Mumps primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nate Michalak, B.A.

Overview

Mumps can be prevented with the MMR vaccine. The United States is replacing MMR with the MMRV vaccine, which also protects against chickenpox. A single dose is on average 78% effective at preventing mumps while 2 doses is on average 88% effective. In general all age groups should receive 2 doses of MMR or MMRV vaccine unless an individual has evidence of immunity. The vaccine is contraindicated in pregnant women, individuals with egg or neomycin allergies and immune-compromised or severely immune-suppressed individuals.

Primary Prevention

  • Mumps can be prevented with MMR (measles-mumps-rubella) vaccine.[1]
  • 2 doses of vaccine is 88% (range 66-95%) effective
  • 1 dose of vaccine is 78% (range 49-92%) effective
  • Multiple vaccine strains exist:[2]
  • The Jeryl Lynn strain is most commonly used in developed countries, but has been shown to have reduced efficacy in epidemic situations.
  • The Leningrad-Zagreb strain is commonly used in developing countries, but appears to have superior efficacy in epidemic situations.
  • In the US, MMR is now being supplanted by MMRV, which adds protection against chickenpox.

Vaccine Contraindications

  • Women who are pregnant[3]
  • Women are recommended to avoid pregnancy for 3 months after vaccination
  • Sever egg allergy - children with mild egg allergies can be vaccinated but should be monitored for 20 minutes after receipt
  • Neomycin
  • HIV-positive children who are NOT immunocompromised should still receive MMR vaccination.

CDC Vaccination Recommendations

Children

  • Children should receive 2 doses of MMR vaccine:[1]
  • First dose at 12 - 15 months of age
  • Second dose at 4 - 6 years of age
  • Children can receive the second dose earlier as long as it is at least 28 days after the first dose

Post-High School Students

  • Students at post-high school educational institutions, such as college, trade schools, and training programs, who do not have evidence of immunity (protection) against mumps need two doses of MMR vaccine, separated by at least 28 days.

Adults

  • People who are born during or after 1957 who do not have evidence of immunity against mumps should get at least one dose of MMR vaccine.

International Travelers

  • Children 12 months of age or older should have two doses of MMR vaccine, separated by at least 28 days.
  • Teenagers and adults without evidence of immunity to mumps should have two doses of MMR vaccine, separated by at least 28 days.

Risk for travellers

For non-immune travellers coming from areas without indigenous transmission, the risk of exposure to mumps virus is increased in an environment of insufficient vaccination coverage.

Vaccine

  • Live attenuated vaccine normally in fixed combination with vaccines against rubella and measles, or rubella, measles and varicella.
  • Following primary immunization (2 doses in children aged 1-2 years) protection against mumps is likely to extend into adulthood.

References

  1. 1.0 1.1 Mumps Vaccination. Centers for Disease Control and Prevention (May 29, 2015). http://www.cdc.gov/mumps/vaccination.html Accessed March 15, 2016.
  2. Peltola H, Kulkarni PS, Kapre SV, Paunio M, Jadhav SS, Dhere RM (2007). "Mumps outbreaks in Canada and the United States: Time for new thinking on mumps vaccines". Clin Infect Dis. 45: 459&ndash, 66.
  3. Galazka AM, Robertson SE, Kraigher A (1999). "Mumps and mumps vaccine: a global review". Bull World Health Organ. 77 (1): 3–14. PMC 2557572. PMID 10063655.

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