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Waning immunity against mumps in vaccinated young adults, France 2013
Sabine Vygen1, Aurélie Fischer, Laure Meurice
1French Institute for Public Health Surveillance (InVS), Department of Coordination of Alerts and Regions (DCAR), Regional office in Aquitaine.
Abstract:
In 2013, 15 clusters of mumps were notified in France; 72% (82/114) of the cases had been vaccinated twice with measles-mumps-rubella vaccine. To determine whether the risk of mumps increased with time since the last vaccination, we conducted a case-control study among clusters in universities and military barracks. A confirmed case had an inflammation of a salivary gland plus laboratory confirmation in 2013. A probable case presented with inflammation of a salivary gland in 2013 either lasting for > 2 days or with epidemiological link to a confirmed case. Controls had no mumps symptoms and attended the same university course, student party or military barracks. We collected clinical and vaccination data via web questionnaire and medical records. We calculated adjusted odds ratios (aOR) using logistic regression. 59% (50/85) of cases and 62% (199/321) of controls had been vaccinated twice. The odds of mumps increased for twice-vaccinated individuals by 10% for every year that had passed since the second dose (aOR 1.10; 95% confidence interval (CI): 1.02-1.19; p = 0.02). Mumps immunity waned with increasing time since vaccination. Our findings contributed to the French High Council of Public Health's decision to recommend a third MMR dose during outbreaks for individuals whose second dose dates > 10 years.
Insights
Mumps outbreaks in France show that immunity wanes over time, even after two measles-mumps-rubella (MMR) vaccine doses. The risk of mumps increases annually after the second MMR dose, highlighting the need for booster shots.
Area of Science:
- Epidemiology
- Immunology
- Public Health
Background:
- Mumps outbreaks occurred in France in 2013, with a high percentage of cases vaccinated twice with the measles-mumps-rubella (MMR) vaccine.
- This suggests potential waning immunity or vaccine ineffectiveness in certain populations.
Purpose of the Study:
- To investigate the relationship between the time elapsed since the last measles-mumps-rubella (MMR) vaccination and the risk of mumps infection.
- To inform public health recommendations regarding mumps vaccination strategies.
Main Methods:
- A case-control study was conducted within mumps clusters in French universities and military barracks.
- Data on clinical symptoms and vaccination history (including dates) were collected via web questionnaires and medical records.
- Logistic regression analysis was used to calculate adjusted odds ratios (aOR) for mumps risk based on time since vaccination.
Main Results:
- Among twice-vaccinated individuals, the odds of contracting mumps increased by 10% for each year since the second measles-mumps-rubella (MMR) vaccine dose (aOR 1.10; 95% CI: 1.02–1.19; p=0.02).
- This indicates a significant waning of immunity over time post-vaccination.
- The findings were instrumental in the French High Council of Public Health's recommendation for a third MMR dose during outbreaks for those vaccinated over 10 years prior.
Conclusions:
- Waning immunity following the standard two-dose measles-mumps-rubella (MMR) vaccination schedule is a significant factor in mumps outbreaks.
- Increased time since the second MMR dose is associated with a higher risk of mumps infection.
- Public health strategies may need to incorporate booster MMR vaccinations to maintain population immunity, especially during outbreaks.
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