title: Meta-analysis of vaccine effectiveness of mumps-containing vaccine under different immunization strategies in China.
abstract: OBJECTIVE
  To evaluate vaccine effectiveness (VE) of mumps-containing vaccine (MuV) under different immunization strategies.
  
  
  METHODS
  We conducted Medline, Embase, China National Knowledge Internet (CNKI), and Wan Fang Database (WF) searches for Chinese and English language articles describing studies of mumps VE in a Chinese population. Evaluated articles were scored on quality using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models. Sensitivity analysis, subgroup analysis and meta-regression were conducted to explore heterogeneity.
  
  
  RESULTS
  A total of 32 studies in 19 papers were included; 14 were case-control studies, and 18 were cohort studies. Half of the studies were of high quality; 41% were of moderate quality. The overall VE for mumps containing vaccine (either one dose or two doses) was 85% (95% CI 76-90%) for cohort studies and 88% (95% CI 82-92%) for case-control studies. Using random effects meta-regression we found significant differences in some study covariates; for instance, VE varied by population (VE=88% in day care versus 69% in pupil, p=0.008) and emergency versus routine immunization (VE=80% for routine immunization versus 95% for emergency immunization, p=0.041). However, these results must be interpreted with caution due to the low number of studies in subgroups, with the permutation test giving non-significant results that indicated that the results may be due to chance.
  
  
  CONCLUSIONS
  MuV provides good protection from mumps infection. Further studies of mumps VE with larger sample sizes enabling subgroup analyses will be needed to confirm our findings.
authors.affiliation: National Center of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Huaqing
authors.initials: H
authors.lastname: Wang
authors.affiliation: National Center of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Hu
authors.affiliation: National Center of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Guomin
authors.initials: G
authors.lastname: Zhang
authors.affiliation: National Center of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Jingshan
authors.initials: J
authors.lastname: Zheng
authors.affiliation: National Center of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: National Center of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China. Electronic address: anzj@chinacdc.cn.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: An
mesh_terms: D002681:China / Q000453:epidemiology; D006801:Humans; D009107:Mumps / Q000517:prevention & control*; D009108:Mumps Vaccine / Q000627:therapeutic use*; D014611:Vaccination / Q000379:methods*
chemical_list: D009108:Mumps Vaccine
keywords: Meta-analysis; Mumps vaccine; Vaccine effectiveness