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© 2006 American Academy of Pediatrics
Outbreak prompts change to recommendations on mumps
A committee of the Centers for Disease Control and Prevention (CDC) has updated its mumps vaccination recommendations in response to the ongoing mumps outbreak in the United States, and the recommendations have been endorsed by the Academy.
The CDC's Advisory Committee on Immunization Practices (ACIP) issued the recommendations in response to the outbreak of mumps involving more than 4,000 people in 12 Midwestern states. A notice of the changes was posted as an MMWR Early Release on June 1.
The new ACIP recommendations endorse the AAP recommendation for routine measles-mumps-rubella (MMR) vaccination at 12 to 15 months and a second dose at 4 to 6 years, and specify that students attending colleges and other post-high school institutions receive two doses of MMR vaccine.
The updated recommendations include four changes to the current policy:
- Evidence of immunity through documentation of adequate vaccination now will be defined as receipt of one dose of a live mumps virus vaccine for preschool-aged children and adults not at high risk and two doses for school-aged children (grades K-12) and for adults at high risk (i.e., persons who work in health care facilities, international travelers and students enrolled in post-high school education institutions). The prior policy considered one dose of mumps virus vaccine satisfactory evidence of immunity for school-aged children and adults at high risk.
- Current recommendations stipulate that health care workers born before 1957 can be assumed to be immune to mumps. Because birth before 1957 is only presumptive evidence of immunity, ACIP now is recommending that "health care facilities should consider recommending a dose of a live mumps virus vaccine for unvaccinated workers born before 1957 who do not have a history of physician-diagnosed mumps or laboratory evidence of mumps immunity."
- During an outbreak, ACIP now is recommending that consideration be given to administering a second dose of a live mumps virus vaccine to children ages 1 to 4 years (with a minimum interval of 28 days between doses) and to adults born in 1957 or later who have received only one dose, including adults who work at schools and post-high school educational institutions affected by the outbreak.
- During an outbreak, ACIP now recommends that two doses of live mumps virus vaccine be provided to unvaccinated workers born before 1957 who do not have a history of physician-documented mumps or laboratory evidence of immunity to mumps.
These updated recommendations are not contrary to current AAP policy. Recommendation #1 confirms that two doses of mumps-containing vaccine must be received to assure acceptable immunity, and recommendation #3 provides guidance for accelerating the usual schedule of vaccination during an outbreak. The other recommendations deal with immunity to mumps in adults.
Additional information can be found in the AAP Red Book: 2006 Report of the Committee on Infectious Diseases.
