A 9-month-old child receives measles vaccine (MV) as per the IAP schedule. At 15 months, the child needs the MMR vaccine. The mother mentions the child had a febrile seizure 3 days after the first measles dose. What is the recommended approach for the MMR dose?

• A Permanently contraindicate MMR due to previous measles vaccine-associated seizure
• B Substitute MMR with MR vaccine to remove the mumps component that causes seizures
• C Defer MMR until 5 years of age to prevent recurrent febrile seizures
• D Give MMR at 15 months; febrile seizure post-vaccination is a precaution, not contraindication — pre-medication with antipyretics is recommended ✓

Explanation

A febrile seizure following a prior MMR or measles vaccine dose is a precaution, not a contraindication, for subsequent MMR administration. The risk of febrile seizure with MMR is approximately 1 in 3,000 doses and is associated with the measles component causing fever at days 7–12 post-vaccination. Children with a personal or family history of febrile seizures benefit from prophylactic antipyretics at the time of vaccination and 1-2 days following. Withholding MMR exposes the child to greater risk from measles, mumps, and rubella infection than from vaccine-associated febrile seizures.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.