Mumps outbreak, 2006: 84% of cases double-vaxed

[Guest guest]

Could this be an example of hypervaccinated people demonstrating

inadaquate antibody response to vaccines? Or just a general

reflection of how useless these shots can be? I don't understand why

they're saying that, on the one hand, the vax was ineffective against

a new strain yet, on the other, the vax proved effective in states

which didn't have an outbreak. Call me stupid but, uh, how's that

work?

http://news./s/ap/20080409/ap_on_he_me/mumps_vaccine

By LINDA A. JOHNSON, Associated Press Writer

49 minutes ago

Most of the college students who got the mumps in a big outbreak in

2006 had received the recommended two vaccine shots, according to a

study that raises questions about whether a new vaccine or another

booster shot is needed. The outbreak was the biggest in the U.S.

since shortly before states began requiring a second shot for

youngsters in 1990.

Nearly 6,600 people became sick with the mumps, mostly in eight

Midwest states, and the hardest-hit group was college students ages

18 to 24. Of those in that group who knew whether they had been

vaccinated, 84 percent had had two mumps shots, according to the

study by the Centers for Disease Control and Prevention and state

health departments.

That " two-dose vaccine failure " startled public health experts, who

hadn't expected immunity to wane so soon — if at all.

The mumps virus involved was a relatively new strain in the U.S., not

the one targeted by the vaccine, although there's evidence from

outbreaks elsewhere the shots work well against the new strain.

The researchers, reporting in Thursday's New England Journal of

Medicine, note the virus likely came from travelers or students from

the United Kingdom, where mumps shots are voluntary and there was a

much larger mumps outbreak of the same strain. Many countries don't

vaccinate against mumps, so future cases brought from overseas are

likely.

" If there's another outbreak, we would evaluate the potential benefit

of a third dose to control the outbreak, " said researcher Dr. Jane

Seward, deputy director of the CDC's viral diseases division.

Mumps is spread by respiratory secretions and saliva among people in

close contact, making college students particularly susceptible.

Students' sharing of drinks and utensils, and sexual activity,

probably increased their exposure.

Mumps causes fever and swollen salivary glands in the cheeks. Before

the vaccine, complications such as deafness, viral meningitis and

testicle inflammation, which can cause sterility, were common and

there were a couple million U.S. cases a year.

The only U.S. vaccine, made by Whitehouse Station, N.J.-based Merck &

Co., hasn't been changed since its introduction in 1967 and there are

no plans to change it, said Barbara Kuter, Merck's executive director

of pediatric affairs.

Over 500 million doses have been sold since the 1970s, when it was

put in the combination measles-mumps-rubella shot.

Dr. Bradley, a member of the American Academy of Pediatrics

committee on infectious diseases, said his group is talking about

possible changes to the vaccine recommendations schedule with CDC and

other health agencies.

Now two shots are recommended, one at 12 to 15 months and the other

at age 4 to 6.

It might not be cost effective to give everyone a third shot, but it

should be considered for college students, said Dr. Marcella,

an epidemiologist at University of Medicine and Dentistry of New

Jersey's School of Public Health.

Dr. Schaffner, head of preventive medicine at Vanderbilt

University School of Medicine, said what's need is a longer-lasting

shot.

" It's clear that over time, immunity wanes somewhat, " he said. " We

need a better vaccine. "

Seward said other CDC studies on the 2006 outbreak found two mumps

shots protected about 85 percent of people from the new strain — not

quite enough to prevent spread even with the nearly 90 percent

vaccination rate at the time.

The outbreak was in Illinois, Iowa, Kansas, Minnesota, Missouri,

Nebraska, South Dakota and Wisconsin.