Tag: vaccine effectiveness

I Refuse to Listen to Bad Advice About Flu Shots, and I Won’t Apologize for It

The only thing that seems to be more rampant than the flu this season are the articles pushing people to skip a flu shot.

POPSUGAR moms will hopefully go somewhere else for advice about flu shots.
POPSUGAR moms will hopefully go somewhere else for advice about flu shots.

They. Are. Everywhere.

I Refuse to Listen to Bad Advice About Flu Shots

Why are we seeing so many folks attacking flu shots lately?

It’s simple. A bad flu season reminds people that they should get vaccinated and protected. We see the same thing when there are outbreaks of measles, mumps, and pertussis, etc.

And then those folks who are truly anti-vaccine have to come out and justify why they still don’t believe in vaccines.

That leaves us with arguments like this:

“Whenever I start to get worried that I’ll end up with the flu if I don’t get the shot, I remember that it isn’t always effective.”

Jen Glantz on Do You Need To Get A Flu Shot?

It is true that the flu shot is not always effective, but if you are only going to use things that are 100% effective, then why would you take “lots of vitamins and natural supplements” when you have the flu, things that have been shown to be ineffective?

“Side effects can include soreness around the injection side, a low-grade fever for a few days, and muscle aches. Now, I know that this may seem like a small price to pay to avoid getting the full-blown flu, but if I can avoid any sickness at all, why not try?”

Jen Glantz on Do You Need To Get A Flu Shot?

Uh, if you want to try and avoid any sickness, why not get a flu shot? Even when it isn’t as effective as we would like, a flu shot can help reduce your chance of hospitalization, serious flu complications, and of dying with the flu.

“Have you ever taken a step back and learned more about what the heck is actually inside the flu shot? ”

Jen Glantz on Do You Need To Get A Flu Shot?

I know exactly what’s in the flu shot.

Does anyone at POPSUGAR?

Got something you want published online? Head over to POPSUGAR...
Got something you want published online? Head over to POPSUGAR…

Even with a disclaimer from an Editor, POPSUGAR should be ashamed of themselves for publishing an article that says the flu shot is filled with toxins. In addition to an ingredients list, the CDC explains that “all ingredients either help make the vaccine, or ensure the vaccine is safe and effective.”

Flu shot ingredients are not toxins!

“Instead of injecting myself with toxins, I do things like practice good hygiene, take lots of vitamins and natural supplements, and rely on my body and it’s strength to fight off any unwanted bacteria. The human body is an incredible thing, and I trust it. I also like it to ride out things naturally.”

Jen Glantz on Do You Need To Get A Flu Shot?

The flu is a virus, not a bacteria, but I get the point that the author is attempting to make. The thing is though, that while the human body is certainly incredible, relying on it to get you over the flu is not always an easy ride. We often have to pay a high price for natural immunity.

And the people who die with the flu don’t die because of poor hygiene or because they don’t take enough vitamins and supplements. They die because they have the flu. And more often than not, especially in the case of children, because they are unvaccinated.

“For some people, getting the flu shot is at the very top of their to-do list, but for me, it’s something I refuse to do. And that’s OK too.”

Jen Glantz on Do You Need To Get A Flu Shot?

It is certainly OK that Jen Glantz doesn’t get a flu shot each year. At least it is OK as long as she doesn’t get the flu and give it to someone else.

It is not OK that POPSUGAR gives her a voice on such an important topic. Don’t listen to them.

It’s not as big a deal when she writes about the “importance” of drinking both hot and cold water each day, drinking apple cider vinegar for bloating, the best baby names of the year, or how to pee when wearing a wedding dress. That’s the kind of clickbait type content you expect from a POPSUGAR type site.

But scaring people and making them think that there are toxins in flu shots?

Save it for GOOP.

What to Know About Bad Flu Shot Advice

This year’s bad flu season wasn’t limited to folks getting sick… There was also a lot of bad flu shot advice going around.

More on Bad Flu Shot Advice

What Is the Evidence for Alternative Vaccine Schedules?

There is plenty of evidence that the standard immunization schedule is safe and effective.

What about the alternative vaccine schedules that some folks push?

Is there any evidence that is safe to delay or skip any of your child’s vaccines?

Alternative Vaccine Schedules

Many people think of Dr. Bob Sears when they think of alternative vaccine schedules.

Bob Sears appeared on Fox & Friends in 2010 for the segment
Bob Sears appeared on Fox & Friends for the segment “Vaccines: A Bad Combination?”

He created both:

  • Dr Bob’s Selective Vaccine Schedule
  • Dr Bob’s Alternative Vaccine Schedule

He didn’t invent the idea of the alternative vaccine schedule though.

Well before Dr. Bob appeared on the scene, Dr. Jay Gordon had been on Good Morning America with Cindy Crawford to discuss vaccines and how she had decided to delay vaccinating her baby.

Where did she get the idea?

After the segment, Dr. Jay stated:

“They edited the segment to make me sound like a vaccination proponent. We also have to understand the impact of a person as well-known as Cindy Crawford delaying vaccines for over six months.”

Jay Gordon

Dr. Jay has long talked about only giving infants one vaccine at a time and waiting until they are “developmentally solid” before vaccinating.

1983 historical immunization schedule
When Bob Sears came out with his vaccine book, Jenny McCarthy was also pushing the too many too soon myth and rallying folks to go back to the 1983 schedule that left kids at risk for meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease.

Similarly, other folks have pushed ideas about delaying and skipping vaccines before Dr. Bob, including:

  • Donald Miller and his User-Friendly Vaccination Schedule – no vaccines until age two years and no live vaccines and when you begin vaccinating your child, give them one at a time, every six months (first published in 2004)
  • Stephanie Cave – starts at 4 months and delays many vaccines
  • homeopaths with immunization schedules that say to wait until six months and then start giving nosodes every five days
  • chiropractors with immunization plans that say to get regular chiropractic adjustments instead of vaccines
  • Paul Thomas‘ vaccine friendly plan
  • Jenny McCarthy and Generation Rescue’s Turn Back the Clock immunization plan which recommends substituting the latest schedule with the 1983 immunization schedule or a schedule from another country, like Denmark, Sweden, Finland, or Iceland.

Of course, Dr. Bob is the one who popularized the idea of the alternative vaccine schedule in 2007, when he published The Vaccine Book: Making the Right Decision for Your Child.

That’s when parents started to bring copies of his schedule into their pediatrician’s office, requesting to follow Dr. Bob’s schedule instead of the standard immunization schedule from the CDC.

What’s the Evidence for Alternative Vaccine Schedules?

There is no evidence that following an alternative vaccine schedule is safe for your kids.

“No alternative vaccine schedules have been evaluated and found to provide better safety or efficacy than the recommended schedule, supported by the Advisory Committee on Immunization Practices of the CDC and the Committee on Infectious Diseases of the AAP (the committee that produces the Red Book).

Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”

American Academy of Pediatrics

What’s the first clue that these so-called alternative vaccine schedules have absolutely no evidence behind them?

They are all different!

Paul Thomas, for example, doesn’t even offer his patients the rotavirus vaccine. Dr. Bob, on the other hand, has it on his list of vaccines that “that could protect a baby from a very potentially life-threatening or very common serious illness” and is sure to give it at 2, 4, and 6 months.

How slow should you go?

Both Dr. Bob and Dr. Paul give two vaccines at a time with their schedules, but Dr. Jay and Dr. Miller say to give just one at a time.

“Would any scientist give SIX vaccines at once to a baby? Asking for trouble. One at a time makes so much more sense.”

Jay Gordon

And while some start their schedules at 2 or 4 months, others delay until 6 months or 2 years.

There is also the fact that the folks who create these schedules admit that there is no evidence for what they are doing…

“No one’s ever researched to see what happens if you delay vaccines. And do babies handle vaccines better when they’re older? This is really just a typical fear that parents have when their babies are young and small and more vulnerable. Since I don’t know one way or the other, I’m just happy to work with these parents, understand their fears and their worries, and agree to vaccinate them in a way that they feel is safer for their baby.”

Bob Sears on The Vaccine War

But there has been research on delaying vaccines.

Unvaccinated kids aren’t healthier – they just get more vaccine preventable diseases. Most of which are life-threatening, even in this age of modern medicine, with access to good nutrition and sanitation.

So whether you only get one or two vaccines at a time; delay until four months, six months, or two years before you get started; skip all live vaccines or just wait until your child is “developmentally solid” to give them;  or go with some other non-standard, parent-selected, delayed protection vaccine schedule, the only things that you can be sure of is that there is no evidence to support your decision and that you will leave your kids unprotected and at risk for getting a vaccine-preventable disease.

“…when I give your six-week-old seven different vaccines with two dozen antigens, I am supposed to try to convince you that the adverse reactions you have heard about are just coincidences.”

Jay Gordon

Better yet though. Find a pediatrician who will listen and answer your questions about vaccines, concerns about vaccine myths and misinformation, explain that no vaccine is optional, and not just simply pander to  your fears.

What to Know About the Evidence for Alternative Vaccine Schedules

There is no evidence that skipping or delaying any vaccines with an alternative vaccine schedules can keep your kids safe from vaccine preventable diseases.

More on the Evidence for Alternative Vaccine Schedules

The Strategic Plan to Develop a Universal Influenza Vaccine

Even before you get to talk about problems with flu vaccine effectiveness,  it becomes clear that everyone wants a better flu vaccine.

One big problem with the current generation of flu vaccines?

You have to get them each and every year.

Developing a Better Flu Vaccine

So what would we all want in a new and better flu vaccine?

It would:

  • last longer, so you didn’t have to get a new vaccine every year
  • be more effective
  • cover more flu vaccine strains, so it wasn’t a “guess” about which flu strains to include in the flu vaccine each year and we didn’t have to worry about drifted flu vaccine strains or new and emerging strains for which there is no vaccine

A universal flu vaccine, which covers all possible flu strains, would be ideal.

So why haven’t we been working on developing a universal flu vaccine?

Well, we have.

It just isn’t that easy.

Many different research teams have been working on a universal flu vaccine for years and some have already had some success.

Does that mean we will see a universal flu vaccine soon?

Unfortunately, of the almost 40 organizations working on improved flu vaccines, including a universal flu vaccine, about 30 are still in preclinical or phase 1 trials. So the answer is no, we will not see a universal flu vaccine soon.

The Strategic Plan to Develop a Universal Influenza Vaccine

Maybe that will change now that more and more folks are pushing for a better flu vaccine and we see the effects of severe flu seasons without a good vaccine.

Of course, talk isn’t enough.

“A priority for the National Institute of Allergy and Infectious Diseases (NIAID) is development of an influenza vaccine providing durable protection against multiple influenza strains, including those that may cause a pandemic, i.e., a universal influenza vaccine. To invigorate research efforts, NIAID developed a strategic plan focused on knowledge gaps in three major research areas, as well as additional resources required to ensure progress towards a universal influenza vaccine. NIAID will use this plan as a foundation for future investments in influenza research and will support and coordinate a consortium of multidisciplinary scientists focused on accelerating progress towards this goal.”

Erbelding et al on A Universal Influenza Vaccine: The Strategic Plan for the National Institute of Allergy and Infectious Diseases

That’s why it is also encouraging that we have seen the:

  • The Flu Vaccine Act would help fund a universal flu vaccine.the Pathway to a Universal Influenza Vaccine workshop convened by the National Institute of Allergy and Infectious Diseases (NIAID) in 2017
  • the Strategic Plan for Developing a Universal Influenza Vaccine by the NIAID that was announced in 2018
  • U.S. Sen. Ed Markey (D-MA) introduced the Flu Vaccine Act, which would invest $1 billion towards development of a universal flu vaccine

Knowing that developing a universal flu vaccine is a priority of the NIAID and that so many organizations are already working towards this goal is very reassuring.

Hopefully we are a lot closer than some folks thing.

Until then, a seasonal flu vaccine is the best way to avoid the flu and serious flu complications.

What to Know About Developing a Universal Influenza Vaccine

Developing a better flu vaccine, including a universal flu vaccine, is an even bigger priority with the announcement of the Strategic Plan for Developing a Universal Influenza Vaccine.

More on Developing a Universal Influenza Vaccine

What to Do If Your Child Is Exposed to Hepatitis A

Hepatitis A is a vaccine preventable disease.

The hepatitis A vaccine was first added to the immunization schedule in 1996, but wasn’t made a universal recommendation for all children until 2006. At first, it was just given to high risk kids.

Now all toddlers begin to get a two dose hepatitis A vaccine series beginning when they are 1 to 2 years old, with 6 to 18 months between the doses.

Unfortunately, unlike many other vaccines, there was never a catch-up plan for those who were unvaccinated, so some teens and many adults are still not vaccinated and still not protected against hepatitis A infections.

Getting Exposed to Hepatitis A

How do you get hepatitis A?

“The hepatitis A virus is able to survive outside the body for months. High temperatures, such as boiling or cooking food or liquids for at least 1 minute at 185°F (85°C), kill the virus, although freezing temperatures do not.”

CDC on Hepatitis A Questions and Answers

Unlike hepatitis B, which is spread through blood and body fluids, people who are infected with hepatitis A shed the virus in their stool.

So you can get infected by having close contact with someone who has hepatitis A or by eating or drinking contaminated food or water.

How do you know if you have been exposed?

While an employee in the produce department at a Kroger in Kentucky recently exposed folks to hepatitis A, back in 2016 it was a Whole Foods in Michigan that was linked to an outbreak.
While an employee in the produce department at a Kroger in Kentucky recently exposed folks to hepatitis A, back in 2016 it was a Whole Foods in Michigan that was linked to an outbreak.

Exposures are most common in local common-source outbreaks caused by sick food handlers at restaurants and grocery stores and multi-state hepatitis A outbreaks caused by contaminated foods. These types of exposures are usually announced by your local or state health department.

Other exposures occur if you are living with someone who develops hepatitis A or travel to a country where hepatitis A is still common.

What to Do If Your Unvaccinated Child Is Exposed to Hepatitis A

If your unvaccinated child is exposed to hepatitis A, you should talk to your pediatrician or local health department about starting post-exposure prophylaxis as soon as possible and not longer than 14 days, including either:

  • the first dose of hepatitis A vaccine, with plans to get the second dose of vaccine in 6 months, or
  • a dose of immune globulin (provides a passive transfer of antibodies)

In general, getting the hepatitis A vaccine is preferred over getting immune globulin for most healthy people between 12 months and 40 years of age. For infants less than 12 months (too young to be vaccinated) and unvaccinated adults over age 40 years, immune globulin is preferred after an exposure to hepatitis A.

Immune globulin is also preferred for anyone who is immunocompromised or chronic liver disease.

What if it has been more than 14 days since the exposure?

While it is likely too late for immune globulin, your unvaccinated child should still likely get a dose of hepatitis A vaccine to protect against future exposures. And watch carefully over the next 15 to 50 days (the incubation period) for symptoms of hepatitis A, which can include jaundice, fever, and vomiting, etc. Many children don’t have symptoms though, so your child could develop hepatitis A, and be contagious and expose others without your even knowing it.

If post-exposure vaccination works, can’t you just wait until your child is exposed to get vaccinated? That might work – if you could be sure about each and every exposure that your child will ever have. Since that’s not possible, don’t delay getting vaccinated and put your child at risk of getting hepatitis A.

What to Do If Your Vaccinated Child Is Exposed to Hepatitis A

The hepatitis A vaccine is very effective.

One dose provide 95% protection against hepatitis A infections and the second dose boosts the efficacy rate up to 99%.

If your child is partially vaccinated, with just one dose and has been exposed to hepatitis A, get the second dose if it has been at least six months since he was vaccinated. Otherwise, talk to your pediatrician or local health department, but your child is likely considered protected.

What to Know About Getting Exposed to Hepatitis A

Learn what to do if your child is exposed to hepatitis A, especially if they aren’t already vaccinated and protected.

More on Getting Exposed to Hepatitis A

FluMist Is Coming Back

FluMist is a live, attenuated nasal spray flu vaccine.

While pediatricians, parents and kids loved it, since it wasn’t a shot, it hasn’t been available since 2016 because it was found to be less effective than flu shots against the H1N1 strain of flu.

The History of FluMist

FluMist had been a good option for kids who don't want to get a flu shot every year.
FluMist had been a good option for kids who don’t want to get a flu shot every year. Photo by Vincent Iannelli, MD

The FluMist nasal spray was first approved in 2003 for healthy kids over age 5 years and adults up to age 49 years.

In 2007, the age range was expanded to included healthy children between the ages of 2 and 5 years.

It quickly became a favorite of kids who didn’t like the idea of getting a flu shot each year, although some kids didn’t like getting something sprayed into their nose.

Next, in 2012, FluMist Quadrivalent, with protection against four strains of flu virus, was approved.

While some experts initially thought it might work better than traditional flu shots and it actually became the preferred flu vaccine for kids in 2014, by 2016, FluMist was no longer recommended in the United States.

The Return of FluMist

On February 12, 2017, at a meeting of the Advisory Committee on Immunization Practices (ACIP), members voted to once again recommended FluMist Quadrivalent to prevent the flu. It will be available for next year’s flu season, although the recommendation still has to be approved by the director of the CDC.

What happened to FluMist?

“In the 2013-2014 influenza season, when lower than expected effectiveness of FluMist Quadrivalent was first observed, Influenza A (H1N1) was the predominant circulating influenza virus strain. When the data showing lower than expected vaccine effectiveness became available, FDA began working with MedImmune to investigate potential reasons for this finding.”

FDA Information Regarding FluMist Quadrivalent Vaccine

Although they worked on a fix after the 2013-2014 influenza season, the following season showed poor effectiveness for all flu vaccines because of a drifted flu strain. So it wasn’t until the following year that it was noticed that FluMist still didn’t work as well as a flu shot against H1N1 flu strains, at least not in the United States.

Surprisingly, studies in other countries, including Finland and the UK showed that FluMist did work.

And now MedImmune, the company that makes FluMist, has replaced the H1N1 seed virus it uses to make FluMist, and preliminary testing shows that it is more effective and should be as effective as a flu shot.

That’s why the ACIP voted 12-2 to make FluMist available for the 2018-2019 flu season.

Will you get it for your kids next year, instead of a regular flu shot? If the number of parents and kids asking for FluMist this year is any guide, many will be glad it’s back.

What to Know About the Return of FluMist

FluMist has hopefully been improved, been made more effective, and will be ready to help prevent the flu for the 2018-2019 flu season. It will be an especially good option for those kids who don’t want a shot.

More on the Return of Flumist

What to Do If Your Child Is Exposed to the Flu

During a bad flu season, especially when effectiveness of the flu vaccine is less than ideal, parents want to know how to protect their kids from the flu.

Protecting Kids from the Flu

Cover your coughs and sneezes so you don't spread the flu virus to other people.
Covering your coughs and sneezes might help prevent the spread of the flu virus to other people.

Of course,  the best way to protect kids from the flu and serious complications of the flu is to get a flu vaccine each year.

Still, the flu vaccine isn’t perfect.

So, what else can you do?

Like other respiratory diseases that are mainly spread by coughing and sneezing, you can help reduce the risk that your kids will get sick by:

  • as much as possible and practical, keeping your kids away from other people, especially those who are obviously sick
  • encouraging your kids and others to properly cover their coughs and sneezes
  • teaching your kids to wash their hands properly
  • encouraging your kids to not touch their eyes, nose, or mouth, or to bite their nails or put things in their mouth, like their pencil or pen
  • cleaning and disinfecting surfaces that your child will likely touch
  • encouraging others to stay home from school or work when they have the flu until they are fever free for at least 24 hours, although they might be contagious for even longer

While these techniques might not work, they are certainly better than doing nothing and simply letting your kids catch the flu.

What to Do If Your Child Is Exposed to the Flu

If your kids do anything outside the home, even if they don’t go to daycare or school, there might come a time during a long flu season when they get exposed to someone with the flu.

What do you do?

“Prevention (prophylaxis) is a term used when someone who does not have flu symptoms is given Tamiflu to help stop them from getting the flu because they are exposed to or come into close contact with someone (for example live with or take care of someone) who has the flu.”

FDA on Tamiflu: Consumer Questions and Answers

In addition to watching for classic flu symptoms to develop over the next one to four days, if your child is unvaccinated or it is a year during which the flu vaccine is not very effective, if your child is in a high risk group for severe complications from the flu (under age two to five years or any age with chronic medical problems), then you might ask your pediatrician about:

  • a once a day dose of Tamiflu (Oseltamivir), which is recommended as a preventative in infants as young as three months old
  • a once a day dose of Relenza (Zanamivir), which is recommended as a preventative in children as young as five years old, unless they have respiratory problems, like asthma

But that doesn’t mean that everyone should take these flu medicines every time they are exposed to someone with the flu. If these medicines are overused, flu viruses will develop resistance and they won’t work, just like happened to some of the older anti-viral flu medicines, amantadine and rimantadine.

Still, if your child with diabetes, uncontrolled asthma, muscular dystrophy, or healthy four month old is closely exposed to someone with the flu, then taking Tamiflu to prevent a potentially severe case of the flu is likely a good idea.

What to Do If Your Child Gets the Flu

And if your child gets the flu?

Believe it or not, most healthy school age kids with the flu don’t need to be seen by their pediatrician.

“When treatment is started within two days of becoming sick with flu symptoms, antiviral drugs can lessen symptoms and shorten the time you are sick by about one day. They may reduce the risk of complications such as ear infections in children, and pneumonia and hospitalizations in adults. For people at high risk of serious flu complications, early treatment with an antiviral drug can mean the difference between having milder illness instead of more severe illness that might require a hospital stay.”

CDC on What You Should Know About Flu Antiviral Drugs

You should see your pediatrician or other health care provider at the first sign of flu symptoms if they are at high risk for serious complications of the flu and they might benefit from Tamiflu, which includes those under two to five years old and children with any chronic medical problems.

And of course, seek medical attention if your child with the flu is showing signs of a severe case of the flu, such as trouble breathing, dehydration, or being inconsolable, etc.

You should also seek medical attention if your child with the flu was getting better, but then starts to get worse again, with a return of fever, worsening cough, or severe headache, etc.

When in doubt, call your pediatrician!

What to Know About Protecting Kids from the Flu

In addition to avoiding people who are sick with the flu, see your pediatrician as soon as possible if your younger, high risk child is gets sick after being exposed to someone with the flu.

More on Protecting Kids from the Flu

What to Do If Your Child Is Exposed to Mumps

Although things are much better than they were in the pre-vaccine era, we still have mumps outbreaks in the United States.

How does that work?

Waning immunity and folks who are unvaccinated.

How Contagious is Mumps?

Mumps is contagious, but not nearly as contagious as other vaccine-preventable diseases, such as measles.

“Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected.”

CDC on Transmission of Measles

Unlike measles, which is so contagious that you can get it if you are simply in the same room with someone that is sick, mumps typically requires prolonged, close contact.

“When you have mumps, you should avoid prolonged, close contact with other people until at least five days after your salivary glands begin to swell because you are contagious during this time. You should not go to work or school. You should stay home when you are sick with mumps and limit contact with the people you live with; for example, sleep in a separate room by yourself if you can.”

CDC on Mumps Outbreak-Related Questions and Answers for Patients

How do you get mumps?

Since the virus spreads through saliva and mucus, you can get sick if you are in close contact with someone with mumps and they:

  • cough or sneeze
  • use a cup or eating utensil that you then use
  • touch an object or surface that you then touch (fomites)

And like many other vaccine-preventable diseases, people with mumps are usually contagious just before they begin to show symptoms.

“The mumps virus replicates in the upper respiratory tract and spreads through direct contact with respiratory secretions or saliva or through fomites. The risk of spreading the virus increases the longer and the closer the contact a person has with someone who has mumps.”

CDC on Mumps for Healthcare Providers

The need for prolonged, close contact is likely why most outbreaks these days are on college campuses.

Is Your Child Protected Against the Mumps?

Tips to prevent getting sick with the mumps.
You can prevent the mumps.

The MMR vaccine protects us against mumps – and measles and rubella.

One dose of MMR is 78% effective at preventing mumps, while a second dose increases that to 88%. Unfortunately, that protection can decrease over time.

Kids get their first dose of MMR when they are 12 to 15 months old. While the second dose of MMR isn’t typically given until just before kids start kindergarten, when they are 4 to 6 years old, it can be given earlier. In fact, it can be given anytime after your child’s first birthday, as long as 28 days have passed since their first dose.

“Evidence of adequate vaccination for school-aged children, college students, and students in other postsecondary educational institutions who are at risk for exposure and infection during measles and mumps outbreaks consists of 2 doses of measles- or mumps-containing vaccine separated by at least 28 days, respectively. If the outbreak affects preschool-aged children or adults with community-wide transmission, a second dose should be considered for children aged 1 through 4 years or adults who have received 1 dose. In addition, during measles outbreaks involving infants aged <12 months with ongoing risk for exposure, infants aged ≥6 months can be vaccinated.”

CDC on Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices

And although it won’t count as their first dose, in special situations, kids can get an early MMR once they are six months old.

What to Do If Your Unvaccinated Child Is Exposed to Mumps

To be considered fully vaccinated and protected against mumps, kids need two doses of MMR – one at 12 to 15 months and another when they are 4 to 6 years.

“Although mumps-containing vaccination has not been shown to be effective in preventing mumps in persons already infected, it will prevent infection in those persons who are not yet exposed or infected. If persons without evidence of immunity can be vaccinated early in the course of an outbreak, they can be protected prior to exposure.”

Surveillance Manual

If your unvaccinated child is exposed to mumps, you should talk to your pediatrician or local health department, but unlike measles and chicken pox, there are no recommendations to start post-exposure prophylaxis.

Mumps quarantine sign

Unfortunately, neither a post-exposure dose of MMR nor immune globulin work to prevent mumps after you are already exposed. They should still get an MMR though, as it will provide immunity against measles and rubella, and mumps if they don’t get a natural infection.

“Persons who continue to be exempted from or who refuse mumps vaccination should be excluded from the school, child care, or other institutions until 21 days after rash onset in the last case of measles.”

Manual for the Surveillance of Vaccine-Preventable Diseases

Be sure to alert your pediatrician if you think your child might have measles or another vaccine-preventable disease.
Be sure to alert your pediatrician if you think your child might have measles or another vaccine-preventable disease.

Unvaccinated kids who are exposed to mumps will likely need to be quarantined, as you watch for signs and symptoms of measles developing over the next 12 to 25 days.

If your exposed child develops mumps, be sure to call your health care provider before going in for a visit, so that they can be prepared to see you and so you don’t expose other people to mumps. Your child with suspected mumps should be wearing a mask before going out in public and if possible, will be put in a negative pressure room in the emergency room or doctor’s office.

It is very important to understand that simply wearing a mask doesn’t eliminate the risk that your child with mumps could expose others, it just reduces the risk. You still want to avoid other people!

What to Do If Your Vaccinated Child Is Exposed to Mumps

If your fully vaccinated child is exposed to mumps, does that mean you are in the clear?

Again, it depends on what you mean by fully vaccinated.

It also depends on what you mean by exposed. Is it someone in the same school that your child has had no real contact with or a sibling that he is around all of the time?

And is your child fully vaccinated for his age or has he had two doses of MMR?

Since kids get their first dose of MMR at 12 to 15 months and the second when they are 4 to 6 years old, it is easy to see that many infants, toddlers and preschoolers who are following the immunization schedule are not going to be fully vaccinated against mumps, even if they are not skipping or delaying any vaccines.

“In the case of a local outbreak, you also might consider vaccinating children age 12 months and older at the minimum age (12 months, instead of 12 through 15 months) and giving the second dose 4 weeks later (at the minimum interval) instead of waiting until age 4 through 6 years.”

Ask the Experts about MMR

In most cases, documentation of age-appropriate vaccination with at least one dose of MMR is good enough protection. That’s because the focus in controlling an outbreak is often on those folks who don’t have any evidence of immunity – the unvaccinated.

And one dose of MMR is about 78% effective at preventing mumps infections. A second dose does increase the vaccine’s effectiveness against mumps to over 88%.

An early second dose is a good idea though if your child might be exposed to mumps in an ongoing outbreak, has only had one dose of MMR, and is age-eligible for the second dose (over age 12 months and at least 28 days since the first dose). Your child would eventually get this second dose anyway. Unlike the early dose before 12 months, this early dose will count as the second dose of MMR on the immunization schedule.

“Persons previously vaccinated with 2 doses of a mumps virus–containing vaccine who are identified by public health authorities as being part of a group or population at increased risk for acquiring mumps because of an outbreak should receive a third dose of a mumps virus–containing vaccine to improve protection against mumps disease and related complications.”

Recommendation of the Advisory Committee on Immunization Practices for Use of a Third Dose of Mumps Virus–Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak

And in some cases, folks should now get a third of dose of MMR.

This third dose of MMR is not for post-exposure prophylaxis though, which again, doesn’t work for mumps. It is to prevent mumps from ongoing exposures.

You should still watch for signs and symptoms of mumps over the next 12 to 25 days though, as no vaccine is 100% effective. Your vaccinated child won’t need to be quarantined though.

Most importantly, in addition to understanding that vaccines are safe and necessary, know that the ultimate guidance and rules for what happens when a child is exposed to mumps will depend on your local or state health department.

What to Know About Getting Exposed to Mumps

Talk to your pediatrician if your child gets exposed to mumps, even if you think he is up-to-date on his vaccines, as some kids need a third dose of the MMR vaccine during on-going mumps outbreaks.

More on Getting Exposed to Mumps