Mumps vaccination: When is it recommended?
The Standing Commission on Vaccination (STIKO) at the Robert Koch Institute recommends mumps vaccination for all children from eleven months of age. Two vaccinations are necessary for basic immunization – i.e. complete, reliable protection against mumps viruses. These should be administered within the first two years of life.
For older children and adolescents who have been vaccinated against mumps only once or not at all, the mumps vaccination should be made up for or completed as soon as possible.
Mumps vaccination is also recommended for employees in medical or community settings (e.g., hospitals, doctors’ offices, day care centers, schools, vacation homes, refugee shelters, etc.) if the individual was born after 1970, has never had mumps, and has never been vaccinated against mumps or has been vaccinated only once.
The mumps vaccine
There is currently no single vaccine against mumps, but only combination vaccines, which additionally protect against certain other pathogens:
- The MMR vaccine prevents infection with measles, mumps and rubella.
- The MMRV vaccine additionally protects against varicella (chickenpox).
Active immunization through live mumps vaccine
The vaccine against mumps contained in the MMR and MMRV vaccines consists of attenuated, live pathogens (attenuated mumps viruses), i.e. it is a live vaccine (just like the other included vaccines against measles, rubella and varicella).
The attenuated pathogens cause no or at most mild symptoms, but still stimulate the immune system to produce specific antibodies against the pathogen in question. It usually takes about ten to 14 days from the injection of the vaccine for such a response to occur. This is therefore an active vaccination – in contrast to passive immunization, in which ready-made antibodies are administered and their protection fades after a short time.
Mumps vaccination: How is it carried out?
The STIKO experts recommend that infants receive the mumps vaccination (more precisely: the MMR or MMRV vaccination) according to the following schedule:
- The first vaccination dose between eleven and 14 months of life.
- The second vaccination dose between the completed 15th and the 23rd month of life.
- There should be at least four weeks between the two vaccination dates.
Older children and adolescents who have received only one mumps vaccination (i.e. MMR or MMRV vaccination) should receive the missing second vaccination dose as soon as possible.
Health care workers in educational institutions or community settings (including interns) born after 1970 who do not have (adequate) immunity to mumps are recommended by the experts to:
- Those who have never been vaccinated against mumps or have an unclear vaccination status should receive MMR vaccination twice at least four weeks apart.
- Those who have been vaccinated against mumps at least once in the past should receive the missing second dose of MMR vaccine.
If someone is already immune to one of the diseases measles, mumps, rubella or varicella (MMRV) (e.g. because of having lived through the disease), the MMR vaccination or MMRV vaccination can still be administered. The risk of side effects does not increase.
How long does the mumps vaccination last?
Once a person has received the full basic immunization – that is, two MMR(V) shots – the vaccine protection usually lasts a lifetime. Even slightly declining vaccination titers (mumps antibodies are measured) do not affect vaccination protection according to current knowledge. A mumps booster vaccination is therefore not necessary.
Where is the vaccine injected?
The vaccine (MMR or MMRV vaccine) is usually injected into the side of the thigh, sometimes also into the upper arm.
Post-exposure vaccination
If people who have not been vaccinated or have only been vaccinated once against mumps or do not know their vaccination status have had contact with infected persons, post-exposure vaccination can be administered quickly. This is called postexposure vaccination or postexposure prophylaxis (exposure = being exposed to disease-causing factors such as mumps viruses). Here, physicians usually use the MMR vaccine.
It should be given three days, maximum five days, after (suspected) contact, if possible. It can protect against an outbreak of the disease and alleviate symptoms. In addition, it helps to prevent the disease from spreading further after an outbreak, for example in a community setting (barring vaccination).
Mumps vaccination: When should it not be given?
In some cases, doctors may not administer the mumps vaccine:
- During pregnancy (see also notes below).
- In acute, febrile illness (> 38.5 degrees Celsius) (a cold, on the other hand, is not a contraindication)
- In case of known hypersensitivity to components of the vaccine
Mumps vaccination: pregnancy and breastfeeding
The mumps vaccine is a live vaccine and therefore must not be administered during pregnancy. The attenuated pathogens of live vaccines could possibly endanger the unborn child.
After a mumps vaccination, women should not become pregnant for one month!
However, if a vaccination was inadvertently administered, it is not necessary to terminate the pregnancy. Numerous studies of mumps vaccination during or shortly before pregnancy have not shown an increased risk of fetal malformations.
Nursing mothers may receive the measles-mumps-rubella vaccine. Studies have shown that mothers can excrete and transmit the attenuated vaccine viruses through breast milk. However, it has not yet been established that infants fall ill as a result.
Mumps despite vaccination
Vaccination against mumps offers a very high, but not 100 percent protection against infection. Therefore, it can happen under certain circumstances that someone falls ill with mumps despite the two doses of vaccination. However, the course of the disease is then usually milder than in non-vaccinated persons.
Primary vaccination failure
Secondary vaccination failure
In addition, there is also the possibility of secondary vaccination failure: In this case, the body initially produces sufficient antibodies against mumps, but this vaccination protection decreases too much over time. At some point, immunity may be so low that contact with the pathogens leads to mumps disease despite vaccination.
Due to quite high vaccination rates, the vaccination protection also does not experience a natural “refreshment” via “wild” mumps viruses. In addition, there are subtypes of these naturally occurring mumps pathogens against which the vaccination is not effective, experts suspect.
Mumps vaccination: side effects
The mumps vaccination – or the MMR or MMRV vaccination – is generally well tolerated. Side effects occur only rarely.
Local reactions at the injection site (redness, swelling, pain) develop in about five out of every 100 people vaccinated within the first three days. Sometimes swelling of neighboring lymph nodes is also observed.
Also possible are mild general symptoms such as faintness, increased temperature or fever (in young children possibly with febrile convulsion), headache or gastrointestinal complaints. All these reactions to the vaccination usually subside after a short time without consequences.
Rarely, a mild swelling of the testicles or joint complaints occur temporarily as a reaction to the vaccination. The latter is most likely to be observed in adolescents and adults. Very rarely, allergic reactions or prolonged joint inflammation occur.
In a few isolated cases worldwide, brain inflammation has also been observed. So far, however, it has not been possible to prove that it was triggered by the vaccination.
If the body reacts with fever to the mumps vaccination, a febrile convulsion can develop in less than one in a thousand vaccinated infants and young children. It usually has no further consequences.
No autism due to MMR vaccination!
A few years ago, a British study with twelve participants unsettled the population. In the study, published in 1998, a possible connection between the MMR vaccination and autism was suspected.
In the meantime, however, it has turned out that deliberately wrong results were published – the responsible physician and researcher was no longer allowed to practice and the published study was completely revoked.
No diabetes due to mumps vaccination
In rare cases, mumps viruses can cause inflammation of the pancreas – the organ that produces the messenger substance insulin. If the gland then produces too little insulin, diabetes develops.
Because of this, some people feared that the attenuated vaccine viruses could also inflame the organ and thus cause diabetes. To date, however, scientists have not been able to establish a link between a mumps vaccination and diabetes in several studies. Even that the actual disease leads to diabetes has not yet been proven.
