and all side effects your child has after receiving this vaccine. If the child ever needs to receive a booster dose, you will need to tell the doctor if the previous shots caused any side effects.

Becoming infected with measles, mumps, rubella, or varicella is much more dangerous to your child's health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.

Get emergency medical help if your child has any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if your child has any of these serious side effects:

  • problems with hearing or vision;
  • extreme drowsiness, fainting;
  • fussiness, irritability, crying for an hour or longer;
  • easy bruising or bleeding, unusual weakness;
  • seizure (black-out or convulsions); or
  • high fever (within a few hours or a few days after the vaccine).

Less serious side effects include:

  • redness, pain, swelling, or a lump where the shot was given;
  • headache, dizziness;
  • low fever, joint or muscle pain; or
  • nausea, vomiting, diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Read the entire detailed patient monograph for Proquad (Measles Mumps Rubella Varicella Vaccine Live) »

What is Patient Information Overview?

A concise overview of the drug for the patient or caregiver from First DataBank.

Proquad Overview - Patient Information: Side Effects

SIDE EFFECTS: Pain/redness/swelling at the injection site, fever, rash, and fussiness may occur. If any of these effects persist or worsen, tell the doctor or pharmacist promptly.

Infrequently, temporary symptoms such as fainting/dizziness/lightheadedness, vision changes, numbness/tingling, or seizure-like movements have happened after vaccine injections. Tell your health care provider right away if you have any of these symptoms soon after receiving an injection. Sitting or lying down may relieve symptoms.

Remember that the doctor has prescribed this medication because he or she has judged that the benefit to your child is greater than the risk of side effects. Many children using this medication do not have serious side effects.

Tell the doctor immediately if any of these rare but serious side effects occur: easy bruising/bleeding, joint pain/stiffness, seizures with fever.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact the doctor or pharmacist.

Contact the doctor for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967. In Canada, you may call Health Canada at 1-866-234-2345.

Read the entire patient information overview for Proquad (Measles Mumps Rubella Varicella Vaccine Live)»

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Proquad FDA Prescribing Information: Side Effects
(Adverse Reactions)


Children 12 to 23 Months of Age

ProQuad (measles mumps rubella varicella vaccine live) was administered to 4497 children 12 to 23 months of age in clinical trials without concomitant administration with other vaccines. The safety of ProQuad (measles mumps rubella varicella vaccine live) was compared with the safety of M-M-R II and VARIVAX given concomitantly at separate injection sites. The safety profile for ProQuad (measles mumps rubella varicella vaccine live) was similar to the component vaccines. Children in these studies were monitored for up to 42 days post- vaccination. The only systemic vaccine-related adverse experiences that were reported at a significantly greater rate in individuals who received ProQuad (measles mumps rubella varicella vaccine live) than in individuals who received M-M-R II and VARIVAX concomitantly at separate injection sites were fever ( ≥ 102°F [ ≥ 38.9°C] oral equivalent or abnormal) (21.5% versus 14.9%, respectively), and measles-like rash (3.0% versus 2.1%, respectively). Both fever and measles-like rash usually occurred within 5 to 12 days following the vaccination, were of short duration, and resolved with no long-term sequelae. Pain/tenderness/soreness at the injection site was reported at a statistically lower rate in individuals who received ProQuad (measles mumps rubella varicella vaccine live) than in individuals who received M-M-R II and VARIVAX concomitantly at separate injection sites (22.0% versus 26.7%, respectively). The only vaccine-related injection-site adverse experience that was more frequent among recipients of ProQuad (measles mumps rubella varicella vaccine live) than recipients of M-M-R II and VARIVAX was rash at the injection site (2.3% versus 1.5%, respectively). Table 1 summarizes the frequencies of injection-site and systemic adverse experiences that were reported as vaccine related by the investigator among > 1% of children in these clinical trials.

Table 1: Vaccine-Related Injection-Site and Systemic Adverse Experiences Reported in 21 % of Children Who Received 1 Dose of ProQuad (measles mumps rubella varicella vaccine live) or M-M-R II and VARIVAX at 12 to 23 Months of Age (0-42 Days Postvaccination)

Adverse Experiences ProQuad (measles mumps rubella varicella vaccine live)
(N = 4497)
(N = 2038)
Injection Site
  Pain/tenderness/soreness 22.0 26.7
  Erythema 14.4 15.8
  Swelling 8.4 9.8
  Ecchymosis 1.5 2.3
  Rash 2.3 1.5
  Fever ≥ 102°F ( ≥ 38.9°C)§ 21.5 14.9
  Irritability 6.7 6.7
  Measles-like rash 3.0 2.1
  Varicella-like rash 2.1 2.2
  Rash (not otherwise specified) 1.6 1.4
  Upper respiratory infection 1.3 1.1
  Viral exanthema 1.2 1.1
  Diarrhea 1.2 1.3
Injection-site adverse experiences for M-M-R II and VARIVAX are based on occurrence with either of the vaccines administered.
Designates a solicited adverse experience. Injection-site adverse experiences were solicited only from Days 0-4 postvaccination.
§ Temperature reported as oral equivalent or abnormal.

The following additional vaccine-related clinical adverse experiences (incidence ≥ 0.2% but < 1%) were observed in individuals following a single dose of ProQuad (measles mumps rubella varicella vaccine live) . Solicited adverse experiences are designated with the symbol ().

Infections and infestations: otitis, otitis media, pharyngitis, viral infection.

Metabolism and nutrition disorders: anorexia.

Psychiatric disorders: crying, insomnia, sleep disorder.

Nervous system disorders: somnolence.

Respiratory, thoracic, and mediastinal disorders: cough, nasal congestion, respiratory congestion, rhinorrhea.

Gastrointestinal disorders: vomiting.

Skin and subcutaneous tissue disorders: miliaria rubra, rubella-like rash*.

General disorders and administration site conditions: malaise.

Post-marketing reports

The following additional adverse events have been reported with ProQuad (measles mumps rubella varicella vaccine live) in post-marketing experience.

Infections and infestations: herpes zoster, varicella.

Immune system disorders: anaphylactic reaction.

Nervous system disorders: ataxia, convulsion, febrile seizure.

Skin and subcutaneous tissue disorders: pruritus.

Adverse Experiences after vaccination with M-M-RII or VARIVAX

Other adverse experiences have been reported in clinical studies and with marketed use of either M-M-R II, the monovalent component vaccines of M-M-R II, or VARIVAX. These adverse effects are listed below without regard to causality or frequency.

Infections and infestations

Atypical measles, candidiasis, cellulitis, infection, influenza, measles, orchitis, parotitis, respiratory infection, skin infection.

Blood and the lymphatic system disorders

Lymphadenitis, regional lymphadenopathy, thrombocytopenia.

Immune system disorders

Anaphylactoid reaction, anaphylaxis and related phenomena such as angioneurotic edema, facial edema, and peripheral edema, anaphylaxis in individuals with or without an allergic history.

Psychiatric disorders

Agitation, apathy, nervousness.

Nervous system disorders

Afebrile convulsions or seizures, aseptic meningitis (see below), Bell's palsy, cerebrovascular accident, dizziness, dream abnormality, encephalitis (see below), encephalopathy (see below), Guillain- Barre syndrome, headache, hypersomnia, measles inclusion body encephalitis (see CONTRAINDICATIONS), ocular palsies, paraesthesia, polyneuritis, polyneuropathy, subacute sclerosing panencephalitis (see below), syncope, transverse myelitis, tremor.

Eye disorders

Edema of the eyelid, irritation, optic neuritis, retinitis, retrobulbar neuritis.

Ear and labyrinth disorders

Ear pain, nerve deafness.

Vascular disorders


Respiratory, thoracic and mediastinal disorders

Bronchial spasm, bronchitis, epistaxis, pneumonitis (see CONTRAINDICATIONS), pneumonia, pulmonary congestion, rhinitis, sinusitis, sneezing, sore throat, wheezing.

Gastrointestinal disorders

Abdominal pain, flatulence, hematochezia, mouth ulcer.

Skin and subcutaneous tissue disorders

Erythema multiforme, Henoch-Schonlein purpura, herpes simplex, impetigo, panniculitis, purpura, skin induration, Stevens-Johnson syndrome, sunburn.

Musculoskeletal, connective tissue and bone disorders

Arthritis and/or arthralgia (usually transient and rarely chronic [see below]), musculoskeletal pain, myalgia, pain of the hip, leg, or neck, swelling.

General disorders and administration site conditions

Injection-site complaints (burning and/or stinging of short duration, eczema, edema/swelling, hive-like rash, discoloration, hematoma, induration, lump, vesicles, wheal and flare), inflammation, lip abnormality, papillitis, roughness/dryness, stiffness, trauma, varicella-like rash, venipuncture site hemorrhage, warm sensation, warm to touch.

Post-marketing surveillance

The discussion that follows describes adverse reactions which have been identified post-approval for the monovalent components of ProQuad (measles mumps rubella varicella vaccine live) . Because these reactions are described in the literature or reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship.

Death from various, and in some cases unknown, causes has been reported rarely following vaccination with measles, mumps, and rubella vaccines; however, a causal relationship has not been established in healthy individuals. Death as a direct consequence of disseminated measles vaccine virus infection has been reported in severely immunocompromised individuals in whom a measles-containing vaccine is contraindicated and who were inadvertently vaccinated. However, there were no deaths or permanent sequelae reported in a published post-marketing surveillance study in Finland involving 1.5 million children and adults who were vaccinated with M-M-R II during 1982 to 1993.16

Encephalitis and encephalopathy have been reported approximately once for every 3 million doses of the combination of measles, mumps, and rubella vaccine contained in M-M-R II. Post-marketing surveillance of the more than 400 million doses that have been distributed worldwide (1978 to 2003) indicates that serious adverse events such as encephalitis and encephalopathy continue to be rarely reported. In no case has it been shown conclusively that reactions were actually caused by the vaccine; however, the data suggest the possibility that some of these cases may have been caused by measles vaccines. The risk of such serious neurological disorders following live measles virus vaccine administration remains far less than that for encephalitis and encephalopathy with wild-type measles (1 per 2000 reported cases).

Arthralgia and/or arthritis (usually transient and rarely chronic), and polyneuritis are features of infection with wild-type rubella and vary in frequency and severity with age and gender, being greatest in adult females and least in prepubertal children. Following vaccination in children, reactions in joints are generally uncommon (0 to 3%) and of brief duration. In women, incidence rates for arthritis and arthralgia are generally higher than those seen in children (12 to 26%), and the reactions tend to be more marked and of longer duration. Symptoms may persist for a matter of months or on rare occasions for years. In adolescent girls, the reactions appear to be intermediate in incidence between those seen in children and adult women. In women 35 to 45 years old these reactions are generally well tolerated and rarely interfere with normal activities.

Chronic arthritis has been associated with wild-type rubella infection and has been related to persistent virus and/or viral antigen isolated from body tissues. Only rarely have vaccine recipients developed chronic joint symptoms.

There have been reports of subacute sclerosing panencephalitis (SSPE) in children who did not have a history of infection with wild-type measles but did receive measles vaccine. Some of these cases may have resulted from unrecognized measles in the first year of life or possibly from the measles vaccination. Based on estimated measles vaccine distribution in the United States (US), the association of SSPE cases to measles vaccination is about one case per million vaccine doses distributed. This is far less than the association with infection with wild-type measles, 6 to 22 cases of SSPE per million cases of measles. The results of a retrospective case-controlled study suggest that the overall effect of measles vaccine has been to protect against SSPE by preventing measles with its inherent higher risk of SSPE.

Cases of aseptic meningitis have been reported to VAERS following measles, mumps, and rubella vaccination. Although a causal relationship between other strains of mumps vaccine and aseptic meningitis has been shown, there is no evidence to link Jeryl Lynn™ mumps vaccine to aseptic meningitis.

The reported rate of zoster in recipients of VARIVAX appears not to exceed that previously determined in a population-based study of healthy children who had experienced wild-type varicella.17 In clinical trials, 8 cases of herpes zoster were reported in 9454 vaccinated individuals 12 months to 12 years of age during 42,556 person-years of follow-up. This resulted in a calculated incidence of at least 18.8 cases per 100,000 person-years. All 8 cases reported after VARIVAX were mild and no sequelae were reported. The long-term effect of VARIVAX on the incidence of herpes zoster is unknown at present.

Read the entire FDA prescribing information for Proquad (Measles Mumps Rubella Varicella Vaccine Live) »


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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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