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Assessment of mumps-containing vaccine effectiveness during an outbreak: Importance to introduce the 2-dose schedule

Chao Ma1, Yan Liu2,3, Jihai Tang4

  • 1a Department of National Immunization Program , Chinese Center for Disease Control and Prevention , Beijing , China.

Human Vaccines & Immunotherapeutics
|January 30, 2018
PubMed
Abstract

Insights

Mumps vaccine effectiveness (MuCV) in China is declining, especially with one dose. A two-dose measles-mumps-rubella (MMR) vaccine schedule may be necessary for better mumps control.

Area of Science:

  • Epidemiology
  • Vaccinology

Background:

  • China has utilized various mumps-containing vaccines (MuCV) since 1990, including monovalent, measles-mumps (MM), and measles-mumps-rubella (MMR) vaccines.
  • The Expanded Program on Immunization (EPI) in China has included a single dose of MuCV (MMR) since 2007, raising concerns about effectiveness due to large-scale mumps outbreaks.

Purpose of the Study:

  • To assess the vaccine effectiveness (VE) of different MuCVs during a 2015 mumps outbreak in a primary school.
  • To compare the VE of monovalent mumps vaccine, MM vaccine, and MMR vaccine based on vaccination history and timing.

Main Methods:

  • A retrospective cohort study was conducted involving 2370 students, with 1908 included for MuCV VE assessment.
  • Vaccination histories and clinical data were collected from records and logs; parental questionnaires confirmed illnesses and attack rates (AR).
  • Vaccine effectiveness was calculated using the formula: VE = (AR in unvaccinated - AR in vaccinated) / (AR in unvaccinated).

Main Results:

  • Out of 2370 students, 283 had clinical mumps. The attack rate was 17.5% in unvaccinated, 10.6% in one-dose, and 9.9% in two-dose MuCV recipients.
  • Overall VE was 40% for one dose and 44% for two doses.
  • MMR vaccine showed higher VE (60%) compared to monovalent mumps vaccine (22%) and MM vaccine (2%), with effectiveness decreasing significantly more than 5 years post-vaccination.

Conclusions:

  • The 2015 mumps outbreak highlighted low and declining one-dose MuCV effectiveness.
  • China's immunization program should consider adopting a two-dose MMR schedule to enhance mumps control and improve population immunity.
Keywords:
ChinaMumpseffectivenessschedulevaccine

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