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Mumps-containing vaccine effectiveness during outbreaks in two schools in Guangdong, China, 2012
Wang Man1, Zhao Jin-Kou, Wang Tao
1Chinese Field Epidemiology Training Programme, Beijing, China . ; Zhongshan Municipal Center for Disease Control and Prevention, Zhongshan, China .
Introduction:
Mumps-containing vaccine was licensed in the 1990s in China with a single dose administered routinely to children aged 18-24 months since 2008. However, an increase in reported mumps cases during the period 2009 to 2012 casts doubt on the effectiveness of a single-dose mumps vaccination. In March 2012, large numbers of mumps cases in a day-care centre and primary school in Guangdong Province were investigated to estimate the effectiveness of mumps-containing vaccine.
Methods:
A mumps case was defined as a case with acute onset of unilateral or bilateral swelling of the parotid gland or other salivary glands. Clinical data were collected among students and staff members in the two schools from 6 February to 3 June 2012. Vaccination history was obtained from immunization certificates. Vaccine effectiveness (VE) was calculated among children in classes that had more than two mumps cases.
Results:
The cohort included 369 children from seven classes, four from the day-care centre and three from the primary school. Vaccination certificates available for 347 children showed immunization coverage of 82% (285/347). The overall attack rate was 14.6% (54/369); the VE for a single dose of mumps vaccine was 65% (95% confidence interval [CI]: 19%-85%) when given within three years and 15% (95% CI: -2%-52%) when given three to six years before the outbreak. For two doses of vaccine the VE was 53% (95% CI: -15-80%).
Discussion:
A single dose of mumps-containing vaccine was not effective to prevent these outbreaks among preschool and schoolchildren. A second dose of mumps-containing vaccine to four to five-year-old children should be considered in China.
Insights
A single dose of mumps vaccine was not effective in preventing outbreaks in China. A second dose for young children should be considered to improve mumps control.
Area of Science:
- Epidemiology
- Vaccinology
- Public Health
Background:
- Mumps vaccination in China began in the 1990s, with a single dose recommended for children 18-24 months old since 2008.
- An increase in mumps cases from 2009-2012 raised concerns about the single-dose vaccine's effectiveness.
- An investigation in Guangdong Province in 2012 assessed mumps vaccine effectiveness during an outbreak.
Purpose of the Study:
- To estimate the vaccine effectiveness (VE) of the mumps-containing vaccine in China.
- To evaluate the impact of single-dose mumps vaccination on outbreak control.
- To inform vaccination policy regarding mumps prevention.
Main Methods:
- A case definition for mumps was established based on salivary gland swelling.
- Clinical data and vaccination histories were collected from students and staff in affected schools.
- Vaccine effectiveness was calculated using data from children in classes with multiple mumps cases.
Main Results:
- The study included 369 children, with 82% immunization coverage.
- The overall attack rate for mumps was 14.6%.
- Single-dose mumps vaccine effectiveness was 65% within three years and 15% at three to six years prior to the outbreak. Two-dose VE was 53%.
Conclusions:
- A single dose of the mumps vaccine demonstrated low effectiveness in preventing outbreaks among preschool and school-aged children.
- The findings suggest that a single-dose strategy is insufficient for controlling mumps.
- Implementing a second dose of the mumps vaccine for four to five-year-old children is recommended for improved public health outcomes in China.
