The CDC is looking for an excuse to "mandate" a 3rd or 4th dose of the MMR vaccine.
College mumps outbreak casts doubt on effectiveness of current 2 shots
By Linda A. Johnson
THE ASSOCIATED PRESS
Most of the college students who got the mumps in a big outbreak in 2006 had received the recommended two vaccine shots, according to a study that raises questions about whether a new vaccine or another booster shot is needed.
The outbreak was the biggest in the United States since shortly before states began requiring a second shot for youngsters in 1990.
Nearly 6,600 people became sick with the mumps, mostly in eight Midwestern states, and the hardest-hit group was college students ages 18 to 24. Of those in that group who knew whether they had been vaccinated, 84 percent had had two mumps shots, according to the study by the Centers for Disease Control and Prevention and state health departments.
That "two-dose vaccine failure" startled public-health experts, who hadn't expected immunity to wane so soon, if at all.
The mumps virus involved was a relatively new strain in the U.S., not the one targeted by the vaccine, although there's evidence from outbreaks elsewhere that the shots work well against the new strain.
The researchers, reporting in today's issue of the New England Journal of Medicine, note that the virus likely came from travelers or students from the United Kingdom, where mumps shots are voluntary and there was a much larger mumps outbreak of the same strain. Many countries don't vaccinate against mumps, so future cases brought from overseas are likely.
"If there's another outbreak, we would evaluate the potential benefit of a third dose to control the outbreak," said researcher Dr. Jane Seward, deputy director of the CDC's viral diseases division.
Mumps is spread by respiratory secretions and saliva among people in close contact, making college students particularly susceptible.
Mumps causes fever and swollen salivary glands in the cheeks. Before the vaccine, complications such as deafness, viral meningitis and testicle inflammation, which can cause sterility, were common, and there were a couple million U.S. cases a year.
Dr. John Bradley, a member of the American Academy of Pediatrics committee on infectious diseases, said his group is talking about possible changes to the vaccine recommendations schedule with CDC and other health agencies. Now two shots are advised, one at 12 to 15 months and the other at age 4 to 6.
On the Net
• American Academy of Pediatrics: www.aap.org
• CDC: www.cdc.gov/ vaccines/default.htm