Mumps cases set to surge, DH advisers warn

Mumps cases may begin to surge this autumn as the dip in MMR uptake in the 1990s begins to affect levels of protection in the population, DH advisers have warned.

MMR jab: uptake fell sharply in late 1990s

The UK’s Joint Committee on Vaccination and Immunisation (JCVI) said that GPs should check adolescents’ MMR status and offer vaccination to those who have missed doses.

In the minutes of its latest meeting released this week, the JCVI subcommittee on adolescent vaccinations said that there had already been a number of ‘significant’ mumps outbreaks in the UK over the past decade. To date, it said that cases 'have mainly been limited to unimmunised or partially immunised individuals'.

But the JCVI added that the immunity provided by mumps drops over time. ‘Estimates of waning immunity vary, but it may be reasonable to assume that protection from infection falls to around 60% after 10-15 years,’ it warned.

The subcommittee said that a ‘resurgence of mumps may be expected’ once young unimmunised adults begin university.

UK MMR uptake levels fell from above 90% to less than 80% (see graph) after a February 1998 Lancet paper by former surgeon Andrew Wakefield claimed the vaccine was linked to the development of autism.

Children born after February 1994, who would have been due for their pre-school MMR vaccination as uptake levels fell after February 1998, will begin university this autumn.

‘A number of outbreaks have occurred in young adults in universities probably due to the contact patterns in those settings as close contact may be required for infection of those with at least some vaccine-induced immunity,’ the subcommittee said.

‘A resurgence of mumps may be expected in that population in future years due to the decline in MMR coverage during the last decade.’

The JCVI said that adding or moving MMR doses to boost protection may shift the burden of disease and, without more evidence, that no advice adjusting dosing to boost immunity could be given.

‘The subcommittee concluded that it may be most effective and cost effective to re-enforce current policy to check the MMR status of adolescents and offer missed vaccinations,’ minutes from its meeting said.

‘This may be particularly important in coming years to prevent not only mumps but measles and rubella outbreaks in under-immunised birth cohorts.

The subcommittee added: ‘Communications to adolescents could highlight the severe nature of these diseases to young adults.’

The Health Protection Agency (HPA) warned earlier this year that poor uptake of MMR jabs on Merseyside was leaving babies and toddlers at risk as the region faced its largest measles outbreak in decades.

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