Peltola H, Davidkin I, Paunio M, Valle M, Leinikki P, Heinonen O P
Hospital for Children and Adolescents, PO Box 281, FIN-00029 HUS, Helsinki, Finland.
JAMA. 2000;284(20):2643-7. doi: 10.1001/jama.284.20.2643.
Many countries use trivalent measles-mumps-rubella (MMR) vaccine for their mumps and rubella immunization programs. In Finland, a national 2-dose MMR vaccination program for children, free of charge and on a voluntary basis, was launched in 1982. Serological confirmation of all suspected cases of mumps and rubella has been required since 1987. Despite intensive surveillance, no persistent sequelae or deaths attributable to vaccination have been detected. Indigenous mumps and rubella were eliminated in 1996, but 4 imported cases of mumps and 2 of rubella occurred from 1997 to 1999. Lack of secondary cases indicates sufficient immunity in the community. Compared with an epidemic year, up to thousands of cases of mumps meningoencephalitis and orchitis and around 50 cases of congenital rubella syndrome are now avoided annually. A 2-dose vaccine regimen in children during the last 17 years (1983-1999) has interrupted circulation of the target viruses entirely. Finland is the first country documented to be free of indigenous mumps and rubella (measles was eliminated in 1996). Despite the ongoing possibility of imported disease, major outbreaks probably can be avoided by maintaining high vaccination coverage and the 2-dose policy. JAMA. 2000;284:2643-2647.
许多国家在其腮腺炎和风疹免疫规划中使用三价麻疹-腮腺炎-风疹（MMR）疫苗。在芬兰，1982年启动了一项针对儿童的全国性两剂次MMR疫苗接种计划，该计划免费且自愿。自1987年以来，一直要求对所有疑似腮腺炎和风疹病例进行血清学确诊。尽管进行了强化监测，但尚未检测到任何与疫苗接种相关的持续性后遗症或死亡病例。1996年消除了本土腮腺炎和风疹病例，但在1997年至1999年期间出现了4例输入性腮腺炎病例和2例输入性风疹病例。没有二代病例表明社区中存在足够的免疫力。与疫情年份相比，现在每年可避免多达数千例腮腺炎脑膜脑炎和睾丸炎病例以及约50例先天性风疹综合征病例。在过去17年（1983 - 1999年）中，儿童的两剂疫苗接种方案已完全阻断了目标病毒的传播。芬兰是首个有记录表明已消除本土腮腺炎和风疹的国家（麻疹于1996年消除）。尽管仍有可能出现输入性疾病，但通过维持高疫苗接种覆盖率和两剂接种政策，可能避免大规模疫情爆发。《美国医学会杂志》。2000年；284:2643 - 2647。
