Kathleen Fullerton, Vaccine Safety and Development Activity, Epi and Surv Division, CDC, 1600 Clifton Road, Mailstop E-61, Atlanta, GA, USA, Robert P. Pless, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-61, Atlanta, Georgia, USA, and Susan Reef, Centers for Disease Control and Prevention, National Immunization Program, Rubella/Mumps Activity Chief, 1600 Clifton Road, NE, MS E-61, Atlanta, Georgia, USA.
KEYWORDS:
mumps, vaccine, urabe, adverse events, safety, efficacy, cost-benefit
BACKGROUND:
The International Task Force for Disease Eradication (ITFDE) identified mumps, but not measles, as a candidate for global eradication. As countries embark on measles elimination activities, an opportunity to reach the ITFDE goal exists: mumps vaccine is available in combination with measles and rubella. However, there is debate about the safety and efficacy of the available mumps vaccine strains: the occurrence of post-vaccination aseptic meningitis resulted in the discontinuation of the Urabe strain from most routine immunization programs in the late 1980’s. With alternatives being more expensive, bivalent measles-rubella vaccine is of choice for measles control activities in many countries. At a meeting in September 2001, WHO reaffirmed the acceptability of the continued use of the Urabe strain. Understanding the safety profile of each vaccine strain will prevent missed opportunities for controlling mumps worldwide.
OBJECTIVE(S):
To review the available information on the safety, efficacy and cost of different mumps virus vaccine strains used worldwide in light of the WHO recommendation to maintain the Urabe strain.
METHOD(S):
A full MEDLINE search was conducted for English-language papers regarding the safety and efficacy of mumps vaccines. Additional articles were obtained using their references.
RESULT(S):
The initial search identified 456 articles. 390 articles address specific adverse events and safety issues. Of these, 54 evaluate aseptic meningitis, 77 autism, 30 IBD, 11 Crohn's disease, 13 anaphylaxis, 2 the placental transfer of mumps virus, and 13 diabetes. Strain-specific findings are discussed.
CONCLUSIONS(S):
Mumps vaccines differ in their safety profiles. However until cost differences can be minimized, some countries will continue to rely on products that have been deemed unacceptable by other countries.
LEARNING OBJECTIVES:
To understand the controversy around mumps vaccination related to differences between various vaccine strains, and the potential to eradicate the disease.
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