FSBSI "Chumakov FSC R&D IBP RAS", Moscow, Russia; Infectious Clinical Hospital No. 1, Moscow, Russia.
Infectious Clinical Hospital No. 1, Moscow, Russia.
Public Health. 2020 Sep;186:8-11. doi: 10.1016/j.puhe.2020.06.009. Epub 2020 Jul 28.
Mumps is a highly contagious viral infection prevented by immunization with live attenuated vaccines. Mumps vaccines have proven to be safe and effective; however, rare cases of aseptic meningitis (AM) can occur after vaccination. The range of meningitis occurrence varies by different factors (strain, vaccine producer, and so on). Monovaccines or divaccines (mumps-measles vaccine), prepared from the strain Leningrad-3 (L-3), are used in Russia. Meningitis occurrence after vaccination has been established previously as very low. Nevertheless, with the number of children being vaccinated every year, vaccine-associated AM cases still occur. There is no official statistics on AM incidence after mumps vaccines, and information on AM features as an adverse event of mumps vaccination is limited and mostly devoted to vaccines, prepared from strains other than L-3.
The study included patients with AM who were vaccinated against mumps in the previous 30 days before the present disease onset during 2009-2019.
Patients admitted to Infectious Clinical Hospital No. 1, Moscow, Russia, with AM were observed by a pediatrician and were screened for etiological agents of meningitis.
Seven patients were enrolled, and clinical features and the course of infection are presented.
Detection of only 7 cases of AM associated with mumps vaccination during the 10-year period supports very low occurrence of this adverse event after immunization with the L-3 strain-based mumps vaccines. Nevertheless, the annual number of AM cases that occur after mumps vaccination remains unknown and poorly diagnosed in practice because of the low awareness of physicians of this adverse reaction. Detection and objective coverage of such cases can lead to a weakening of 'antivaccination' moods in a society and to restoration of confidence in the healthcare system.
腮腺炎是一种由活减毒疫苗免疫预防的高度传染性病毒感染。腮腺炎疫苗已被证明是安全有效的；然而，接种疫苗后仍可能发生罕见的无菌性脑膜炎（AM）病例。脑膜炎的发生范围因不同因素（菌株、疫苗生产商等）而异。俄罗斯使用的疫苗为 Leningrad-3（L-3）株制备的单价疫苗或双价疫苗（腮腺炎-麻疹疫苗）。此前已经确定，接种疫苗后发生脑膜炎的概率非常低。然而，由于每年接种疫苗的儿童数量众多，仍会发生与疫苗相关的 AM 病例。俄罗斯没有 AM 发病率的官方统计数据，关于 AM 作为腮腺炎疫苗接种不良反应的信息有限，主要涉及除 L-3 株以外的其他菌株制备的疫苗。
本研究纳入了 2009 年至 2019 年期间在出现本次疾病前 30 天内接种腮腺炎疫苗的 AM 患者。
在俄罗斯莫斯科传染病临床医院 1 号，由儿科医生观察接种腮腺炎疫苗后出现 AM 的患者，并对其进行脑膜炎病因检测。
共纳入 7 例患者，介绍了其临床特征和感染过程。
在 10 年期间仅发现 7 例与腮腺炎疫苗接种相关的 AM 病例，表明接种 L-3 株腮腺炎疫苗后发生这种不良反应的概率非常低。然而，由于医生对这种不良反应的认识不足，实际上，每年接种腮腺炎疫苗后发生 AM 的病例数量和诊断情况仍不清楚。发现并客观报道此类病例可能会减弱社会中的“反疫苗”情绪，并恢复公众对医疗保健系统的信心。
