Tag: duration of protection

Does Your Child with Parotitis Have Mumps?

Even though they might never have had or seen a kid with mumps, most people know the tell-tale signs and symptoms.

Classically, mumps is associated with parotitis, with swelling of the salivary glands.
Classically, mumps is associated with parotitis, with swelling of the salivary glands.

But mumps isn’t the only thing that causes parotitis, especially in the post-vaccine era.

Does Your Child with Parotitis Have Mumps?

So having parotitis doesn’t automatically mean that you have mumps.

“Mumps is diagnosed by a combination of symptoms and physical signs and laboratory confirmation of the virus, as not all cases develop characteristic parotitis and not all cases of parotitis are caused by mumps.”

Mumps Questions and Answers

What else can cause parotitis?

  • bacterial infections, including Staphylococcus aureus, especially when the swelling is just on one side of the child’s face
  • blockage of the salivary gland because of a stone in the duct that drains the glands (sialadenitis), again, would be more common on just one side of the child’s face
  • viral infections, including adenovirus, Epstein-Barr virus (EBV), CMV, coxsackie A virus, HHV-6, influenza A, parainfluenza virus types 1, 2 and 3, and echovirus
  • less common causes in children might include medications, benign and malignant tumors, and immunologic diseases

So how do you know if your child with parotitis has the mumps or some other infection or condition?

“Mumps infection is most often confused with swelling of the lymph nodes of the neck. Lymph node swelling can be differentiated by the well-defined borders of the lymph nodes, their location behind the angle of the jawbone, and lack of the ear protrusion or obscuring of the angle of the jaw, which are characteristics of mumps.”

Mumps for Healthcare Providers

There are an increasing number of mumps outbreaks being reported these days and many cases are in vaccinated teens, so it might be easy to just say it is the mumps and recommend that you wait it out, as there is no treatment for the mumps or most other viral infections.

The only problem with that strategy is that if your child has a bacterial infection that is causing their parotitis, then they will likely need antibiotics. Some even go on to develop abscesses that need to be drained. Getting diagnosed with mumps might delay their treatment. And kids with mumps get quarantined far longer than kids with other viral infections.

Fortunately, testing is available, either a real-time RT-PCR (rRT-PCR) or mumps virus culture from a parotid duct swab. You can also do titer testing, although testing for the mumps virus is considered to be more accurate.

So does your child with parotitis have mumps?

They likely do if they have acute parotitis lasting at least 2 days, and either:

  • a positive test for serum anti-mumps immunoglobulin M (IgM) antibody,
  • a positive test for mumps virus with  the reverse transcription polymerase chain reaction (RT-PCR) test or culture
  • a link or exposure to someone else with mumps

Of course, there are other signs and symptoms of mumps besides parotitis. In fact, instead of the parotid gland, your child with mumps could have swelling of other salivary glands, like their sublingual or submandibular gland.

Confusing things, some kids with mumps do have parotitis on just one side of their face, or one side swells before the other. So you can’t say it isn’t mumps just because it is one side. And some kids with mumps never even develop parotitis, but may still have other symptoms and go on to develop complications of mumps.

“CDC recommends that a buccal or oral swab specimen and a blood specimen be collected from all patients with clinical features compatible with mumps.”

CDC on Collecting and Shipping Specimens for Suspected Mumps Cases

Still, many recent studies have confirmed few actual cases of mumps among kids with parotitis, especially among sporadic, non-outbreak cases. That makes it important to actually confirm that a child has mumps if you are going to diagnosis them with mumps.

And get your kids vaccinated and protected. The mumps vaccine isn’t perfect, but you are still much more likely to get mumps if you are unvaccinated.

What to Know About Mumps and Parotitis

While most kids with mumps have parotitis, not everyone with parotitis will have mumps, as there are many other things that cause pain and swelling of the parotid glands.

More on Mumps and Parotitis

Why Do Some Vaccines Need Boosters?

Vaccines work.

They aren’t perfect though, which is why some vaccines need booster doses to help them provide long lasting protection.

Why Do Some Vaccines Need Boosters?

To be clear, just because you get more than one dose of a vaccine, that doesn’t make it a booster dose.

For example, infants get multiple doses of the DTaP, polio, Hib, hepatitis B, Prevnar, and rotavirus vaccines, but those are part of the primary series for those vaccines. They aren’t boosters.

“A “classical” prime-boost immunization schedule is, thus, to allow 4 to 6 months to elapse between priming and booster doses, hence the generic “0-1-6 month” (prime-prime-boost) schedule. Secondary antigen exposure thus results in the production of higher-affinity antibodies than primary responses.”

Plotkin’s Vaccines (Seventh Edition)

Getting the booster shot in a vaccine series is important to get full protection.
Getting the booster dose in a vaccine series is important to get full protection.

Classic booster doses are the:

But why do we need these booster doses?

While one or more doses of the primary series of the vaccine leads to the production of plasma cells and protective antibodies, the booster dose then causes a secondary immune response and the production of more long-lived plasma cells. That’s how we get higher levels of protective antibodies that will last longer.

Which Vaccines Don’t Need Boosters?

In general, live vaccines don’t need booster doses.

So why do we get a second dose of MMR?

This isn’t a classic booster dose. It protects the small percentage of people who don’t respond to the first dose.

Some folks may need a booster dose of the MMR vaccine in certain circumstances though, specifically if they are caught up in a mumps outbreak.

What to Know About Vaccine Booster Doses

Some vaccines need booster doses to help you get full protection. Don’t skip them.

More on Vaccine Booster Doses

Myths About the Yellow Fever Vaccine

Endemic yellow fever was eliminated in the United States in 1905, way before the first yellow fever vaccine was developed (1935) and licensed (1953).

How did that work?

Yellow fever is a now vaccine preventable disease that is spread by mosquito bites.

In the United States, it was actually eliminated by controlling the Aedes aegypti mosquitoes that spread the yellow fever virus before the vaccine was even developed. These control efforts were also done in Cuba, Panama, and Ecuador, etc., places where yellow fever was common and led to outbreaks in the United States.

Why Haven’t We Eradicated Yellow Fever?

So why is yellow fever still a problem if we can control the the Aedes aegypti mosquitoes that carry the yellow fever virus?

“Mosquitoes breed in tropical rainforests, humid, and semi-humid environments, as well as around bodies of still water in and close to human habitations in urban settings. Increased contact between humans and infected mosquitoes, particularly in urban areas where people have not been vaccinated for yellow fever, can create epidemics.”

Yellow fever: Questions and Answers

It’s because we can control the mosquitoes in urban areas, in and around cities. You can’t really control or eliminate mosquitoes in tropical rain forest regions, which is why it is difficult to eradicate yellow fever, malaria, dengue fever, and other mosquito borne diseases.

But we have a vaccine, don’t we?

“Eradication of yellow fever is not feasible since we are unable to control the virus in the natural animal hosts.”

Yellow fever: Questions and Answers

Unfortunately, we aren’t the only ones who can become infected with yellow fever. Monkeys get infected with the yellow fever virus in rain forests, infect Haemagogus and Sabethes mosquitoes, which bite people in those areas.

“Urban transmission of yellow fever virus occurs when the virus is spread from human to human by the Aedes aegypti mosquitoes.”

Yellow fever – Brazil

That likely means that yellow fever will never be completely eradicated, unlike small pox.

Yellow Fever Vaccines Myths

But just because yellow fever can’t be eradicated doesn’t mean that it can’t be eliminated.

A single dose of the yellow fever vaccine is safe and provides life-long protection for 99% of people.

“Vaccination is the most powerful known measure for yellow fever prevention: a single dose can provide life-long immunity at a cost of approximately US$1.”

WHO on Eliminating Yellow Fever Epidemics (EYE) Strategy: Meeting demand for yellow fever vaccines

And as cases of yellow fever increase in some countries, like Brazil, getting more people vaccinated is the only way to stop this deadly disease.

People line up to get a yellow fever vaccine near Kinshasa.
People line up to get a yellow fever vaccine near Kinshasa. Photo by WHO/E. Soteras Jalil

Tragically, anti-vaccination myths and misinformation may be keeping folks from getting vaccinated and protected. Propaganda and anti-vaccine scare videos have them thinking that the yellow fever vaccine is dangerous, part of a conspiracy to depopulate the world, or that it doesn’t work.

It is also important to know that:

  • When traveling to or from some countries, a yellow fever vaccine isn’t enough – you need an International Certificate of Vaccination proving that you were vaccinated.

    You should not skip getting the yellow fever vaccine if you are traveling to an area where yellow fever is endemic, including many parts of areas of Africa and South America.

  • While you are most at risk during the rainy season, especially during outbreaks, it is also possible to get yellow fever during the dry season.
  • Yellow fever is a serious, life-threatening disease.
  • There is no cure for yellow fever.
  • While serious side effects to the yellow fever vaccine have been reported, including anaphylaxis, yellow fever vaccine-associated neurologic disease (YEL-AND), and yellow fever vaccine-associated viscerotropic disease (YEL-AVD), they are very rare.
  • The yellow fever vaccine is a live virus vaccine, but shedding is not an issue. Unless at a high risk of exposure, getting the yellow fever vaccine is usually not recommended if you are pregnant or breastfeeding though.
  • It is not usually necessary to get a booster dose of the yellow fever vaccine.
  • Some countries require proof of yellow fever vaccination if you have traveled from a country where there is still a risk of getting yellow fever, so that you don’t import yellow fever into their country.

As yellow fever cases are on the rise in Brazil, with an associated increase in travel associated cases, it is important that everyone understand that vaccines are safe and necessary.

What to Know About Yellow Fever Vaccine Myths

Yellow fever cases are increasing and so are anti-vaccine myths about the yellow fever vaccine, which are keeping some folks from getting vaccinated and protected, even as they are threatened by a potential outbreak.

More on Yellow Fever Vaccines Myths

Is the HPV Vaccine a Savior or the Most Dangerous Vaccine Ever Made?

I’m still surprised at the responses some parents have when I mention that it is time for their kids to get their HPV vaccine.

Despite what you might read on the Internet, the HPV vaccines are safe and necessary.
Despite what you might read on the Internet, the HPV vaccines are safe and necessary.

While most say things like, “good, I was wondering when they would start it,” a minority still use arguments that could come straight off of any anti-vaccine website or forum.

Is the HPV Vaccine Dangerous?

The HPV isn’t dangerous, but it is easy to see why some parents still think that it is.

How many myths about the HPV vaccine have you heard?

“I don’t like this vaccine… Heaven help us if we have a generation of kids who get a hepatitis B vaccine and a HPV vaccine and they think that now unprotected sex is okay…

I don’t think it is really clear that this vaccine is really as safe as they say it is and it is certainly not as dangerous as they say it is, but I recommend against it in my practice.”

Dr. Jay Gordon discussing the HPV vaccine on the Ricki Lake Show

You can rest assured that they aren’t true.

Deciding to Get an HPV Vaccine

The HPV vaccines are well studied and in continuing studies have only been found to cause mild side effects, just like most other vaccines.

Still undecided?

“The manufacturers of Cervarix and Gardasil are following patients in Scandinavia for at least 15 years to verify that protection from both vaccines lasts at least that long.”

National Cancer Institute on HPV Vaccines

Parents who are still hesitant should know that:

  • Gardasil, the first HPV vaccine, was approved by the FDA in 2006. The first phase 1 and phase 2 trials began in 1997. It has been given to over 200,000,000 children, teens, and young adults for over 10 years now all over the world.
  • while fainting might occur after vaccination, it is also not uncommon after other vaccinations and medical procedures, especially in teens. It is not a specific issue caused by the HPV vaccine or any vaccine, for that matter.
  • the HPV vaccine does not cause primary ovarian failure, venous blood clots, behavior problems, multiple sclerosis, autoimmune disorders, or any of the other serious side effects you read on the Internet
  • while the HPV vaccine won’t protect against all forms of HPV, it protects against the forms that are most likely to cause cervical cancer. Just two types of HPV, types 16 and 18, cause 70% of cervical cancers, and another two types, types 6 and 11, cause 90% of genital warts. All are included in the Gardasil vaccine and Cervarix includes the types most likely to cause cervical cancer.
  • HPV is not rare – in fact, it is the most common sexually transmitted infection in the United States. While many infections do go away on their own, spontaneously, others linger and can cause cervical cancer.
  • HPV doesn’t just cause cervical cancer though, it can also cause vaginal, vulvar, penile, and anal, and oropharyngeal cancer, and genital warts
  • the HPV vaccines seem to provide long lasting protection, although, as with any new vaccine, we won’t know just how long the true duration of protection is until the vaccines have been out even longer. So far, Gardasil and Cervarix are providing protection that lasts at least 8 and 9 years.
  • boys need the HPV vaccine too, as there are around 11,000 cases of HPV induced cancer in men each year, including anal cancer and cancers of the mouth/throat and penis.
  • you want your child to get the HPV vaccine before they are having sex, to prevent them from ever getting infected with HPV, which is why it is routinely recommended when kids are 11 to 12 years old. That they are not sexually active yet is the whole point! As with other vaccines, if you continue to wait, you might eventually wait too long, although you can still get the vaccine if they are already sexually active, even if they are already infected with HPV, as it might protect them against another strain that they don’t have yet.
  • getting the HPV vaccine does not make it more likely that a teen will have sex
  • using condoms will not prevent all HPV infections. HPV can also spread through nonpenetrative sexual contact.
  • cervical cancer is serious, with about 4,200 women dying of cervical cancer each year, even in this age of routine pap tests
  • although you may hear that the HPV vaccine has been banned in some places, it is still offered in Japan, Utah, and other places where they talk about these bans, and since 2014, at least 64 countries have added the HPV vaccine to their immunization schedule

Get educated about vaccines and get your kids their HPV vaccine series. Remember that if you start the series before your kids are 15 years old, they only need two doses of the vaccine. After 15 years, they need 3 doses.

What To Know About Deciding to Get an HPV Vaccine

The HPV vaccines are safe, they work, and are necessary, which are beliefs shared by experts and most parents who decide to get their kids vaccinated and protected against HPV.

More Information on Deciding to Get an HPV Vaccine

 

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