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Mumps: a current epidemiologic pattern as a necessary background for the choice of a vaccination strategy
C Zotti1, O Ossola, R Barberis
1Dipartimento di Sanità Pubblica e Microbiologia, Università di Torino, Italy. zotti@molinette.unito.it
Abstract:
Before the measles mumps rubella (MMR) vaccination was widely offered, the epidemiologic data about mumps (morbidity, immunization level, vaccine coverage) were analyzed in Piedmont region (Italy). The disease had a 3- to 5-year epidemic recurrence with morbidity rate between 40 and 150/100,000; the surveillance conducted by 'sentinel' pediatricians showed that the notifications underestimated the real data by about 5- to 7-fold. The 12-year-old subjects showed an immunization level (reached by the disease or the vaccination) of about 50% and their parents tended to refuse the MMR vaccination. Only 54% of the 3- to 5-year-old children received the MMR vaccine in the second year of life and the frequency of the vaccination failure was about 10%. The strategy of vaccination should take into account this epidemiologic pattern, to program an offer adequate to reach mumps control/elimination; the strategy of our region should include the active offer in the second year of life to reach higher coverage, a second offer at 4-6 and/or 12 years of life, when other vaccinations are given and the choice of a highly efficacious vaccine. The improvement of the notification system could also allow a more sensitive surveillance of epidemiologic patterns.
Insights
Mumps outbreaks occurred every 3-5 years before widespread MMR vaccination. Low vaccine coverage and parental refusal necessitate improved vaccination strategies for mumps control.
Area of Science:
- Epidemiology
- Public Health
- Vaccinology
Background:
- Mumps exhibited 3-5 year epidemic cycles with significant morbidity before widespread measles, mumps, and rubella (MMR) vaccination.
- Surveillance data from sentinel pediatricians indicated that reported mumps cases were underestimated by 5-7 fold.
Purpose of the Study:
- To analyze the epidemiologic data of mumps, including morbidity, immunization levels, and vaccine coverage in the Piedmont region (Italy) before widespread MMR vaccination.
- To inform vaccination strategies for effective mumps control and potential elimination.
Main Methods:
- Analysis of historical epidemiologic data on mumps incidence and recurrence.
- Assessment of immunization levels in 12-year-olds and vaccine coverage in 3-5 year olds.
- Evaluation of vaccination failure rates.
Main Results:
- Mumps showed epidemic recurrence every 3-5 years with morbidity rates of 40-150/100,000.
- Only 54% of children aged 3-5 received the MMR vaccine in their second year of life, with a 10% vaccination failure rate.
- Immunization levels in 12-year-olds reached approximately 50%, with parental refusal of MMR vaccination noted.
Conclusions:
- The existing epidemiologic pattern necessitates an active vaccination strategy, including offers in the second year of life and booster doses at 4-6 and/or 12 years.
- Utilizing a highly efficacious vaccine and improving the notification system are crucial for enhanced mumps surveillance and control.
- Regional vaccination strategies must adapt to achieve higher coverage rates for mumps control and elimination.