Use of a Third Dose of the Measles Mumps Rubella Vaccine During Mumps Outbreaks

Marcia L. Buck, PharmD, FCCP, FPPAG, BCPPS


Pediatr Pharm. 2018;24(3) 

In This Article

Abstract and Introduction


Among the actions considered by the Advisory Committee on Immunization Practices (ACIP) during their October 2017 meeting was a recommendation for administration of a third dose of the measles, mumps, rubella (MMR) or MMR with varicella (MMRV) vaccine in the setting of a mumps outbreak.[1] This recommendation comes as the result of a significant increase in the number of mumps outbreaks in the United States over the several years. After a period for public comment, the recommendation was unanimously approved by the ACIP in January 2018.

In their report published in the January 12th issue of Morbidity and Mortality Weekly Report, Marin and colleagues described a substantial increase in cases since 2012, with 6,369 cases in 2016 and 5,629 in 2017.[2] The data, collected from state health departments throughout the country, revealed 150 mumps outbreaks (defined as 3 or more cases of mumps linked by time and place) between January 1, 2016 and June 20, 2017. These outbreaks alone accounted for 9,200 cases. Seventy-five (50%) of the outbreaks occurred at universities. The median number of cases per outbreak was 10, with 20 outbreaks (13%) accounting for more than 50 cases. Most cases involved young adults, with a median age at diagnosis of 21 years. Among the patients with a complete vaccination record, 78% had received 2 doses of MMR during childhood.