title: Sustained transmission of mumps in a highly vaccinated population: assessment of primary vaccine failure and waning vaccine-induced immunity.
abstract: From January to July 1991, an outbreak of mumps occurred in Maury County, Tennessee. At the primarily affected high school, where 98% of students and all but 1 student with mumps had been vaccinated before the outbreak, 68 mumps cases occurred among 1116 students (attack rate, 6.1%). Students vaccinated before 1988 (the first year mumps vaccination was required for school attendance in Tennessee) may have been at greater risk of mumps than those vaccinated later (65[6.1%] of 1001 vs. 2[2.2%] of 89; risk ratio, 2.9; 95% confidence interval, 0.7-11.6). Of 13 persons with confirmed mumps who underwent serologic testing, 3 lacked IgM antibody in well-timed acute- and convalescent-phase serum specimens. Vaccine failure accounted for a sustained mumps outbreak in a highly vaccinated population. Most mumps cases were attributable to primary vaccine failure. It is possible that waning vaccine-induced immunity also played a role.
authors.affiliation: Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: P A
authors.initials: PA
authors.lastname: Briss
authors.forename: L J
authors.initials: LJ
authors.lastname: Fehrs
authors.forename: R A
authors.initials: RA
authors.lastname: Parker
authors.forename: P F
authors.initials: PF
authors.lastname: Wright
authors.forename: E C
authors.initials: EC
authors.lastname: Sannella
authors.forename: R H
authors.initials: RH
authors.lastname: Hutcheson
authors.forename: W
authors.initials: W
authors.lastname: Schaffner
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007117:Immunization, Secondary; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008499:Medical Records; D009107:Mumps / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D009108:Mumps Vaccine / Q000276:immunology*; D012307:Risk Factors; D013714:Tennessee / Q000453:epidemiology; D013997:Time Factors; D017211:Treatment Failure; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D009108:Mumps Vaccine