Vaccine Study Center, Division of Research, Kaiser Permanente , Oakland, CA, USA.
Hum Vaccin Immunother. 2020 Dec 1;16(12):3098-3102. doi: 10.1080/21645515.2020.1756153. Epub 2020 May 13.
Mumps outbreaks among previously vaccinated young adults raise concerns regarding waning vaccine immunity. This study identified, described and assessed the changing incidence of mumps cases following mumps-containing vaccination (MMR/MMRV) in a non-mumps outbreak setting. Potential cases between 1996 and 2018 were identified by the international classification of disease codes or by mumps laboratory test orders among Kaiser Permanente Northern California members. Medical charts were reviewed to confirm diagnoses, timing relative to vaccination and clinical characteristics. Among 474 potential cases, 257 (54.2%) were confirmed after chart review. A third of the cases were <10 years old at diagnosis and 48% were over 25 years. Most cases (92.2%) had parotitis and 5% of males had orchitis. Mumps rates decreased from 8.5 to 1.8/1,000,000 person-years as time since the second MMR/MMRV dose increased from <2 years to ≥10 years. Similarly, rates decreased from 16.3 to 3/1,000,000 person-years after at least 1 dose of MMR/MMRV. Mumps rates were higher among children aged ≤10 years compared with older age groups. In conclusion, in the context of a non-outbreak setting, this study suggests that waning of vaccine immunity to mumps appeared to have minimal clinical impact.
在已接种疫苗的年轻成年人中爆发腮腺炎引起了人们对疫苗免疫力下降的担忧。本研究在非腮腺炎爆发环境中,确定、描述和评估了接种含腮腺炎疫苗(MMR/MMRV)后的腮腺炎病例的发病率变化。在 Kaiser Permanente Northern California 成员中,通过国际疾病分类代码或腮腺炎实验室检测订单确定了 1996 年至 2018 年之间的潜在病例。通过审查医疗记录来确认诊断、与疫苗接种的时间关系以及临床特征。在 474 例潜在病例中,有 257 例(54.2%)经图表审查后得到确认。三分之一的病例在诊断时年龄<10 岁,48%的病例年龄超过 25 岁。大多数病例(92.2%)有腮腺炎,5%的男性患有睾丸炎。随着距第二剂 MMR/MMRV 接种时间的增加(从<2 年增加到≥10 年),腮腺炎发病率从 8.5 降至 1.8/100 万人口年。同样,至少接种一剂 MMR/MMRV 后,发病率从 16.3 降至 3/100 万人口年。≤10 岁儿童的腮腺炎发病率高于年龄较大的组。总之,在非爆发环境下,本研究表明,腮腺炎疫苗免疫力下降似乎对临床影响极小。