New CDC recommendations will raise questions about when to give a booster dose of a mumps vaccine (MMR, etc).
Almost 6,000 patients had mumps in the U.S. in 2017...possibly putting them at risk for hearing loss, meningitis, and encephalitis.
Risk seems higher in people living in close-knit settings such as college dorms...even if they had the 2-dose MMR series as a child. Immunity seems to be waning...plus some kids aren't getting immunized.
Now CDC recommends a booster dose of mumps vaccine in an outbreak.
But don't give boosters until your health dept identifies target groups. It's too soon to say if routine boosters will limit outbreaks.
Stay tuned for communication from your health department or check their website. To get alerts automatically, sign up for your state's Health Alert Network (HAN).
If booster immunizations are recommended during an outbreak, give a single MMR dose to patients who've previously had one or 2 doses. Give a second dose at least 4 weeks later to complete the series if patients have never had the vaccine...or vaccine history is unknown.
But don't give MMR to immunocompromised patients...since it's a live vaccine. If needed, vaccinate household contacts of these patients.
Also avoid MMR during pregnancy...and advise women not to become pregnant for 4 weeks after MMR vaccination. The vaccine's live rubella virus could theoretically lead to birth defects.
Don't rely on mumps antibody titers to determine whether patients are protected...it's too soon to say what level provides immunity.
- MMWR Morb Mortal Wkly Rep 2018;67(1):33-8
- MMWR Recomm Rep 2013;62(RR-04):1-34
- N Engl J Med 2017;377(10):947-56