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Mumps in Vaccinated Children and Adolescents: 2007-2019
Leah Shepersky1, Mona Marin1, John Zhang1
1Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Insights
Most US pediatric mumps cases involve vaccinated children, highlighting the need for continued vigilance. Suspect mumps in all patients, even if vaccinated, due to ongoing outbreaks.
Area of Science:
- Epidemiology
- Vaccinology
Background:
- Mumps cases significantly decreased post-1967 vaccine introduction.
- Outbreaks persist in vaccinated populations, particularly in schools, since 2006.
Purpose of the Study:
- Analyze pediatric mumps cases in the US from 2007-2019.
- Describe characteristics of cases during the 2015-2019 resurgence.
Main Methods:
- Utilized National Notifiable Diseases Surveillance System data.
- Examined incidence and vaccination status of pediatric mumps cases.
- Described demographic, clinical, and vaccination data.
Main Results:
- Pediatric cases comprised 32% of total mumps cases (2007-2019).
- 87% of pediatric cases had received at least one measles, mumps, and rubella (MMR) vaccine dose.
- Most cases were not linked to international travel; complications and hospitalizations were low.
Conclusions:
- One-third of US mumps cases since 2007 were in children and adolescents, mostly vaccinated.
- Clinicians must consider mumps in parotitis cases regardless of vaccination status or travel history.
Background:
Despite a >99% reduction in US mumps cases after the introduction of mumps vaccine in 1967, outbreaks have occurred in schools and other settings involving vaccinated children and adolescents since 2006.
Methods:
We analyzed mumps cases reported by US health departments to the National Notifiable Diseases Surveillance System. We present the incidence and vaccination status of pediatric cases (age <18 years) during 2007-2019 and describe demographic, clinical, and vaccination characteristics of pediatric cases reported during the most recent resurgence in 2015-2019.
Results:
During 2007-2019, 9172 pediatric cases were reported, accounting for a median of 32% of all cases reported each year (range: 13%-59%). A median of 87% (range: 81%-94%) of pediatric patients each year had previously received ≥1 measles, mumps, and rubella (MMR) vaccine dose. During 2015-2019, of 5461 pediatric cases reported, only 2% of those with known import status (74%) were associated with international travel. One percent of patients had complications and 2% were hospitalized. Among patients aged ≥1 year with known vaccination status (72%), 74% of 1- to 4-year-olds had received ≥1 MMR dose and 86% of 5- to 17-year-olds had received ≥2 MMR doses. Since 2016, pediatric mumps cases have been reported in most US states each year (range: 38-45 states).
Conclusions:
Since 2007, one-third of US reported mumps cases occurred in children and adolescents, the majority of whom were vaccinated. Clinicians should suspect mumps in patients with parotitis or mumps complications, regardless of age, travel history, and vaccination status.
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