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Aseptic meningitis as a complication of mumps vaccination
Abstract:
In 1989 a nationwide surveillance of neurologic complications after the administration of mumps vaccine was conducted in Japan, based on the notification of cases and the testing of mumps viruses isolated from cerebrospinal fluid for their relatedness to the vaccine by nucleotide sequence analysis. Among 630,157 recipients of measles-mumps-rubella trivalent (MMR) vaccine containing the Urabe Am9 mumps vaccine, there were at least 311 meningitis cases suspected to be vaccine-related. In 96 of these 311 cases, mumps virus related to the vaccine was isolated from cerebrospinal fluid. The unusually high incidence may have been partly a result of the adverse media publicity of the problem at the time of surveillance. We analyzed clinical features of 165 and 27 laboratory-confirmed mumps vaccine-related meningitis cases that occurred among the recipients of MMR and monovalent mumps vaccines, respectively, during a 1-year period after the introduction of MMR vaccine. The incidence of vaccine-related meningitis was similar among the recipients of MMR and monovalent Urabe Am9 mumps vaccines. Meningitis was generally mild and there were no sequelae from the illness. The complication was more frequent among male than among female children.
Insights
A 1989 Japanese study found mumps vaccine-related meningitis in 311 cases, with 96 confirmed by virus analysis. Most cases were mild, with no long-term effects, and occurred more in males.
Area of Science:
- Neurology
- Vaccinology
- Virology
Background:
- A nationwide surveillance was conducted in Japan in 1989 to investigate neurologic complications following mumps vaccination.
- The surveillance focused on meningitis cases suspected to be vaccine-related after the administration of the Urabe Am9 mumps vaccine, included in the measles-mumps-rubella (MMR) vaccine.
Purpose of the Study:
- To analyze the clinical features of mumps vaccine-related meningitis.
- To determine the incidence and characteristics of meningitis following MMR and monovalent mumps vaccine administration.
Main Methods:
- Nationwide case notification and laboratory testing of mumps viruses from cerebrospinal fluid.
- Nucleotide sequence analysis to confirm vaccine virus relatedness.
- Clinical data analysis of confirmed meningitis cases.
Main Results:
- Out of 630,157 MMR vaccine recipients, 311 suspected meningitis cases were reported, with 96 confirmed by mumps virus isolation related to the vaccine.
- The incidence of vaccine-related meningitis was similar for both MMR and monovalent Urabe Am9 mumps vaccines.
- Meningitis cases were generally mild, with no reported sequelae, and were more frequent in male children.
Conclusions:
- Mumps vaccine-related meningitis is a rare complication.
- The complication is typically mild and self-limiting.
- Further research into vaccine safety and public health communication is warranted.