Perspectives on the Relative Resurgence of Mumps in the United States

doi:10.1001/archpedi.1988.02150050037025

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Vol. 142 No. 5, May 1988

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Perspectives on the Relative Resurgence of Mumps in the United States

Stephen L. Cochi, MD; Stephen R. Preblud, MD; Walter A. Orenstein, MD

Am J Dis Child. 1988;142(5):499-507.

Abstract

• Although the United States has enjoyed great successin the control of mumps since the licensure of live virus mumpsvaccine in 1967, a relative resurgence of mumps during the 1986-1987period has raised concerns about the long-term effectivenessof mumps vaccine. We reviewed mumps surveillance data, historicalinformation on mumps vaccine distribution and recommendationsfor its use, survey data on levels of mumps immunization inUS children during the 1973-1985 period, the effect of mumpsimmunization school laws on the reported incidence of mumpsamong states with and without such laws, and studies of mumpsvaccine effectiveness. Following licensure, a decade elapsedbefore mumps vaccine was endorsed as a routine immunizationof childhood, while immunization survey and vaccine distributiondata reflected only gradual acceptance of the vaccine. However,mumps incidence declined during this period, resulting in arelatively underimmunized cohort of children born between 1967and 1977 who grew up during a period when the risk of exposureto mumps was rapidly declining. The resurgence of mumps since1986 has been characterized by a selective increase in incidenceand a shift in the age group at highest risk to middle and highschool students in those states lacking comprehensive mumpsimmunization school laws. Postlicensure field evaluations ofmumps vaccine effectiveness have not demonstrated waning vaccine-inducedimmunity. The data indicate that the relative resurgence ofmumps in the United States is chiefly due to a failure to vaccinateall susceptible persons, especially those who are now between10 and 19 years old. Mumps immunization school laws offer anapproach to deal with the problem of continuing susceptibilityin school-age populations.

(AJDC 1988;142:499-507)

Author Affiliations

From the Division of Immunization, Center for Prevention Services, Centers for Disease Control, Atlanta.

Footnotes

Accepted for publication Jan 21, 1988.

Reprint requests to Technical Information Services, Center forPrevention Services, Centers for Disease Control, Atlanta, GA30333.

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