MMRV vaccine

{{Short description|Combination vaccine against measles, mumps, rubella, and varicella viruses}} {{Use dmy dates|date=October 2019}} {{cs1 config |name-list-style=vanc |display-authors=6}} {{Infobox drug | Verifiedfields = changed | verifiedrevid = 447558193 | type = combo | image = | caption =

| tradename = Proquad, Priorix Tetra | Drugs.com = {{drugs.com|monograph|measles-mumps-and-rubella-vaccine}} | MedlinePlus = | DailyMedID = Proquad | pregnancy_AU = B2 | pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{cite web | title=Measles virus vaccine/mumps virus vaccine/rubella virus vaccine/varicella virus vaccine (Proquad) Use During Pregnancy | website=Drugs.com | date=16 October 2019 | url=https://www.drugs.com/pregnancy/measles-virus-vaccine-mumps-virus-vaccine-rubella-virus-vaccine-varicella-virus-vaccine.html | access-date=26 January 2020 | archive-date=19 October 2019 | archive-url=https://web.archive.org/web/20191019060824/https://www.drugs.com/pregnancy/measles-virus-vaccine-mumps-virus-vaccine-rubella-virus-vaccine-varicella-virus-vaccine.html | url-status=live }}</ref> | pregnancy_category = | routes_of_administration = Subcutaneous, intramuscular | ATC_prefix = J07 | ATC_suffix = BD54 | ATC_supplemental =

| legal_AU = S4 | legal_AU_comment = <ref name="Proquad AU" /><ref name="Priorix-Tetra AU" /> | legal_BR =  | legal_BR_comment = | legal_CA = Rx-only | legal_CA_comment = /{{nbsp}}Schedule D<ref name="Proquad CA">{{cite web | title=Proquad Product information | website=Health Canada | date=9 May 2014 | url=https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88411 | access-date=10 June 2024 | archive-date=10 June 2024 | archive-url=https://web.archive.org/web/20240610050012/https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88411 | url-status=live }}</ref><ref name="Priorix-Tetra CA">{{cite web | title=Priorix Tetra Product information | website=Health Canada | date=4 June 2008 | url=https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=78322 | access-date=10 June 2024 | archive-date=10 June 2024 | archive-url=https://web.archive.org/web/20240610050056/https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=78322 | url-status=live }}</ref> | legal_DE =  | legal_DE_comment = | legal_NZ =  | legal_NZ_comment = | legal_UK =  | legal_UK_comment = | legal_US = Rx-only | legal_US_comment = <ref name="Proquad FDA label">{{cite web | title=Proquad- measles, mumps, rubella and varicella virus vaccine live injection, powder, lyophilized, for suspension | website=DailyMed | date=5 November 2024 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=73eae9fc-507b-4c9c-883d-63eb2e3cc6f6 | access-date=7 October 2025 | archive-date=21 April 2025 | archive-url=https://web.archive.org/web/20250421061329/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=73eae9fc-507b-4c9c-883d-63eb2e3cc6f6 | url-status=live }}</ref> | legal_EU = Rx-only | legal_EU_comment = <ref name="Proquad EPAR" /> | legal_UN =  | legal_UN_comment = | legal_status = Rx-only

| CAS_number_Ref = {{cascite|correct|??}} | CAS_number = 1704519-64-1 | CAS_supplemental = | PubChem = | PubChemSubstance = | IUPHAR_ligand = | DrugBank = | ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} | ChemSpiderID = none | UNII = | KEGG = | ChEBI = | ChEMBL = | synonyms = Measles, Mumps, Rubella, and Varicella Virus Vaccine Live }}

The '''MMRV vaccine''' is a combination vaccine against measles, mumps, rubella (German measles), and varicella (chickenpox).<ref name="Proquad FDA label" /><ref name="Proquad EPAR" /> It contains the combined measles vaccine, mumps vaccine, rubella vaccine, and varicella vaccine into a single injection.<ref name="Proquad FDA label" /><ref name="Proquad EPAR" /> The MMRV vaccine has similar immunogenicity and overall safety profiles to the MMR vaccine administered with or without the varicella vaccine. The MMRV vaccine is typically given to children between one and two years of age.<ref>{{cite journal | vauthors = Kowalzik F, Faber J, Knuf M | title = MMR and MMRV vaccines | journal = Vaccine | volume = 36 | issue = 36 | pages = 5402–5407 | date = August 2018 | pmid = 28757060 | doi = 10.1016/j.vaccine.2017.07.051 | series = Progress in Vaccines }}</ref>

Several companies supply MMRV vaccines. Proquad is marketed by Merck and was approved in 2005, for use in the United States for children aged twelve months of age through twelve years of age.<ref name="Proquad FDA label" /> Stand-alone virus measles, mumps, rubella, and varicella vaccines had been previously licensed in 1963, 1967, 1969, and 1995, respectively.<ref name=Good2015>{{cite journal | vauthors = Goodson JL, Seward JF | title = Measles 50 Years After Use of Measles Vaccine | journal = Infectious Disease Clinics of North America | volume = 29 | issue = 4 | pages = 725–743 | date = December 2015 | pmid = 26610423 | doi = 10.1016/j.idc.2015.08.001 }}</ref><ref>{{cite web |title=Measles: information about the disease and vaccines Questions and Answers |url=https://www.immunize.org/catg.d/p4209.pdf |website=Immunization Action Coalition | date=November 2018 |access-date=28 November 2022 |archive-date=28 November 2022 |archive-url=https://web.archive.org/web/20221128011445/https://www.immunize.org/catg.d/p4209.pdf |url-status=live }}</ref> An MMRV vaccine called Priorix Tetra<ref>{{cite journal | vauthors = Wellington K, Goa KL | title = Measles, mumps, rubella vaccine (Priorix; GSK-MMR): a review of its use in the prevention of measles, mumps and rubella | journal = Drugs | volume = 63 | issue = 19 | pages = 2107–2126 | date = 2003 | pmid = 12962524 | doi = 10.2165/00003495-200363190-00012 | s2cid = 46973762 }}</ref><ref>{{cite web | title=GlaxoSmithKline Clinical Trial Register | website=GlaxoSmithKline | url=http://ctr.gsk.co.uk/Summary/Vaccine_Priorix_Tetra/studylist.asp | archive-url=https://web.archive.org/web/20071130025501/http://ctr.gsk.co.uk/Summary/Vaccine_Priorix_Tetra/studylist.asp | archive-date=30 November 2007 | access-date=19 October 2019}}</ref> by GlaxoSmithKline is available in some of the member states of the European Union.<ref>{{cite web | title=Monovalent and multivalent measles, mumps, rubella and / or varicella vaccines | website=European Medicines Agency (EMA) | date=14 December 2012 | url=https://www.ema.europa.eu/en/medicines/human/referrals/monovalent-multivalent-measles-mumps-rubella-or-varicella-vaccines | access-date=7 October 2025}}</ref><ref>{{cite web | title=Priorix-tetra | website=The Australian Immunisation Handbook | date=4 June 2018 | url=https://immunisationhandbook.health.gov.au/vaccines/priorix-tetra | archive-url=https://web.archive.org/web/20191019055834/https://immunisationhandbook.health.gov.au/vaccines/priorix-tetra | archive-date=19 October 2019 | url-status=live | access-date=18 October 2019}}</ref><ref>{{cite journal | vauthors = Bauchau V, Van Holle L, Cohen C | title = Modelling Hospitalisation Ratios for Febrile Convulsions and Severe Varicella Under Combined Measles, Mumps, Rubella, and Varicella (MMRV-Priorix-Tetra) Compared to Separate MMR + V Vaccination | journal = Drug Safety | volume = 38 | issue = 11 | pages = 1095–1102 | date = November 2015 | pmid = 26251259 | pmc = 4608986 | doi = 10.1007/s40264-015-0326-4 }}</ref><ref>{{cite web | title=PEI Table of vaccines for measles with a valid marketing authorisation | website=PEI, Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und biomedizinische Arzneimittel | date=19 October 2019 | url=https://www.pei.de/EN/medicinal-products/vaccines-human/measles/measles-node.html | archive-url=https://web.archive.org/web/20191019060437/https://www.pei.de/EN/medicinal-products/vaccines-human/measles/measles-node.html | archive-date=19 October 2019 | url-status=live | language=de | access-date=18 October 2019}}</ref>

==Recommendations==

The MMRV vaccine, a combined MMR and varicella vaccine, simplifies the administration of the vaccines.<ref name=Vesikari>{{cite journal | vauthors = Vesikari T, Sadzot-Delvaux C, Rentier B, Gershon A | title = Increasing coverage and efficiency of measles, mumps, and rubella vaccine and introducing universal varicella vaccination in Europe: a role for the combined vaccine | journal = The Pediatric Infectious Disease Journal | volume = 26 | issue = 7 | pages = 632–638 | date = July 2007 | pmid = 17596807 | doi = 10.1097/INF.0b013e3180616c8f | s2cid = 41981427 }}</ref>

==Adverse events==

Rare but serious adverse events reported following Proquad vaccination include allergic reactions, including swelling of the lips, tongue, or face; difficulty breathing or closing of the throat; hives; paleness; weakness; dizziness; a fast heartbeat; deafness; long-term seizures, coma, or lowered consciousness; seizures (jerking or staring) caused by fever; or temporary low platelet count.<ref name=":0" />

For children aged two and younger, the MMRV vaccine is associated with significantly more adverse events compared to separate administration of MMR and varicella vaccinations on the same day.<ref name=":0">{{cite news |archive-url=https://web.archive.org/web/20150120063519/http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmrv.html |title=MMRV (Measles, Mumps, Rubella & Varicella) VIS|date=21 May 2010|archive-date=20 January 2015|publisher=CDC|url=http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmrv.html}}</ref> There are 4.3 additional febrile seizures per 10,000 vaccinated children (95% CI 2.6–5.6), 7.5 additional mostly mild fever episodes per 100 vaccinated children (95% CI, 5.4–9.4) and 1.1 additional measles-like rash per 100 children (95% CI, 0.2–1.8). Febrile seizures caused by the MMRV vaccine occur 7 to 10 days after vaccination. In children age 4–6, there is no evidence for an increased risk in febrile seizures after the administration of Proquad compared to the separate administration of MMR and Varicella vaccines.<ref>{{cite journal | vauthors = Klein NP, Fireman B, Yih WK, Lewis E, Kulldorff M, Ray P, Baxter R, Hambidge S, Nordin J, Naleway A, Belongia EA, Lieu T, Baggs J, Weintraub E | title = Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures | journal = Pediatrics | volume = 126 | issue = 1 | pages = e1–e8 | date = July 2010 | pmid = 20587679 | doi = 10.1542/peds.2010-0665 | doi-access = free }}</ref><ref name=cber>{{cite news |url=https://www.fda.gov/downloads/biologicsbloodvaccines/vaccines/approvedproducts/ucm123800.pdf |title=CBER clinical review of studies submitted in support of licensure of Proquad |publisher=US Food and Drug Administration |date=August 2005 |access-date=16 December 2019 |archive-date=6 May 2017 |archive-url=https://web.archive.org/web/20170506064422/https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM123800.pdf }}</ref>

== Legal status == Proquad was approved for medical use in the United States in September 2005, <ref>{{cite web | title=Proquad | website=U.S. Food and Drug Administration (FDA) | archive-date=23 July 2017 | url=https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm188806.htm | archive-url=https://wayback.archive-it.org/7993/20170723030938/https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm188806.htm | access-date=8 October 2020 }}</ref><ref>{{cite web | title=Proquad | website=U.S. Food and Drug Administration (FDA) | url=https://www.fda.gov/vaccines-blood-biologics/vaccines/proquad | access-date=8 October 2020 | id=STN: 125108 | archive-date=11 November 2020 | archive-url=https://web.archive.org/web/20201111195629/https://www.fda.gov/vaccines-blood-biologics/vaccines/proquad }}</ref> in the European Union in April 2006,<ref name="Proquad EPAR">{{cite web | title=Proquad EPAR | website=European Medicines Agency (EMA) | date=6 April 2006 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/proquad | access-date=8 October 2020 | archive-date=21 October 2020 | archive-url=https://web.archive.org/web/20201021003222/https://www.ema.europa.eu/en/medicines/human/EPAR/proquad | url-status=live }}</ref> in Australia in February 2007,<ref name="Proquad AU">{{cite web | title=Proquad measles mumps rubella varicella live virus vaccine injection vial with prefilled diluent syringe (126157) | website=Therapeutic Goods Administration (TGA) | date=26 May 2022 | url=https://www.tga.gov.au/resources/artg/126157 | access-date=10 June 2024 | archive-date=10 June 2024 | archive-url=https://web.archive.org/web/20240610042043/https://www.tga.gov.au/resources/artg/126157 | url-status=live }}</ref> and in Canada in May 2014.<ref name="Proquad CA" />

Priorix Tetra was approved for medical use in Australia in November 2005,<ref name="Priorix-Tetra AU">{{cite web | title=Priorix-Tetra vaccine 0.5mL powder for injection vial with diluent syringe (107286) | website=Therapeutic Goods Administration (TGA) | date=26 May 2022 | url=https://www.tga.gov.au/resources/artg/107286 | access-date=10 June 2024 | archive-date=31 January 2023 | archive-url=https://web.archive.org/web/20230131231718/https://www.tga.gov.au/resources/artg/107286 | url-status=live }}</ref> and in Canada in June 2008.<ref name="Priorix-Tetra CA" />

== References == {{reflist}}

== Further reading == {{refbegin|30em}} * {{cite journal | title = Notice to Readers: Licensure of a Combined Live Attenuated Measles, Mumps, Rubella, and Varicella Vaccine | journal = MMWR Morb. Mortal. Wkly. Rep. | volume = 54 | issue = 47 | date = December 2005 | url = https://www.cdc.gov/mmwr/PDF/wk/mm5447.pdf | pages = 1212–14 | access-date = 26 January 2020 | archive-date = 20 January 2022 | archive-url = https://web.archive.org/web/20220120023326/http://www.cdc.gov/mmwr/pdf/wk/mm5447.pdf | url-status = live }} * {{cite journal | vauthors = Ma SJ, Li X, Xiong YQ, Yao AL, Chen Q | title = Combination Measles-Mumps-Rubella-Varicella Vaccine in Healthy Children: A Systematic Review and Meta-analysis of Immunogenicity and Safety | journal = Medicine | volume = 94 | issue = 44 | article-number = e1721 | date = November 2015 | pmid = 26554769 | pmc = 4915870 | doi = 10.1097/MD.0000000000001721 }} * {{cite book | title=The immunological basis for immunization series: module 7: measles (update 2009) | publisher=World Health Organization | date=January 2009 | hdl=10665/44038 | isbn=978-92-4-159755-5 | hdl-access=free }} * {{cite book | title=The immunological basis for immunization series: module 16: mumps | publisher=World Health Organization | date=November 2010 | hdl=10665/97885 | isbn=978-92-4-150066-1 | hdl-access=free }} * {{cite book | title=The immunological basis for immunization series: module 11: rubella | publisher=World Health Organization | date=December 2008 | hdl=10665/43922 | isbn=978-92-4-159684-8 | hdl-access=free }} * {{cite book | title = The immunological basis for immunization series: Module 10: Varicella-zoster virus | publisher = World Health Organization | date = May 2008 | hdl = 10665/43906 | isbn = 978-92-4-159677-0 | hdl-access=free }} * {{cite book | title=Immunisation against infectious disease | chapter=Chapter 21: Measles | chapter-url=https://www.gov.uk/government/publications/measles-the-green-book-chapter-21 | publisher=Public Health England | veditors=Ramsay M | url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book | date=December 2019 | access-date=9 October 2020 | archive-date=12 November 2019 | archive-url=https://web.archive.org/web/20191112005859/https://www.gov.uk/government/publications/pneumococcal-the-green-book-chapter-25 | url-status=live }} * {{cite book | title=Immunisation against infectious disease | chapter=Chapter 23: Mumps | chapter-url=https://www.gov.uk/government/publications/mumps-the-green-book-chapter-23 | publisher=Public Health England | veditors=Ramsay M | url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book | date=April 2013 | access-date=9 October 2020 | archive-date=12 November 2019 | archive-url=https://web.archive.org/web/20191112005859/https://www.gov.uk/government/publications/pneumococcal-the-green-book-chapter-25 | url-status=live }} * {{cite book | title=Immunisation against infectious disease | chapter=Chapter 28: Rubella | chapter-url=https://www.gov.uk/government/publications/rubella-the-green-book-chapter-28 | publisher=Public Health England | veditors=Ramsay M | url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book | date=April 2013 | access-date=9 October 2020 | archive-date=12 November 2019 | archive-url=https://web.archive.org/web/20191112005859/https://www.gov.uk/government/publications/pneumococcal-the-green-book-chapter-25 | url-status=live }} * {{cite book | title=Immunisation against infectious disease | chapter=Chapter 34: Varicella | chapter-url=https://www.gov.uk/government/publications/varicella-the-green-book-chapter-34 | publisher=Public Health England | veditors=Ramsay M | url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book | date=March 2013 | access-date=9 October 2020 | archive-date=12 November 2019 | archive-url=https://web.archive.org/web/20191112005859/https://www.gov.uk/government/publications/pneumococcal-the-green-book-chapter-25 | url-status=live }} * {{cite book | publisher = U.S. Centers for Disease Control and Prevention (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | chapter = Chapter 13: Measles | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/meas.html | isbn = 978-0-9904491-1-9 | url = https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | access-date = 9 October 2020 | archive-date = 30 December 2016 | archive-url = https://web.archive.org/web/20161230001534/https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | url-status = live }} * {{cite book | publisher = U.S. Centers for Disease Control and Prevention (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | chapter = Chapter 15: Mumps | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/mumps.html | isbn = 978-0-9904491-1-9 | url = https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | access-date = 9 October 2020 | archive-date = 30 December 2016 | archive-url = https://web.archive.org/web/20161230001534/https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | url-status = live }} * {{cite book | publisher = U.S. Centers for Disease Control and Prevention (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | chapter = Chapter 20: Rubella | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/rubella.html | isbn = 978-0-9904491-1-9 | url = https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | access-date = 9 October 2020 | archive-date = 30 December 2016 | archive-url = https://web.archive.org/web/20161230001534/https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | url-status = live }} * {{cite book | publisher = Centers for Disease Control and Prevention (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | chapter = Chapter 22: Varicella | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html | isbn = 978-0-9904491-1-9 | access-date = 9 October 2020 | archive-date = 7 February 2015 | archive-url = https://web.archive.org/web/20150207091230/http://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html | url-status = live }} * {{cite book | chapter = Chapter 7: Measles | chapter-url = https://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html | veditors = Roush SW, Baldy LM, Hall MA | title = Manual for the surveillance of vaccine-preventable diseases | publisher = U.S. Centers for Disease Control and Prevention (CDC) | location = Atlanta GA | url = https://www.cdc.gov/vaccines/pubs/surv-manual/ | date = March 2019 | access-date = 9 October 2020 | archive-date = 1 August 2020 | archive-url = https://web.archive.org/web/20200801192220/https://www.cdc.gov/vaccines/pubs/surv-manual/ | url-status = live }} * {{cite book | chapter = Chapter 9: Mumps | chapter-url = https://www.cdc.gov/vaccines/pubs/surv-manual/chpt09-mumps.html | veditors = Roush SW, Baldy LM, Hall MA | title = Manual for the surveillance of vaccine-preventable diseases | publisher = U.S. Centers for Disease Control and Prevention (CDC) | location = Atlanta GA | url = https://www.cdc.gov/vaccines/pubs/surv-manual/ | date = March 2019 | access-date = 9 October 2020 | archive-date = 1 August 2020 | archive-url = https://web.archive.org/web/20200801192220/https://www.cdc.gov/vaccines/pubs/surv-manual/ | url-status = live }} * {{cite book | chapter = Chapter 14: Rubella | chapter-url = https://www.cdc.gov/vaccines/pubs/surv-manual/chpt14-rubella.html | veditors = Roush SW, Baldy LM, Hall MA | title = Manual for the surveillance of vaccine-preventable diseases | publisher = U.S. Centers for Disease Control and Prevention (CDC) | location = Atlanta GA | url = https://www.cdc.gov/vaccines/pubs/surv-manual/ | date = March 2019 | access-date = 9 October 2020 | archive-date = 1 August 2020 | archive-url = https://web.archive.org/web/20200801192220/https://www.cdc.gov/vaccines/pubs/surv-manual/ | url-status = live }} * {{cite book | chapter = Chapter 17: Varicella | chapter-url = https://www.cdc.gov/vaccines/pubs/surv-manual/chpt17-varicella.html | veditors = Roush SW, Baldy LM, Hall MA | title = Manual for the surveillance of vaccine-preventable diseases | publisher = Centers for Disease Control and Prevention (CDC) | location = Atlanta GA | url = https://www.cdc.gov/vaccines/pubs/surv-manual/ | date = 9 January 2020 | access-date = 9 October 2020 | archive-date = 1 August 2020 | archive-url = https://web.archive.org/web/20200801192220/https://www.cdc.gov/vaccines/pubs/surv-manual/ | url-status = live }} {{refend}}

== External links == * {{cite web | title=MMRV (Measles, Mumps, Rubella & Varicella) Vaccine Information Statement | website=Centers for Disease Control and Prevention (CDC) | date=August 2021 |url=https://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmrv.html }}

{{DEFAULTSORT:Mmrv Vaccine}} Category:Chickenpox Category:Combination vaccines Category:Drugs developed by GSK plc Category:Live vaccines Category:Measles Category:Drugs developed by Merck & Co. Category:Mumps Category:Rubella

MMRV vaccine

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