Tag: waning immunity

Can Vaccinated Children Be Asymptomatic Carriers of Pertussis?

Why do anti-vaccine folks like to talk about baboons so much?

“Did you know that a study showed that baboons injected with whooping cough vaccine became infected with whooping cough anyway – and silently spread the disease to other baboons for 35 days?”

Anti-vaccine Meme

Is it because baboons are used in the study of vaccines?

That’s part of it, at least when they can find a study where they can cherry pick the results to suit their needs.

The Baboon Study

Like most anti-vaccine talking points, this one about baboons, has some truth to it.

An adult male baboon.
An adult male baboon. Photo by Elizabeth Miller

There was a baboon study with the pertussis vaccine and it found that previously vaccinated baboons could develop asymptomatic carriage of the pertussis bacteria after they were intentionally infected.

Here is where it is important to note that an infection is different than a disease.

The example that many people are familiar with is tuberculosis. It is common to have a TB infection without any signs or symptoms and to not feel sick. The only reason we know that they have TB is because they had a positive TB test.

Unfortunately, about 5 to 10% of these people with TB infections can eventually develop TB disease, with coughing, weight loss, night sweats, fever, and chest pain, etc.

It is kind of the same with the baboons in the study. Twenty-four hours after two previously vaccinated baboons were inoculated with pertussis bacteria in the back of their nose and trachea, an unvaccinated baboon was put in each of their cages.

The vaccinated baboons continued to have pertussis bacteria in their noses, which the researchers had put there, for up to 35 days. And they were able to eventually pass the pertussis bacteria to the unvaccinated baboons in their cages. Vaccinated baboons also became infected or colonized after they were put in a cage with an intentionally infected unvaccinated baboon.

“…animals did not cough and showed no reduction of activity, loss of appetite, or other outward signs of disease.”

Warfel et al on Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model

The vaccinated baboons were infected, but they never did develop symptoms of pertussis.

What Does The Baboon Study Mean?

One thing that is for sure – the baboon study found that the pertussis vaccines work. Only unvaccinated baboons got sick with pertussis.

But does this study explain our current outbreaks of pertussis?

Are vaccinated people becoming colonized and then getting others sick?

I guess it is possible, but we are not baboons in a cage with other baboons. How would we spread a respiratory disease, even if we did become colonized with the bacteria, if we don’t have symptoms?

It may explain part of our outbreaks though.

If vaccinated people do commonly become colonized with pertussis bacteria, then they might very well test positive for pertussis even though they don’t have symptomatic pertussis disease. So when they develop a cold or bronchitis and are found to have a positive pertussis test, then couldn’t that test just indicate that they have a pertussis infection and not disease, even though something else is actually causing their symptoms?

That’s what we think happens with strep carriers, right?

That’s kind of what the baboon study found. All of the baboons tested positive, but only the unvaccinated baboons had symptomatic pertussis disease.

“Baboons vaccinated with wP vaccines exhibit a level of protection that is intermediate between convalescent animals and aP-vaccinated animals. They exhibit no outwards signs of disease and are initially colonized to the same high level as aP-vaccinated animals but clear the infection more rapidly.”

Pinto et al on Pertussis disease and transmission and host responses: insights from the baboon model of pertussis.

It is interesting to note that the baboon study also found that baboons who had received whole cell pertussis vaccines also became carriers. They just didn’t stay carriers for as long as the baboons who got the newer acellular pertussis vaccine. But since they were still carriers, if asymptomatic transmission is such a big problem, wouldn’t it have been a big problem back in the day when everyone got whole cell pertussis vaccines?

The Debate Over Asymptomatic Carriage

Most vaccines prevent the spread of disease.

Do the pertussis vaccines?

Most folks still think so.

“The baboon model pioneered by Warfel et al. is without question a game-changer, shedding light on the impact of vaccination on disease and infection. However, the view it affords is clearer with respect to immunity and pathology than with respect to transmission. We point out that the extrapolation of the possibility of transmission from vaccinated baboons in the laboratory to the probability of transmission from vaccinated humans in the population is unwarranted. More work is needed to elucidate the relative transmissibility of infections in vaccinated vs. unvaccinated hosts. The evidence adduced above suggests, however, that vaccination with aP must have a strong effect on transmission as well as disease.”

Matthieu Domenech de Cellès et al on Epidemiological evidence for herd immunity induced by acellular pertussis vaccines

Even the author of the baboon study has said that “We agree that these data should not be directly extrapolated to pertussis transmission in humans. Although baboons are >96% genetically similar to humans, there are likely differences in how the species respond to vaccination and infection. We also agree that aP-vaccinated infected people are likely less efficient at transmitting pertussis compared with unvaccinated infected people, although it is not clear to what extent.”

Others think that asymptomatic carriage of pertussis might behind a lot of our recent outbreaks. Or at least what helps them grow so large.

Still, it is important to remember that unvaccinated folks do play a role in these outbreaks too. In a pertussis outbreak at a Florida preschool, in which most kids were vaccinated, the outbreak was started by a vaccine-exempt toddler.

And we have seen this in many other areas and it has been confirmed by many studies. Whatever else is contributing to pertussis outbreaks, like waning immunity, they are also associated with vaccine refusal.

“Counties with higher exemption rates had higher rates of reported pertussis among exempted and vaccinated children when compared with the low-exemption counties.”

Imdad et al. on Religious exemptions for immunization and risk of pertussis in New York State, 2000-2011.

But what if the DTaP and Tdap vaccines do cause folks to be asymptomatic carriers?

Even if that is true, understand that these vaccines don’t actually infect you, making you a carrier. They just might not prevent you from becoming a carrier if you are exposed to someone else with pertussis. While that might be a good reason to develop a new and better pertussis vaccine, it certainly isn’t a reason to skip or delay your child’s vaccines now.

Remember that even with our current outbreaks, rates of pertussis were much higher in the pre-vaccine era.

What to Know About Vaccines and Asymptomatic Carriers of Pertussis

The role of asymptomatic carriers and pertussis is controversial, but it certainly isn’t a reason to skip or delay your child’s vaccines.

More on the Vaccines and Asymptomatic Carriers of Pertussis

Which Vaccines Don’t Prevent the Spread of a Disease?

As most folks know, Dr. Bob Sears has been put on probation by the California Medical Board.

Most vaccines don't prevent the spread of diseases?
Most vaccines don’t prevent the spread of disease???

Surprisingly, that hasn’t kept him from posting dangerous misinformation about vaccines, including his latest idea that “most vaccines don’t prevent the spread of a disease.”

Which Vaccines Don’t Prevent the Spread of a Disease?

If vaccines don’t prevent the spread of disease, then how did we eradicate, eliminate, and control so many diseases?

Dr. Bob Sears actually reassured parents that measles wasn't deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe - another well-nourished population with lower vaccination rates than the U.S.
At least seven people have died in Italy with measles over the last few years. That’s not so good for Italy.

When was the last time you saw someone with small pox, rubella, diphtheria, or polio, for example?

It is true that vaccines don’t prevent the spread of some infections though.

There is tetanus, for example, but guess what?

Tetanus isn’t contagious.

Any others?

Well, unlike most other vaccines, the meningococcal B vaccines are not thought to decrease nasal carriage of the meningococcal B bacteria. So if you are vaccinated and an asymptomatic carrier of the bacteria, you could theoretically spread it to someone else, as could someone who is unvaccinated.

Still, the MenB vaccines can protect you from getting actual meningococcal B disease, and if you don’t have meningococcemia or meningococcal meningitis, you won’t expose and spread it to someone else. That’s why the MenB vaccines are especially useful in outbreak situations.

Any others? After all, Dr. Bob did say that “most vaccines don’t prevent the spread of a disease.”

Vaccines That Don’t Prevent the Spread of a Disease

There are a few other examples of vaccines that don’t prevent the spread of a disease.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

Of course, any vaccine that is delayed or skipped won’t work to prevent the spread of a disease.

Just like they are seeing measles outbreaks and deaths now, because of low vaccination rates, in Ukraine there were 17,387 cases of diphtheria and 646 deaths from 1992 to 1997. Also high, were cases of measles (over 23,000 cases in 1993) and pertussis (almost 7,000 cases in 1993).

And because of waning immunity, vaccines don’t do as good a job of preventing the spread of pertussis and mumps as we would like. Still, that’s only when the vaccines don’t work, and even then, as Dr. Bob says, they do work to reduce the severity of symptoms.  During recent mumps outbreaks, the rates of complications are far below historical levels. The same is true for pertussis.

Have you ever seen or heard an unvaccinated child with pertussis? It is truly heartbreaking, especially when you realize how easily it could be prevented.

We typically see the same thing with flu. Even when the flu vaccine isn’t a good match or isn’t as effective as we would like, it still has a lot of benefits, including reducing your risk of dying.

“IPV induces very low levels of immunity in the intestine. As a result, when a person immunized with IPV is infected with wild poliovirus, the virus can still multiply inside the intestines and be shed in the faeces, risking continued circulation.”

Inactivated poliovirus vaccine

Does the fact that IPV, the inactivated polio vaccine, can sometimes lead to infections and shedding mean that it doesn’t prevent infections?

Of course not!

“IPV triggers an excellent protective immune response in most people.”

Inactivated poliovirus vaccine

Most people vaccinated with IPV will be immune, won’t get wild polio, and so won’t be able to get anyone else sick.

Vaccines reduce disease by direct protection of vaccinees and by indirect protection of nonimmune persons. Indirect protection depends on a reduction in infection transmission, and hence on protection (immunity) against infection, not just against disease. If a vaccine were to protect only against disease, and not at all against infection, then it would have no influence on infection transmission in the community and there would be no indirect protection (vaccination of one person would have no influence on any others in the community). It would be possible to reduce disease with such a vaccine but not to eradicate the infection.

Plotkin’s Vaccines

But because IPV doesn’t provide indirect protection, we still use OPV in parts of the world where polio is more of a problem.

Vaccines work. Even the few that don’t prevent the spread of infections, still help to reduce disease.

What’s the Difference Between Infections and Disease?

Wait, is there a difference between infection and disease?

Yes there is, something that Dr. Bob, who actually wrote a book about vaccines, seems to have overlooked.

An infection is simply the presence of a virus, bacteria, or other organism in your body.

A disease, on the other hand, is a virus or bacteria in your body causing signs and symptoms.

All vaccines work to prevent disease, or at least they do when you actually get vaccinated.

A very few don’t prevent infections and the spread of infections, but that is not a good reason to skip or delay your child’s vaccines. In fact, it is one of the reasons why it is important to have high vaccination rates! Even natural infections don’t always keep you from becoming asymptomatic carriers that can infected others. Many people who have natural typhoid (remember Typhoid Mary?) and hepatitis B infections go on to become chronic carriers without any symptoms, but still able to infect others.

If you understand that a few vaccines don’t prevent the spread of infections, then you should understand that you can’t hide in the herd and expect to be protected, even though most folks around you are vaccinated.

What to Know About Vaccines and the Spread of Disease

Despite what Dr. Bob says, almost all vaccines work to prevent the spread of disease and infections, at least they do when you get your kids vaccinated.

More on Vaccines and the Spread of Disease

Is Mutating Mumps More Than the MMR Can Manage?

It is not news that we have been seeing more cases of mumps in recent years.

It is also isn’t news that many of these folks are vaccinated.

“Long Beach has been hit with a mumps outbreak that is vaccine-resistant. According to health officials in the Long Island town, almost two dozen individuals are believed to have contracted the virus, with four confirmed cases and at least 14 suspected ones.”

Natural News

That sites like Natural News is putting out misinformation about vaccine-resistant strains of mumps also shouldn’t be news to anyone.

Why Do Folks Think That Vaccine-Resistant Viruses Are Causing Mumps Outbreaks?

So are vaccine-resistant mumps viruses causing outbreaks?

There is no good evidence of that and plenty of evidence that our current vaccines, even though they aren’t perfect, do cover all wild strains of mumps.

Unfortunately, it might not be surprising that some folks are confused about vaccine-resistant mumps viruses, when we have health officials saying things like:

“Sometimes nature throws a strain at us that might have mutated a little bit, and coverage of the vaccine is not 100 percent.”

Dr. Lawrence Eisenstein, Nassau County Health Commissioner

Dr. Eisenstein’s “might have mutated a little bit” comment got twisted into “the outbreak is most likely attributable to a new strain of the virus that is resistant to vaccines” by health reporters

And out of Arkansas, where there have also been large mumps outbreaks:

“We are actually to the point that we are worried that this vaccine may indeed not be protecting against the strain of mumps that is circulating as well as it could.”

Dr. Dirk Haselow, Arkansas State Epidemiologist

Of course, to say that the vaccine may not be protecting folks “as well as it could” doesn’t mean it doesn’t work because the wild type mumps virus has evolved or mutated enough to surmount our current MMR vaccine.

Is Mutating Mumps More Than the MMR Can Manage?

Although anything is possible, we fortunately have plenty of research that says that the mumps virus hasn’t mutated and that the MMR still works.

During an outbreak, universities make sure students are up-to-date with their MMR vaccines.
During an outbreak of mumps, some kids are getting a third dose of the MMR vaccine.

In fact, although the MMR vaccine is made from the A strain or genotype of mumps, it provides good protection against all 12 known strains of wild mumps viruses, including genotype G that has been causing most of the recent outbreaks.

But how can it cover a different strain of virus that isn’t in the vaccine?

Because not all viruses and vaccines are like influenza.

“The genotyping of the mumps virus is based on the Small Hydrophobic (SH) protein, a nonstructural protein and genetically the most variable one. Based on the SH-protein 12 different mumps viruses were detected up to now. In recent epidemics in Western countries the genotype G was mainly detected, while the mumps viruses used in the live attenuated mumps vaccines belong to genotype A (Jeryl Lynn) and to a lesser extent to genotype B (Urabe). However, antibodies against the SH protein have not yet been observed in human serum. It is, therefore, unlikely that antibodies against the SH protein play an important role in antibody-mediated virus neutralization.”

Sabbe et al. on The resurgence of mumps and pertussis

It is well known that you need a very specific match of the flu vaccine to the wild flu virus that is going around to get good protection, but for many other viruses, the differences that determine the strain or genotype have nothing to do with how antibodies will recognize the virus.

“Since mumps virus is monotypic, vaccine from any strain should provide lifelong protection against subsequent infection.”

Palacios et al. on Molecular Identification of Mumps Virus Genotypes from Clinical Samples: Standardized Method of Analysis

Like measles, mumps is a monotypic virus.

“Studies have demonstrated that blood sera from vaccinated persons cross-neutralizes currently circulating mumps strains.”

CDC on Mumps for Healthcare Providers

And like measles, the mumps vaccine (MMR), protects against all strains of wild mumps viruses.

“Compared with attack rates of 31.8%–42.9% among unvaccinated individuals, attack rates among recipients of 1 dose and 2 doses of the Jeryl Lynn vaccine strain were 4%–13.6% and 2.2%–3.6%, respectively.”

Dayan et al. on Mumps Outbreaks in Vaccinated Populations: Are Available Mumps Vaccines Effective Enough to Prevent Outbreaks?

And like other vaccines, the mumps vaccine (MMR) works.

Waning immunity may be an issue, but that certainly isn’t a reason to skip or delay this vaccine and put your kids, and everyone else, at risk to get mumps.

What to Know About Mumps Strains and Outbreaks

The MMR vaccines covers all strains of mumps and getting fully vaccinated is the best way to make sure your kids don’t get mumps.

More on Mumps Strains and Outbreaks

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

What to Do If Your Child Is Exposed to Pertussis

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

How does that work?

Waning immunity and folks who are unvaccinated.

How Contagious is Pertussis?

Pertussis is very contagious, but not quite as contagious as other vaccine-preventable diseases, such as measles.

That’s why the focus on controlling pertussis outbreaks is usually looking at close contacts – those who were within about 3 feet for at least 10 hours a week or who had direct face-to-face contact with the person when they were contagious.

Have you gotten a letter from your child's school about pertussis yet?
Have you gotten a letter from your child’s school about pertussis yet?

So when you get a letter about a possible case of pertussis in your child’s school, it may be a a general warning and not that your child is at risk.

How do you get pertussis?

“Persons with pertussis are infectious from the beginning of the catarrhal stage through the third week after the onset of paroxysms or until 5 days after the start of effective antimicrobial treatment.”

Manual for the Surveillance of Vaccine-Preventable Diseases

Spread by respiratory droplets (coughing and sneezing), pertussis symptoms usually start about 5 to 10 days after being exposed to someone else who is in the early stage of their pertussis infection.

While pertussis symptoms can linger for up to 10 weeks, someone who has pertussis is most contagious during the first 2 or 3 weeks of symptoms.

Is Your Child Protected Against Pertussis?

Two pertussis vaccines, DTaP and Tdap, help protect us against pertussis.

In the Unites States, they are routinely given as a primary series (DTaP) at 2, 4, and 6, and 15 to 18 months, with a booster dose at age 4 years. And then a booster of Tdap at age 11 to 12 years. Later, Tdap is given again during each pregnancy, between 27 and 36 weeks gestation. Adults who have never had a dose of Tdap should get caught up, especially if they will be around a baby.

Protection from the pertussis vaccines wanes or wears off, so even fully vaccinated children and adults can still get pertussis. Of course, you are much more likely to get pertussis if you are unvaccinated and you will likely have more severe illness if you are unvaccinated.

Postexposure Antimicrobial Prophylaxis for Pertussis

Fortunately, as with meningitis was caused by Neisseria meningitidis and Haemophilus influenzae type b (Hib), taking antibiotics after being exposed to someone with pertussis can help prevent you from getting sick.

There are only specific situations for which this type of postexposure antimicrobial prophylaxis is recommended though, so for example, you wouldn’t usually give everyone in a school antibiotics because a few kids had pertussis.

Why not give antibiotics to everyone who might have been exposed to someone with pertussis?

“…there are no data to indicate that widespread use of PEP among contacts effectively controls or limits the scope of pertussis outbreaks.”

Postexposure Antimicrobial Prophylaxis

In addition to the fact that it likely wouldn’t stop our pertussis outbreaks, overuse of antibiotics can have consequences.

Situations in which postexposure antibiotics (azithromycin, clarithromycin, and erythromycin, or Bactrim) likely would be a good idea include:

  • household contacts of a known pertussis case
  • to help control an outbreak in a limited closed setting, like a daycare
  • contacts of a pertussis cases who are at high risk for severe pertussis, including pregnant women, infants, especially infants less than 4 months old, and people with chronic medical problems
  • contacts of a pertussis cases who are also contacts of someone who is at high risk for severe pertussis

What if you were exposed to someone with pertussis and have already gotten sick?

If your child was exposed to pertussis and is now coughing, then in addition to antibiotics, pertussis PCR testing and/or culture will also likely be done to confirm that they have pertussis. And remember that their contacts might need postexposure antibiotics.

Kids who have been exposed to pertussis and who have been coughing for more than 3 weeks won’t need antibiotics or testing, as it is too late for the antibiotics to be helpful and likely too late for testing to be accurate. Fortunately, after 3 weeks, they should no longer be contagious.

What to Do If Your Unvaccinated Child Is Exposed to Pertussis

Unvaccinated kids who are exposed to pertussis should follow the postexposure antimicrobial prophylaxis guidelines.

They should also get caught up on their immunizations, including DTaP if they are between 2 months and 6 years, or Tdap if they are older.

What to Do If Your Vaccinated Child Is Exposed to Pertussis

Since protection from the pertussis vaccines wanes, even kids who are fully vaccinated should follow the postexposure antimicrobial prophylaxis guidelines if they are exposed to pertussis.

Then why get vaccinated?

Again, being vaccinated, your child will be much less likely to get pertussis than someone who is unvaccinated. Even though the pertussis vaccine isn’t perfect, it has been shown that children who had never received any doses of DTaP (unvaccinated children) faced odds of having pertussis at least eight times higher than children who received all five doses.

What to Know About Getting Exposed to Pertussis

Talk to your pediatrician if your child gets exposed to pertussis to make sure he doesn’t need post-exposure prophylaxis to keep him from getting sick, even if you think he is up-to-date on his vaccines.

More on Getting Exposed to Pertussis

Mumps at the National Cheerleaders Association All-Star National Championship

The boys and girls at the 2018 National Cheerleaders Association All-Star National Championship in Dallas were hoping to go home with a trophy.

Some got a little more – exposure to mumps.

Mumps at the National Cheerleaders Association All-Star National Championship

If you don’t have a kid in competitive cheer, you should know that the NCA All-Star Nationals is a big deal.

Over 1,300 teams with more than 23,000 cheerleaders were competing. They came from 9 countries and 38 states for a 3 day competition at the Kay Bailey Hutchison Convention Center in downtown Dallas.

The Texas Department of State Health Services has issued a warning that a person with mumps was present at the NCA All-Star Nationals.
The Texas Department of State Health Services has issued a warning that a person with mumps was present at the NCA All-Star Nationals.

They worked hard, but they had fun.

And some of them may have been exposed to mumps.

What to Do If You Were Exposed to Mumps at the NCA All-Star Nationals

So what do you do if you were exposed to mumps in Dallas?

While mumps is a vaccine-preventable disease, even kids who have gotten two MMR shots can still get mumps. That’s because waning immunity causes the vaccine to become less effective over time.

Still, mumps is not nearly as contagious as other vaccine-preventable diseases, such as measles. You generally have to have close contact with someone with mumps to catch it.

“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

Unless you were on the same team as the person with mumps (if it was a cheerleader), your risk of getting sick probably isn’t that high. Of course, the risk goes up the more contact you had.

Mumps is not just for kids anymoreUnfortunately, neither a post-exposure dose of MMR nor immune globulin work to prevent mumps after you are already exposed.

At this point, whether or not your child is vaccinated, all you can do is wait and watch to see if they develop signs or symptoms of mumps.

With an incubation period of 12 to 25 days, that means that those who were exposed could get sick between March 7 and March 22.

While there is no treatment for mumps, you do want to watch for complications and make sure you don’t expose anyone else.

And if your child is unvaccinated, this exposure is a good reminder that outbreaks still happen, vaccines are necessary, and this is a good time to get caught up.

Mumps and Cheer

Not surprisingly, this isn’t the first time we are hearing about mumps at a cheer competition.

In 2016, mumps exposures at several cheer competitions in North Texas led to at least 11 cases of mumps.

Why cheer? It’s not cheer, but the nature of cheer competitions. You just have a lot of older kids together at these competitions from a lot of different places and the MMR vaccine is known to have an issue with waning immunity.

Fortunately, most of these kids are vaccinated, which helps keep these outbreaks from really getting out of control, like they did in the pre-vaccine era.

What to Know About Mumps at the NCA All-Star Nationals

Tens of thousands of kids could have been exposed to mumps at a cheerleader competition in Dallas.

More on Mumps at the NCA All-Star Nationals

 

 

 

Do Your Kids Need a Mumps Booster Shot?

Traditionally, kids get vaccines to protect them against mumps when they are 12 to 15 months old (1st dose of MMR) and again before starting kindergarten (2nd dose of MMR).

Do Your Kids Need a Mumps Booster Shot?

Routine use of the mumps vaccine, which was first licensed in 1967, has helped to greatly reduce the incidence of mumps cases from pre-vaccine era levels.

Outbreaks of mumps the last few years have led to calls for a third dose of MMR in some situations though.

mumps-booster
During an outbreak, universities make sure students are up-to-date with their MMR vaccines.

Does that mean that your kids will need a third dose of the MMR vaccine?

Probably not.

“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

Is there a mumps outbreak in your area?

While that is the main reason to get a third dose of MMR, simply being near an outbreak still doesn’t mean an extra vaccine is necessary.

“In the setting of an identified mumps outbreak, public health authorities should define target groups at increased risk for mumps during the outbreak, determine whether vaccination of at-risk persons is indicated, and provide recommendations for vaccination to health care providers.”

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

Your local or state health department will decide which folks need a third dose of MMR in an outbreak situation.

“Persons at increased risk for acquiring mumps are those who are more likely to have prolonged or intense exposure to droplets or saliva from a person infected with mumps, such as through close contact or sharing of drinks or utensils.”

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

Why not just give everyone a third dose of MMR?

The issue with the mumps vaccine is waning immunity, so it isn’t known how long an extra dose would last, and that’s why at this time, the only recommendation is to give an extra dose during outbreaks.

If you are still unsure about needing a third dose of MMR, ask your pediatrician, school health clinic, or local health department, especially if you have heard about local mumps cases.

What to Know About the Mumps Booster Shot

A third dose of MMR is recommended for some people at high risk to get mumps in an outbreak situation.

More on the Mumps Booster Shot