Tag: mumps outbreaks

Do Vaccinated Kids Who Get Sick Have Milder Disease?

There is another benefit of vaccines that you might not be aware of.

Vaccines are typically very effective, but of course, they aren’t perfect.

Fortunately, even when they don’t work and you do get sick, vaccinated kids will often have milder disease than those who are unvaccinated.

Do Vaccinated Kids Who Get Sick Have Milder Disease?

While no one expects to get a vaccine-preventable disease if they have been vaccinated, it is nice to know that often, you will at least have a milder disease.

“Disease may occur in previously vaccinated individuals. Such breakthroughs are either primary – due to vaccine failure – or secondary. In such cases, the disease is usually milder than in the non-vaccinated.”

Vaccination greatly reduces disease, disability, death and inequity worldwide

Milder mumps and pertussis?

“The number of previous vaccine doses was inversely associated with clinical severity.”

Zamir et al on Characteristics of a large mumps outbreak: Clinical severity, complications and association with vaccination status of mumps outbreak cases

Yes!

And that’s good news for all of the folks concerned about waning immunity with these vaccines.

“A protective effect of vaccination was noted when mean duration of symptoms and hospital stay are analysed, comparing unvaccinated, partially vaccinated and fully vaccinated children. We showed a vaccination dose effect trend, with fully vaccinated children having less-severe RVGE than not vaccinated and partially vaccinated children.”

Justino et al on Clinical Severity and Rotavirus Vaccination among Children Hospitalized for Acute Gastroenteritis in Belém, Northern Brazil

Consider that, in addition to preventing disease:

  • two doses of MMR has been found to have a significant preventive effect against mumps complications, including orchitis, meningitis, and encephalitis, and hospitalization for mumps
  • two doses of the chickenpox vaccine has been found to be very effective at preventing severe disease, in fact, kids with breakthrough chickenpox often don’t have fever, have fewer than 50 spots, and they go away quicker than kids who are unvaccinated.
  • vaccinated kids who get pertussis typically don’t cough as long as those who are unvaccinated
  • the rotavirus vaccine series, in addition to protecting most kids from getting rotavirus infections in the first place, protected all of the vaccinated kids from getting severe infections
  • the flu vaccine reduces the risk of severe disease, especially if you are hospitalized with the flu

What does this all mean?

Two kids with smallpox - one vaccinated and one unvaccinated. Can you guess which is which? The vaccinated child on the right only has one or two spots...
Two kids with smallpox – one vaccinated and one unvaccinated. Can you guess which is which? The vaccinated child on the right only has one or two spots…

It means that vaccines work, even when they don’t work as well as we would like them to!

More On the Severity of Breakthrough Infections

Did CNN Rename Mumps?

It’s a common anti-vaccine myth that we rename diseases to make them go away. It helps them explain the control, elimination, and eradication of diseases, since many of them don’t believe that vaccines actually work.

Simply saying that your article is "Fact Checked" doesn't make it so...
Simply saying that your article is “Fact Checked” doesn’t make it so…

Now imagine that “they” actually found evidence that we did rename vaccine-preventable diseases!

That would be something, wouldn’t it…

Did CNN Rename Mumps?

Of course, they haven’t.

The original CNN story about the USS Fort McHenry stated that the sailors and Marines had parotitis, which was “due to an outbreak of a viral infection similar to mumps.”

Why didn’t they just say that they had mumps?

Because that’s not what they were told by the US Navy’s Fifth Fleet.

“… a military medical team specializing in preventative medical care is expected to deploy in the coming days to make an assessment if further steps may be needed, according to the official.”

US warship quarantined at sea due to virus outbreak

It may come as a surprise to some people, but many viruses and bacteria can cause parotitis. And until the outbreak was further investigated, they didn’t know if it really was mumps or another condition.

Since then, the Navy’s Bureau of Medicine and Surgery (BUMED) has stated that “based on clinical presentation and laboratory testing, these cases are currently classified as probable cases of mumps.”

Still, a very small percentage of the sailors and Marines on board have gotten mumps. That’s because vaccines work, even when they don’t work perfectly well.

More on the Myth that CNN Renamed Mumps

Mumps on the USS Fort McHenry

Like measles, we are seeing more mumps these days.

“Beginning in 1991, the military services implemented universal recruit immunization with a single dose of MMR vaccine, regardless of prior vaccination history. Shortly thereafter, and informed by the results of population serosurveys, the Air Force transitioned to a policy of targeted MMR vaccination, limiting the administration of MMR vaccine to recruits lacking serologic evidence of immunity to measles or rubella. With recent outbreaks of mumps, concerns have arisen that the practice of not specifically screening for mumps immunity in determining the need for MMR vaccine could lead to a relative increase in mumps risk among military recruits subject to screening. “

Eick et al on Incidence of mumps and immunity to measles, mumps and rubella among US military recruits, 2000–2004

Unlike measles, the MMR vaccine provides good, but not great protection against mumps.

And although military recruits are screened to see if they have low titers for measles and rubella, they still aren’t screened for mumps. The theory is that if their measles and rubella titers are low, then their mumps titer will be low too and they will get an MMR vaccine. Of course, this misses some who just have a low mumps titer, possibly an effect of waning immunity.

Mumps on the USS Fort McHenry

And that’s why we have been seeing mumps outbreaks on college campuses and most recently, on a Navy ship, although that isn’t a reason for everyone to go out and check their titers.

A tiny handful of measles outbreaks? There have been over 700 cases in the US during the past two years! There were only 37 cases in 2004.

Robert F. Kennedy, Jr has a lot to say about mumps…

He says that mumps outbreaks have devastated fully vaccinated populations at Harvard, Temple, Syracuse, Louisiana State, IU, and the U of Missouri…

And that mumps “epidemics” haven’t been covered by the media, because they don’t want to embarrass Merck…

Why won’t the media cover the mumps outbreaks! Oh, wait…

He also seems to think that these mumps cases have caused a national security threat

Is any of this true?

The simple fact that you can find a ton of stories in the media about the mumps outbreaks (they are not epidemics) gives you a good clue that they aren’t.

What about the quarantined sailors on the USS Fort McHenry?

That is true, but consider that only 27 of 700 of them have gotten parotitis, presumed to have been caused by mumps.

While you would expect that no one would get mumps or any other vaccine-preventable disease these days, that is just under 4% of those on board the ship.

What would have happened in the pre-vaccine era?

Although deaths were rare, mumps caused a lot of considerable loss of service and sick time in the military in the pre-vaccine era.
Although deaths were rare, mumps caused a lot of considerable loss of service and sick time in the military in the pre-vaccine era.

A whole lot more people would have gotten sick!

In the pre-vaccine era, although mumps was supposed to be a common childhood illness, about 1/3 to 1/2 of military recruits had never had mumps.

That meant big outbreaks of mumps that were hard to control, unlike what we see today.

“This article reports a recent public health response to 3 imported mumps cases occurring at Fort Campbell, Kentucky, that resulted in a contact investigation for 109 close contacts across varied settings. No secondary mumps cases were identified.”

Public Health Response to Imported Mumps Cases – Fort Campbell, Kentucky, 2018

Instead, not only do fewer people get sick during mumps outbreaks these days, but fortunately, they have fewer complications.

What kind of complications?

Mumps causes kids to have fever, puffy cheeks, and a painful, swollen jaw.
Mumps causes kids to have fever, puffy cheeks, and a painful, swollen jaw.

In addition to a swollen jaw, mumps is known to cause orchitis, aseptic meningitis, oophoritis, pancreatitis, and encephalitis.

“Risk was reduced for hospitalization, mumps orchitis and mumps meningitis when patient had received 1 dose of measles, mumps, and rubella vaccine. The protective effect of vaccination on disease severity is critical in assessing the total effects of current and future mumps control strategies.”

Young et al on Mumps Complications and Effects of Mumps Vaccination, England and Wales, 2002–2006

Fortunately, those complications are reduced when you get vaccinated. And so are your risks of actually getting mumps in the first place!

“This study demonstrates a significant preventive effect of two-dose vaccination against mumps complications (orchitis, meningitis, or encephalitis) and hospitalization for mumps.”

Orlíkováet al on Protective effect of vaccination against mumps complications, Czech Republic, 2007-2012.

Kennedy doesn’t mention a protective effect of the MMR vaccine, does he?

Remember, vaccines aren’t perfect, but even those that don’t work as well as the others still protect you from many of the worst complications and are much better than getting the disease naturally.

Mumps was often described as one of the top diseases that incapacitated soldiers in the prevaccine era.
Mumps was often described as one of the top diseases that incapacitated soldiers in the prevaccine era.

Vaccines are safe, with few risks, and are obviously necessary.

Is the mumps vaccine a national security threat? The only threat are the folks who continue to push anti-vaccine misinformation.

More on Mumps on the USS Fort McHenry

Vaccine-Preventable Diseases – Year in Review 2018

Does it seem like we are moving in the wrong direction?

The eradication of smallpox shows just what vaccines can do!
The eradication of smallpox shows just what vaccines can do!

No, smallpox isn’t coming back, but many other vaccine-preventable diseases are.

Vaccine-Preventable Diseases – Year in Review 2018

With the availability of new vaccines and the expanded use of other vaccines, many of us were hopeful of the progress that was being made against vaccine-preventable diseases so far this decade.

Remember, it was just four years ago that the WHO certified India as a polio free country. And after years of declining numbers of wild polio cases, 2018 will be the first year with a higher number of cases than the previous year.

This hasn’t been a good year for measles either. The WHO Region of the Americas has lost its status as having eliminated measles!

In Bolivarian Republic of Venezuela, endemic transmission of measles has been re-established, with spread to neighbouring countries. As a result, the Region has lost its status as having eliminated measles. The Regional Technical Advisory Group, which met in July 2018, emphasized the importance of Regional action and an urgent public health response to ensure re-verification of measles elimination in Bolivarian Republic of Venezuela.

Meeting of the Strategic Advisory Group of Experts on Immunization, October 2018 – Conclusions and recommendations

After years of declining rates, global measles cases and deaths began to jump in 2017, a trend that continued in 2018.

“Outbreaks in North America and in Europe emphasize that measles can easily spread even in countries with mature health systems. Due to ongoing outbreaks, measles is again considered endemic in Germany and Russia.”

2018 Assessment Report of the Global Vaccine Action Plan

And no, this isn’t just a problem in other parts of the world.

Vaccine preventable diseases are just a plane ride away.
Vaccine preventable diseases are just a plane ride away.

More cases in other parts of the world mean more cases in the United States because unvaccinated folks travel out of the country and bring these diseases home with them, getting others sick.

But it wasn’t just measles outbreaks, including the second largest number of cases in 22 years, that we were seeing in 2018:

  • chicken pox – although the 41 cases involving a North Carolina Waldorf school got the most attention, there were at least 6,892 cases of chicken pox last year, which continues to trend down from recent highs of over 15,000 in 2010
  • hepatitis A – clusters of outbreaks in 15 states with at least 11,166 cases, many deaths, with exposures at popular restaurants
  • mumps – from recent highs of over 6,000 cases the last few years, we were “back down” to just over 2,000 mumps cases in 2018
  • pertussis – cases were also down in 2018, with a preliminary count of about 13,439 cases last year
  • meningococcal disease – isolated outbreaks continued last year, with cases at Smith College, Colgate University, and San Diego State University

And of course, we had one of the worst flu seasons in some time last year, with 185 pediatric flu deaths.

Fortunately, there were no cases of diphtheria, neonatal tetanus, polio, or congenital rubella syndrome. At least not in the United States.

Why are some disease counts down when so many folks say the anti-vaccine movement is more active than ever?

Remember, the great majority of people vaccinate and protect their kids!

And vaccines work!

It is best to think of the anti-vaccine movement, which has always been around, as a very vocal minority that is just pushing propaganda to scare parents away from vaccinating and protecting their kids.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad these diseases are, allow themselves to be influenced by anti-vaccine propaganda, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

Also remember that many of these diseases occurred in multi-year cycles in the pre-vaccine era. When an up year hits a cluster of unvaccinated kids, we get bigger outbreaks. And then more folks get vaccinated, starting the cycle all over again. At least until we finally get the disease under better control or finally eradicated.

Want to avoid getting a vaccine-preventable disease this year?

Get vaccinated and protected and encourage everyone else to get vaccinated too.

More on Vaccine-Preventable Diseases – Year in Review 2018