To the editor: Response to Willame, et al., published in Vaccine 35 (2017) 5551–5558, entitled “Pain caused by measles, mumps, and rubella vaccines: A systematic literature review”

• Published in: Vaccine Vol. 36; no. 45; pp. 6587 - 6588
• Main Authors: Lee, Andrew W., Saldutti, Louise P., Wolfson, Lara J., Stek, Jon E., Kuter, Barbara J.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 29.10.2018; Elsevier Limited
• Subjects: Allergy and Immunology; Comparative studies; Confidence intervals; Immunization; Injection; Literature reviews; Measles; Mumps; Pain; Rubella; Vaccines
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2018.08.024

Two of the studies (ref. 22, 21) were very small, with 49 and 60 subjects respectively [3,4]. Because of the small number and size of these studies, additional data are needed to draw firm conclusions. [...]with respect to pain within days of vaccination, the review did not include 2 recent, large randomized, comparative studies which show similar rates of injection-site pain for Priorix and M-M-RII. The data on injection-site pain from these two studies is summarized in the table below, and shows no notable difference between Priorix and M-M-RII (note overlapping 95% confidence intervals):StudySymptomIntensityPriorix®M-M-R®IINn%(95% CI)Nn%(95% CI)115,648 (MMR-160)PainAny*355591925.9(24.4, 27.3)124234928.1(25.6, 30.7)Grade 3†240.7(0.4, 1.0)121.0(0.5, 1.7)115,650 (MMR-162)PainAny*112231127.7(25.1, 30.4)55413223.8(20.3, 27.6)Grade 3†60.5(0.2, 1.2)20.4(0.0, 1.3)N = number of subjects with available results.n/% = number/percentage of subjects with concentration equal to or above specified value.95% CI = 95% confidence interval.*Any Pain = occurrence of any local symptom regardless of their intensity grade.†Grade 3 Pain = cried when limb was moved/spontaneously painful.The preponderance of evidence supports that post-vaccination pain is similar between Priorix and M-M-R II.