Chao Ma1, Yan Liu2,3, Jihai Tang4, Haimei Jia3,5, Wei Qin6, Ying Su4, Huaqing Wang1, Lixin Hao1. 1. a Department of National Immunization Program , Chinese Center for Disease Control and Prevention , Beijing , China. 2. b Department of Expanded Program on Immunization , Hangzhou Center for Disease Control and Prevention , Hangzhou , China. 3. c Chinese Epidemiology Training Program, Chinese Center for Disease Control and Prevention , Beijing , China. 4. d Department of Expanded Program on Immunization , Anhui Center for Disease Control and Prevention , Hefei , China. 5. e Department of Expanded Program on Immunization , Fuzhou Center for Disease Control and Prevention , Fuzhou , China. 6. f Department of Expanded Program on Immunization , Lu'an Center for Disease Control and Prevention , Lu'an , China.
Abstract
INTRODUCTION: China has used 3 different mumps-containing vaccines (MuCV) since 1990: monovalent mumps vaccine, measles-mumps (MM) vaccine, and measles-mumps-rubella (MMR) vaccine, and one dose MuCV (using MMR at 18 months) has been included in the EPI since 2007. MuCV effectiveness has been of concern following large-scale mumps outbreaks. In 2015, an outbreak of mumps occurred in a primary school, which allow us assess vaccine effectiveness of different MuCVs. METHOD: All children in the school were studied as a retrospective cohort. Vaccination histories and case information were obtained from vaccination records and clinic/hospital logs. Parental questionnaires were used to confirm students' illnesses and calculate attack rate (AR). VE was assessed using the formula, VE = (AR in unvaccinated students- AR in the vaccinated students) / (AR in unvaccinated students). VEs of different type of MuCV were compared. RESULTS: In total, 283 students were identified as clinical mumps among the 2370 students, and 1908 students were included for MuCV VE assessment. 213 (including 21 [8.9%] patients) were 2-dose MuCV recipients (AR: 9.9%), 1165 (including 123 [51.9%] patients) were 1-dose recipients (AR: 10.6%), and 530 (including 93 [39.2%] patients) were unvaccinated (AR: 17.5%). VE was 44% for 2 doses and 40% for one dose. For one-MuCV-dose students, estimated mumps VE was 63% for vaccinated within 3 years (between vaccination and this outbreak); 50% for vaccinated within 3 to 5 years; and 34% for vaccinated more than 5 years. Comparing VE by vaccine type and 5-year interval since vaccination, VE for MMR was 60%, which was consistently higher than VE for monovalent mumps vaccine (22%) and MM (2%). CONCLUSION: This outbreak was associated with low and declining 1-dose MuCV effectiveness. China's immunization program should evaluate the potential of a 2-dose MMR schedule to adequately control mumps.
INTRODUCTION: China has used 3 different mumps-containing vaccines (MuCV) since 1990: monovalent mumps vaccine, measles-mumps (MM) vaccine, and measles-mumps-rubella (MMR) vaccine, and one dose MuCV (using MMR at 18 months) has been included in the EPI since 2007. MuCV effectiveness has been of concern following large-scale mumps outbreaks. In 2015, an outbreak of mumps occurred in a primary school, which allow us assess vaccine effectiveness of different MuCVs. METHOD: All children in the school were studied as a retrospective cohort. Vaccination histories and case information were obtained from vaccination records and clinic/hospital logs. Parental questionnaires were used to confirm students' illnesses and calculate attack rate (AR). VE was assessed using the formula, VE = (AR in unvaccinated students- AR in the vaccinated students) / (AR in unvaccinated students). VEs of different type of MuCV were compared. RESULTS: In total, 283 students were identified as clinical mumps among the 2370 students, and 1908 students were included for MuCV VE assessment. 213 (including 21 [8.9%] patients) were 2-dose MuCV recipients (AR: 9.9%), 1165 (including 123 [51.9%] patients) were 1-dose recipients (AR: 10.6%), and 530 (including 93 [39.2%] patients) were unvaccinated (AR: 17.5%). VE was 44% for 2 doses and 40% for one dose. For one-MuCV-dose students, estimated mumps VE was 63% for vaccinated within 3 years (between vaccination and this outbreak); 50% for vaccinated within 3 to 5 years; and 34% for vaccinated more than 5 years. Comparing VE by vaccine type and 5-year interval since vaccination, VE for MMR was 60%, which was consistently higher than VE for monovalent mumps vaccine (22%) and MM (2%). CONCLUSION: This outbreak was associated with low and declining 1-dose MuCV effectiveness. China's immunization program should evaluate the potential of a 2-dose MMR schedule to adequately control mumps.
Authors: Gustavo H Dayan; M Patricia Quinlisk; Amy A Parker; Albert E Barskey; Meghan L Harris; Jennifer M Hill Schwartz; Kae Hunt; Carol G Finley; Dennis P Leschinsky; Anne L O'Keefe; Joshua Clayton; Lon K Kightlinger; Eden G Dietle; Jeffrey Berg; Cynthia L Kenyon; Susan T Goldstein; Shannon K Stokley; Susan B Redd; Paul A Rota; Jennifer Rota; Daoling Bi; Sandra W Roush; Carolyn B Bridges; Tammy A Santibanez; Umesh Parashar; William J Bellini; Jane F Seward Journal: N Engl J Med Date: 2008-04-10 Impact factor: 91.245