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Mumps outbreak in Israel's highly vaccinated society: are two doses enough?

  • E. ANIS (a1) (a2), I. GROTTO (a1) (a3), L. MOERMAN (a1), B. WARSHAVSKY (a1), P. E. SLATER (a1) (a2) and B. LEV (a1)...

Mumps outbreaks in recent years have given rise to questions about the effectiveness of the mumps vaccine. This study examined the epidemiological data from a recent mumps outbreak in Israel and from outbreaks in other countries with high vaccination coverage, and considered whether long-established vaccination policies designed to protect against mumps are in need of revision. Of over 5000 case patients in the Israeli outbreak, half of whom were in the Jerusalem health district, nearly 40% were aged ⩾15 years and, of those whose vaccination status was known, 78% had been fully vaccinated for their age – features similar to those in recent mumps outbreaks in Europe and North America. The epidemiological and laboratory evidence suggests that many previously vaccinated adolescents and young adults are now susceptible to mumps because their vaccine-based immunity has waned. Booster vaccination programmes for those at high risk of infection during mumps outbreaks – particularly those in congregate living environments – merit priority consideration.

Corresponding author
*Author for correspondence: E. Anis, MD, MPH, Director, Division of Epidemiology, Ministry of Health, Israel. (Email:
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2.PE Slater , E Anis , A Leventhal . The control of mumps in Israel. European Journal of Epidemiology 1999; 15: 765787.

3.E Anis , Measles in a highly vaccinated society: the 2007–2008 outbreak in Israel. Journal of Infection 2009; 59: 252258.

4.GH Dayan , S Rubin . Mumps Outbreaks in vaccinated populations: are available mumps vaccines effective enough to prevent outbreaks? Clinical Infectious Diseases 2008; 47: 14581467.

5.JM Conly , BL Johnston . Is mumps making a comeback? Canadian Journal of Infectious Diseases & Medical Microbiology 2007; 18: 79.

6.AE Barskey , JW Glasser , CW LeBaron . Mumps resurgences in the United States: a historical perspective on unexpected elements. Vaccine 2009; 27: 61866195.

8.E Savage , Mumps outbreaks across England and Wales in 2004: observational study. British Medical Journal 2005; 330: 11191120.

9.C Stein-Zamir , Mumps outbreak in Jerusalem affecting mainly male adolescents. Eurosurveillance 2009; 14(50): pii=19440.

13.JD Shanley . The resurgence of mumps in young adults and adolescents. Cleveland Clinic Journal of Medicine 2007; 74: 4248.

14.WHO.Weekly Epidemiological Record, no. 7, 16 February 2007. ( Accessed 20 February 2011.

16.ES McBryde . Network structure can play a role in vaccination thresholds and herd immunity: a simulation using a network mathematical model. Clinical Infectious Diseases 2009; 48: 685686.

17.C Cohen , Vaccine effectiveness estimates, 2004–2005 mumps outbreak, England. Emerging Infectious Diseases 2007: 13(1).

19.Health Protection Agency, UK. Health Protection Report, Vol. 4, No. 2, 15 January 2010 ( Accessed 20 February 2011.

21.GH Dayan , Recent resurgence of mumps in the United States. New England Journal of Medicine 2008; 358: 15801589.

22.G Watson-Creed , Two successive outbreaks of mumps in Nova Scotia among vaccinated adolescents and young adults. Canadian Medical Association Journal 2006; 175: 483488.

23.VS Kancherla , IC Hanson . Mumps resurgence in the United States. Journal of Allergy and Clinical Immunology 2006; 118: 938941.

24.LJ Anderson , JF Seward . Mumps epidemiology and immunity: the anatomy of a modern epidemic. Pediatric Infectious Disease Journal 2008; 27 (10 Suppl.): S75S79.

25.PA Briss , Sustained transmission of mumps in a highly vaccinated population: assessment of primary vaccine failure and waning vaccine-induced immunity. Journal of Infectious Diseases 1994; 169: 7782.

26.H Peltola , Mumps outbreaks in Canada and the United States: time for new thinking on mumps vaccines. Clinical Infectious Diseases 2007; 45: 459466.

28.MM Cortese , Mumps vaccine performance among university students during a mumps outbreak. Clinical Infectious Diseases 2008; 46: 11721180.

29.SA Rubin , Antibody induced by immunization with the Jeryl Lynn mumps vaccine strain effectively neutralizes a heterologous wild-type mumps virus associated with a large outbreak. Journal of Infectious Diseases 2008; 198: 505515.

31.AA Date , Long-term persistence of mumps antibody after receipt of 2 measles-mumps-rubella (MMR) vaccinations and antibody response after a third MMR vaccination among a university population. Journal of Infectious Diseases 2008; 197: 16621668.

32.PK Kutty , Seroprevalence of antibody to mumps virus in the US population, 1999–2004. Journal of Infectious Diseases 2010; 202: 667674.

33.DW Park , Mumps outbreak in a highly vaccinated school population: assessment of secondary vaccine failure using IgG avidity measurements. Vaccine 2007; 25: 46654670.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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