title: Impact of a third dose of measles-mumps-rubella vaccine on a mumps outbreak.
abstract: OBJECTIVE
  During 2009-2010, a northeastern US religious community experienced a large mumps outbreak despite high 2-dose measles-mumps-rubella (MMR) vaccine coverage. A third dose of MMR vaccine was offered to students in an affected community in an effort to control the outbreak.
  
  
  METHODS
  Eligible sixth- to 12th-grade students in 3 schools were offered a third dose of MMR vaccine. Baseline and follow-up surveys and physician case reports were used to monitor mumps attack rates (ARs). We calculated ARs for defined 3-week periods before and after the intervention.
  
  
  RESULTS
  Of 2265 eligible students, 2178 (96.2%) provided documentation of having received 2 previous doses of MMR vaccine, and a high proportion (1755 or 80.6%) chose to receive an additional vaccine dose. The overall AR for all sixth- to 12th-grade students declined from 4.93% in the prevaccination period to 0.13% after vaccination (P < .001). Villagewide, overall AR declined by 75.6% after the intervention. A decline occurred in all age groups but was significantly greater (96.0%) among 11- to 17-year-olds, the age group targeted for vaccination, than among all other age groups. The proportions of adverse events reported were lower than or within the range of those in previous reports of first- and second-dose MMR vaccine studies.
  
  
  CONCLUSIONS
  This is the first study to assess the impact of a third MMR vaccine dose for mumps outbreak control. The decline in incidence shortly after the intervention suggests that a third dose of MMR vaccine may help control mumps outbreaks among populations with preexisting high 2-dose vaccine coverage.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: Ikechukwu U
authors.initials: IU
authors.lastname: Ogbuanu
authors.forename: Preeta K
authors.initials: PK
authors.lastname: Kutty
authors.forename: Jean M
authors.initials: JM
authors.lastname: Hudson
authors.forename: Debra
authors.initials: D
authors.lastname: Blog
authors.forename: Glen R
authors.initials: GR
authors.lastname: Abedi
authors.forename: Stephen
authors.initials: S
authors.lastname: Goodell
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Lawler
authors.forename: Huong Q
authors.initials: HQ
authors.lastname: McLean
authors.forename: Lynn
authors.initials: L
authors.lastname: Pollock
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rausch-Phung
authors.forename: Cynthia
authors.initials: C
authors.lastname: Schulte
authors.forename: Barbara
authors.initials: B
authors.lastname: Valure
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Armstrong
authors.forename: Kathleen
authors.initials: K
authors.lastname: Gallagher
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D007117:Immunization, Secondary; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D009107:Mumps / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D009518:New York; D016896:Treatment Outcome
chemical_list: D022542:Measles-Mumps-Rubella Vaccine