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Am Fam Physician. 2006;74(10):1787-1792

ACIP Updates Mumps Vaccination Schedule

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention has updated its recommendations for mumps vaccination and immunity. The recommendations appear in the June 9, 2006, issue of Morbidity and Mortality Weekly Report.

Failure to control infection has occurred in hospitals and long-term care facilities that house adolescent or young adult patients, resulting in nosocomial transmission. When exposed to an outbreak of mumps, those same health care settings can experience unexpected costs, which may include reassignment of staff members or the closure of wards.

From January 1 through May 2, 2006, there were 2,597 reported cases of mumps in 11 states. This outbreak emphasized the limitations of the 1998 recommendations on the prevention of mumps transmission in health care and other high-risk settings.

Documentation of adequate vaccination, laboratory evidence of immunity, birth before 1957, or documentation of physician-diagnosed mumps presume acceptable evidence of immunity to mumps. However, documented evidence of immunity is now defined as one dose of a live mumps virus vaccine for preschool-age children and adults who are not at high risk for mumps, or two doses for school-age children and high-risk adults such as health care professionals, college students, and international travelers.

It is recommended that family physicians and other health care professionals be immune to mumps. Health care professionals who were born during or after 1957 should receive two doses of a live mumps virus vaccine to achieve adequate vaccination. Those with no history of a mumps vaccination and no other evidence of immunity should receive two doses, and health care professionals who have received only one dose previously should be given a second dose.

Health care facilities should consider recommending one dose of a live mumps virus vaccine to their unvaccinated health care employees who were born before 1957 who do not have a history of physician-diagnosed mumps or laboratory evidence of immunity. A second dose of the mumps vaccine also is recommended for children one to four years of age or for adults who have received only one dose.

These new recommendations for health care professionals may offer increased protection against mumps during an outbreak; however, reviewing the vaccination status of health care professionals may be inefficient, and facilities may want to consider only a routine review of immunity status while still providing other annual disease-prevention measures.

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