The Massachusetts Department of Public Health recently released an “Mumps Advisory” bulletin because of the large outbreak that began in the summer of 2009 and is continuing.

Largely confined to a “tradition-observant Jewish community in New York and New Jersey”, there are now over 2,000 cases reported. Cases are spreading to New England and Canada. The interesting aspect of this is that the majority were immunized with 2 doses of MMR (measles, mumps and rubella) vaccine. The message here is that immunization alone does not necessarily provide protection against mumps.

Of the 7 confirmed cases in Massachusetts in 2008, 6 were due to importation – in people in whom vaccination could not be verified or in those who may have received only one dose of the vaccine.  In 2009, there were 14 confirmed cases nine of which occurred on college campuses. According to the advisory, of the 2 cases confirmed this year along with 2 more probable cases, 1 confirmed and both probable cases were associated with the NY and NJ cases.

Acceptable Evidence of Immunity:

• Children: children get their first dose when they’re a year old with the second dose generally administered just prior to attending school (usually between ages 4-6). The third dose is then administered between the ages of 11-12. There are “catch-up”  schedules printed for older children who have never received the vaccine.
• Adults: All adults require acceptable proof of immunity. For the general public, those born in the US before January 1, 1957 are considered immune with the exception of health care workers who must get lab work to prove their immune status. Two doses of MMR is recommended for everyone born after January 1, 1957 but proof of 1 dose of mumps containing vaccine at age 12 months or older is considered valid.
• For All:  Serologic proof of immunity through vaccine titres (blood samples) that measure your immune response to MMR is proof that your body has developed the appropriate immunity. Keep in mind that one dose of MMR confers immunity on 73%-91% of the time and 2 doses confer immunity between 79% and 95% of the time. So you may have your vaccination records showing that you were immunized but you may not have had a robust response to the vaccine.

High risk groups for getting the infection are:

• health care workers
• international travelers
• college students

If you have any questions, please be sure to speak to your health care provider.

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