Increasing Coverage and Efficiency of Measles, Mumps, and Rubella Vaccine and Introducing Universal Varicella Vaccination in Europe: A Role for the Combined Vaccine
Universal mass vaccination according to a 2-dose measles-mumps-rubella (MMR) vaccine schedule is recommended by the World Health Organization and is fundamental to the control of these important diseases. Very high coverage (first dose, ≥95%; second dose, ≥80%) is necessary to achieve and sustain high population immunity, and eventually interrupt indigenous transmission of these diseases. In 2006, the Advisory Committee on Immunization Practices issued a recommendation for 2 doses of varicella vaccine to be given universally to children. Coadministration of MMR and varicella vaccines, though efficacious and well tolerated, can be difficult because of the 2 separate injections and associated compliance issues. In addition to the general advantages of a combined vaccine, recently registered measles-mumps-rubella-varicella (MMRV) vaccines could facilitate introduction of varicella universal mass vaccination by simplifying administration and providing the potential to achieve high coverage rates for these 4 diseases.