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Moshe Ipp, MBBCh; Eyal Cohen, MD; Morton Goldbach, MD; Colin Macarthur, MBChB

Arch Pediatr Adolesc Med. 2004;158:323-326.

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.

From the Division of Paediatric Medicine, Hospital for Sick Children, and Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario. Dr Ipp was invited to present the results of this study at the 21st Annual Meeting of the European Society for Paediatric Infectious Diseases, April 9-11, 2003, as one of several speakers at a GlaxoSmithKline Vaccine Satellite Symposium. GlaxoSmithKline covered the cost of Dr Ipp's transportation and accommodation at the meeting and provided an honorarium of 1600.

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