Measles, Mumps and Rubella vaccine (live) powder and solvent for solution for injection 0.5ml vials

The purpose of this systematic review is to synthesize the available evidence on the immunogenicity and safety of live viral measles-mumps-rubella (MMR) booster/revaccination and varicella vaccination in children and adolescents with juvenile idiopathic arthritis. PubMed, Scopus, and Web of Science were systematically searched from inception to October 1, 2025, for studies including patients with juvenile idiopathic arthritis who had received live viral MMR or varicella vaccination and reporting immunogenicity, adverse events, vaccine-strain infection, breakthrough infection, or post-vaccination disease activity. Nine studies comprising 743 patients with juvenile idiopathic arthritis were included: five retrospective studies, three prospective cohort studies, and one open-label randomized controlled trial. Seven studies assessed MMR booster or revaccination, whereas two small prospective cohorts assessed varicella vaccination. MMR booster/revaccination was generally immunogenic and clinically safe in the short term, with no consistent increase in disease activity and no serious vaccine-related complications reported. However, 5-year seroprotection after MMR booster was lower among children receiving biologic disease-modifying antirheumatic drugs (DMARDs) at vaccination than among non-bDMARD users for measles (60% vs 86%), mumps (80% vs 94%), and rubella (60% vs 83%). Varicella vaccination induced protective antibodies in 82-83% of patients after two doses, but antibody levels were lower than those in healthy controls; VZV-specific cellular immunity was detectable in 72% in the larger cohort and appeared to persist longer than humoral immunity. No vaccine-strain varicella infection was reported, although mild breakthrough varicella occurred in some vaccinated patients.ConclusionIn clinically stable children with juvenile idiopathic arthritis, the available evidence supports the cautious use of MMR booster/revaccination and varicella vaccination under specialist supervision. The main residual concern is not a consistent safety signal but incomplete or less durable protection in selected biologic-treated patients, particularly for measles and rubella 5 years after MMR booster and for varicella in low responders. These findings support individualized vaccine timing and consideration of post-vaccination serology in selected higher-risk children.What is known• Live viral vaccines in children with juvenile idiopathic arthritis are used cautiously because of concerns about attenuated-virus-related adverse events, disease flare, and reduced immunogenicity during immunosuppressive therapy. • The evidence base is stronger for MMR booster/revaccination than for varicella vaccination, because MMR data include one randomized trial and several larger cohorts, whereas varicella data come from two small prospective cohorts.What is new• MMR booster/revaccination and varicella vaccination appeared generally safe in clinically stable children with juvenile idiopathic arthritis, with no serious vaccine-related complications or vaccine-strain infections reported in the included cohorts. • Five-year seroprotection after MMR booster was lower in biologic-treated children for measles, mumps, and rubella, supporting individualized vaccine timing and selected post-vaccination serologic monitoring.

Abstract licence: CC BY

BackgroundPalmoplantar and periungual warts tend to be recalcitrant. Intralesional immunotherapy can provide high efficacy with additional benefit to distant warts. However, evidence on comparative effects between intralesional immunotherapy with measles, mumps, rubella vaccine (MMR) and tuberculin purified protein derivative (PPD) and roles of dermoscopy in predicting treatment outcomes in palmoplantar/periungual warts is limited.ObjectivesThe study aimed to compare efficacy and safety of intralesional MMR and PPD injections in treatment of palmoplantar/periungual warts and explore associations between dermoscopic findings and treatment outcomes.MethodsWe conducted a double-blind randomized controlled trial involving 40 patients with palmoplantar/periungual warts who were equally assigned to receive MMR or PPD. Intralesional injection was done every 2 weeks until clearance or maximum of 5 treatments.ResultsComplete resolution was higher in MMR than PPD group (90.0% vs. 80.0% in index lesion and 81.3% vs. 54.6% in distant lesions, respectively), although the differences were statistically nonsignificant. Dermoscopic findings were not significantly associated with complete resolution. Local swelling, i.e., the most common adverse event, occurred more frequently in PPD (40.0%) than MMR group (10.0%).ConclusionThis study suggests that intralesional immunotherapy with either MMR or PPD is efficacious in palmoplantar/periungual warts, with MMR showing a trend toward higher clearance and lower adverse events.

Abstract licence: CC BY-NC

IntroductionCommon warts are benign skin lesions caused by human papillomavirus (HPV) infection. They are often resistant to conventional treatments and may cause cosmetic and psychological distress. Immunotherapy is a promising alternative that stimulates the host immune system to clear the virus and the infected cells. This study compared the efficacy and safety of two immunotherapeutic agents, intralesional measles, mumps, and rubella (MMR) vaccine and intralesional vitamin D, in the treatment of common warts.MethodsThis was a single-blind randomised controlled trial conducted at a tertiary care hospital in Kolkata, India. Patients aged 12 years or older with common warts were randomly assigned to receive either intralesional MMR vaccine or intralesional vitamin D every 3 weeks for a maximum of three doses or until complete resolution, whichever was earlier. The primary outcome was the reduction in the size of the largest wart. Secondary outcomes included patients' and physicians' global assessment, complete response rate, adverse effects, and recurrence rate.ResultsA total of 36 patients were enrolled and analysed. Both MMR and vitamin D groups showed a significant reduction in the size of the largest wart throughout the treatment period (P P = 0.14). The recurrence rate was low in both groups (5.9% in the MMR group and 10.5% in the vitamin D group).ConclusionBoth intralesional MMR vaccine and intralesional vitamin D are effective and safe immunotherapeutic options for the treatment of common warts. MMR vaccine may have a slight advantage over vitamin D in terms of complete response rate; however, further studies with larger sample sizes and longer follow-ups are needed to confirm this finding.

Abstract licence: CC BY-NC-SA