Mumps in the Era of Vaccination

In case you missed it, there’s a mumps outbreak in the NHL that’s causing quite the stir.

HealthMap’s Disease Daily explains how these kinds of outbreaks can happen — even if most people are vaccinated.

This post originally appeared on HealthMap’s Disease Daily on May 8, 2014. It has been reposted here with permission from the authors.

Eastern Chipmunk with cheeks filled of food supply, Cap Tourmente National Wildlife Area, Quebec, Canada by Cephas

Eastern Chipmunk with cheeks filled of food supply, Cap Tourmente National Wildlife Area, Quebec, Canada by Cephas

By Jane Huston and Robyn Correll Carlyle

When we hear the word mumps, we picture a young boy wearing wool trousers and suspenders with comically swollen cheeks, left behind while his family takes the brand new Model T to town to see the latest Charlie Chaplin flick. Maybe we’re too imaginative but nonetheless, it sounds like a disease from the past.

So, imagine our surprise when we started hearing reports of a mumps outbreak at Ohio State University (OSU) in early January. What started as a few cases has now spread to more than 300 people throughout the state. And news of other mumps outbreaks have cropped up at Fordham University in New York and the University of Illinois.

The kicker? Most of those affected have been vaccinated.

How is this possible? If these people were vaccinated, how did they still get mumps? Wasn’t the vaccine effective?

The answer is complicated, and there are a few things you need to consider:

1. The majority of people getting sick with the mumps are vaccinated — but that’s because almost everyone is. The percent of small children in the United States with at least one dose of the MMR vaccine has been at or above 90 percent for nearly two decades now.

2. No vaccine is 100 percent effective. But then again, no surgical procedure or medication is either. Even Google goes down occasionally.

The mumps component of the MMR (measles, mumps, rubella) vaccine is between 75- 91 percent effective, and effectiveness is higher with two doses. As a result, up to 10-15 percent of those who get a mumps vaccine won’t actually develop sufficient antibodies to provide immunity, especially during an outbreak.

This can be for a few different reasons: First, the MMR is a live vaccine, which means that it needs to be kept alive to work. If a vaccine is not stored or handled properly, that vaccine can lose its potency and become less effective at helping your body produce antibodies. This is a particularly large challenge in developing countries, where the electricity and infrastructure needed to keep the vaccine at optimal temperatures is sometimes infrequently available. But power outages can happen in the United States, too, and if vaccines aren’t handled properly en route from the manufacturer to the provider’s office or pharmacy, there’s a chance they won’t be as effective.

Second, as much as we want to believe there can be a one-size-fits-all approach in medicine, human bodies aren’t all the same, and not all immune systems will react in the exact same way to vaccines. As a result, there are individuals who, for one reason or another, do not develop an immune response after vaccination, or who do develop some protection against a disease, but that protection is incomplete or temporary.

Fortunately, even if a vaccine fails in an individual, that person has something to fall back on: herd immunity. We’ve written about herd immunity before, and explained its role in protecting those who can’t get vaccinated for age or medical reasons. But herd immunity also protects those who are vaccinated and (unknowingly) do not generate the appropriate immune response.

3. Protection from a disease is not an all-or-nothing thing. Here’s an example: Say you are someone who got one dose of the vaccine and developed a weak, but present, immune response. Those antibodies will probably protect you if you come into contact with one infected individual in passing, but multiple infected individuals in close quarters? Probably not. Your immune system can handle a small amount of exposure to mumps, but not a full-on assault, which is what happens when you get those infected with the mumps in close proximity with a lot of other people — in a college dormitory, for example, or a crowded lecture hall.

4. Even with “breakthrough” cases, vaccination is still our best defense against the mumps. Before vaccination campaigns began in 1967, there were about 186,000 cases every year. In 2013, there were 438. Vaccination has resulted in a roughly 99 percent decrease in the number of mumps cases. So think of how much worse these outbreaks would be if vaccination rates weren’t already high.

Even if you do get the disease after getting vaccinated, chances are it will be a much milder illness. And while mumps might look like nothing more than a case of chipmunk cheeks, it can cause some pretty severe complications like pancreatitis or deafness. Prior to routine vaccination against mumps, 15 percent of cases suffered meningitis, two to five percent pancreatitis, and on rare occasions (about 1 in 20,000), patients could go deaf as a result of mumps infection.

Of the 309 cases of mumps in Ohio so far, there have been only three hospitalizations. If we applied pre-vaccination era hospitalization rates to the same number of cases, that number would be roughly five times higher.

So if anything, these mumps outbreaks demonstrate why vaccines are so important, and why everyone who can be immunized should be.

Unless, of course, you’re into chipmunk cheeks.

Jane manages the Vaccine Finder project at Health Map, the host site of the Disease Daily. Robyn is a contributing writer for the Disease Daily and works as a project manager for a non-profit focused on vaccine education. Both are fully up-to-date on their immunizations.

What We Didn’t Miss, Thanks to the Flu Vaccine

This post originally appeared on Voices for Vaccines. It has been re-posted here with permission from the author. 

In recognition of National Influenza Vaccination Week (NIVW) Voices for Vaccines is participating in a blog relay as part of a countdown to the first day of NIVW. Each day, a different Flu Vaccination Digital Ambassador will post about the importance of flu vaccination as it relates to their readers. You can follow the NIVW conversation on Twitter using hashtag #NIVW2014 and stay tuned as each Digital Ambassador shares who will be posting next. 

Countdown to NIVW blog relay schedule:

What We Didn’t Miss

Last season, influenza took the lives of 109 children. And 90% of those children had not received their flu vaccine.

Despite these statistics, many parents will not get their children vaccinated against the flu. In 2013-2014, less than 60% of children received their flu vaccines, an uptake rate only marginally better than the 42% of adults getting their vaccines.

I get it. Finding a flu vaccine can be a hassle, and if you have kids of different ages, you might have to schlep different kids to different places for different flu vaccines. And you have to go back every year to get them at a time of year when the school year is beginning and soccer practices, lawn work, and after school activities are all competing for your time and attention.

But I also get how terrible the flu is. It’s not just about the deaths. Influenza results in up to 200,000 people being hospitalized and can cost the US economy $87 billion each year. Even if your child is healthy and emerges at the other end of influenza infection unscathed, the flu is an awful illness.

Many people excuse themselves from their flu vaccines, claiming that they make them sick or that they don’t work. Of course, most people know that the mild malaise caused by a vaccine is nothing compared to full-blown illness and that the vaccines affords a 60% effectiveness against preventing influenza. When the vaccine does not prevent influenza, it helps reduce its severity.

45498_10151243273500698_922301626_nMy family’s experience with influenza in 2013 serves as a perfect object lesson for the importance of getting a flu vaccine. We are so grateful we all got our flu vaccines that year.

In January 2013, my husband, my 9 year old, my 4 year old, and I traveled to San Diego to attend a graduation ceremony for my stepson. The day after we arrived, we went to SeaWorld only to have our visit cut short when my 4 year old became warm and too tired to walk and announced that it hurt to breathe.

We rushed to urgent care, and my pre-schooler’s temperature continued to rise. He fell asleep in the waiting room and was coughing intermittently. He must have been achey and uncomfortable because he was moaning and restless. The urgent care doctor was alarmed when he saw him, and I guessed it was the flu because so many of his classmates had caught it in the weeks before we left for California. A lab test confirmed my hunch, and I felt grateful that SeaWorld had been almost empty and hoped that we hadn’t exposed anyone there.

We holed up in our hotel room, and by the next morning my husband had fallen ill as well. Every time my youngest child crawled into my arms only to sneeze on my face, I felt doomed. I figured it was only a matter of time before we were all sick, stuck in the hotel room, and unable to function.

But that never happened. My older child and I never got sick, and the illness was short-lived for both my husband and my pre-schooler. For half of us, the vaccine completely prevented influenza–even though we had very close, prolonged contact with the virus. For the other half of us, the vaccine seemed to mitigate the severity of the illness during a year when influenza seemed particularly virulent and claimed the lives of 171 children. By the time the graduation ceremony took place at the end of the week, we were all fever-free and well enough to attend.

Some would point to our story as a failure–we got our vaccines, and some of us still got sick! I think this interpretation is cynical. We gained so much by being vaccinated. We were spared the worst of what can be an intensely severe disease, we recovered quickly, and we were able to celebrate my stepson’s wonderful accomplishment with him.

So each year, we get our flu vaccines. We get them because influenza is a terrible illness, and any way of preventing it completely or making it less severe is worth the moment of pain (or unhappiness of sniffing) that we have to endure.

You will hear the statistics about children who lost their lives to influenza, but you won’t hear about children who are hospitalized because of the flu. You won’t hear about how miserable they are or how frightening it is to watch them battle the severest illness. You won’t hear about children like Colton, who admitted to the hospital at 15 weeks old with influenza. You won’t hear about the misery of illness or the fear of seeing your child very ill or the stress of being in the hospital, but this story is repeated far too many times every year. And you can help prevent it in your children.

I’m writing today because I don’t want your child to be a statistic or a story. I know you are busy and overwhelmed by parenting and pulled in a million different directions, but it is worth your time and energy to vaccinate your whole family against the flu.

Remember: CDC says an annual flu vaccination is the best protection against flu. Get your flu vaccine and encourage others to do the same by sharing your flu vaccine selfies on social media using the #VaxWithMe tag! Be sure to stop by the other NIVW relay participants’ blogs to learn about flu vaccination for everyone – tomorrow’s post will be hosted by Shot of Prevention.

Karen Ernst is the Parent-Leader of Voices for Vaccines. Neither she nor Voices for Vaccines received any compensation from any governmental agency for publishing this blog post or for participating in the Digital Ambassador program.

Voices for Vaccines is a parent-led nonprofit organization that helps parents advocate for on-time immunization in their communities. Join VFV at

10 Reasons Why #GivingTuesday is the Best Day Ever

This post originally appeared on Salsa Labs’ Salsa Blog on November 25, 2014

Which day is better – #GivingTuesday or Black Friday? Well, here are 10 reasons why #GivingTuesday is so much better than Black Friday…

1. #GivingTuesday is much safer than Black Friday. You can avoid a trip to the hospital after getting trampled by people just trying to get into a store.

2. You don’t have to wake up at the crack of dawn. You can donate at any point during the day, whenever is most convenient for you.

3. You can participate from the comfort of your couch, in your PJs.

4. You can eat ice cream and watch Netflix while donating. That’s always a bonus.

5. You don’t have to break the bank to make a donation.

6. You can feel good about the money you gave, rather than regret the money you spent shopping.

… continue reading the full post here

Please support The Immunization Partnership this #GivingTuesday by going to our website: or by clicking here.