Effect of choice of measles-mumps-rubella vaccine on immediate vaccination pain in infants

Arch Pediatr Adolesc Med. 2004 Apr;158(4):323-6. doi: 10.1001/archpedi.158.4.323.


Objective: To compare acute pain response to 2 measles-mumps-rubella vaccines.

Design: Double-blind clinical trial.

Setting: Hospital for Sick Children, Toronto, Ontario. Patients Forty-nine infants 12 months of age receiving their first measles-mumps-rubella vaccination.

Interventions: Random allocation to receive Priorix or M-M-R II.

Main outcome measures: Pain responses before (baseline) and after (within 15 seconds) vaccination were quantified by visual analog scale (VAS; range, 0-100), completed by the parent and independently by the pediatrician, and the Modified Behavioral Pain Scale (range, 0-10), scored by a coder blinded to the vaccine allocation. Crying (yes or no) and latency to the first cry after injection were also measured.

Results: Twenty-six infants received Priorix and 23 received M-M-R II. There were no differences between the 2 groups in baseline characteristics or prevaccination baseline pain scores. Median pain scores after vaccination (Priorix vs M-M-R II) were as follows: pediatrician VAS, 15 vs 58 (P =.001); parent VAS, 22 vs 53 (P =.007); and Modified Behavioral Pain Scale, 6 vs 8 (P =.02). Median difference in pain scores (after minus before) for Priorix vs M-M-R II were as follows: pediatrician VAS, 15 vs 53 (P =.003); parent VAS, 22 vs 47 (P =.008); and Modified Behavioral Pain Scale, 3 vs 5 (P =.03). The median latency to first cry was 1.5 seconds in the Priorix group compared with 1 second in the M-M-R II group (P =.26).

Conclusions: Priorix vaccine causes significantly less pain than M-M-R II at the time of injection for 12-month-old infants receiving their first measles-mumps-rubella vaccination.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Double-Blind Method
  • Female
  • Humans
  • Infant
  • Injections, Subcutaneous
  • Male
  • Measles-Mumps-Rubella Vaccine / administration & dosage
  • Measles-Mumps-Rubella Vaccine / adverse effects*
  • Pain / etiology*
  • Pain Measurement*
  • Vaccination / adverse effects


  • Measles-Mumps-Rubella Vaccine