MMRワクチン2回接種率の高い地域では、耳下腺炎流行時に3回目の接種を行うことで、接種後すみやかに発生率の減少がみられ、流行のコントロー ルに有用である可能性が示された。米国CDCのIkechukwu U Ogbuanu氏らが、耳下腺炎流行コントロールに対するMMRワクチン3回目接種の影響を評価した初の試験結果として報告した。米国では 2009~2010年に北東部の宗教コミュニティにおいて、MMRワクチン2回接種率が高率であったにもかかわらず耳下腺炎の大規模な流行が発生した。そ の際、同地域の学生に対し、流行のコントロール効果を目的にMMRワクチンの3回目の接種が行われた。Pediatrics誌オンライン版2012年11 月5日号の掲載報告。









Impact of a Third Dose of Measles-Mumps-Rubella Vaccine on a Mumps Outbreak.

Pediatrics. 2012 Nov 5. [Epub ahead of print]

Ogbuanu IU, Kutty PK, Hudson JM, Blog D, Abedi GR, Goodell S, Lawler J, McLean HQ, Pollock L, Rausch-Phung E, Schulte C, Valure B, Armstrong GL, Gallagher K.


Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;


BACKGROUND AND OBJECTIVE:During 2009-2010, a northeastern US religious community experienced a large mumps outbreak despite high 2-dose measles-mumps-rubella (MMR) vaccine coverage. A third dose of MMR vaccine was offered to students in an affected community in an effort to control the outbreak.METHODS:Eligible sixth- to 12th-grade students in 3 schools were offered a third dose of MMR vaccine. Baseline and follow-up surveys and physician case reports were used to monitor mumps attack rates (ARs). We calculated ARs for defined 3-week periods before and after the intervention.RESULTS:Of 2265 eligible students, 2178 (96.2%) provided documentation of having received 2 previous doses of MMR vaccine, and a high proportion (1755 or 80.6%) chose to receive an additional vaccine dose. The overall AR for all sixth- to 12th-grade students declined from 4.93% in the prevaccination period to 0.13% after vaccination (P < .001). Villagewide, overall AR declined by 75.6% after the intervention. A decline occurred in all age groups but was significantly greater (96.0%) among 11- to 17-year-olds, the age group targeted for vaccination, than among all other age groups. The proportions of adverse events reported were lower than or within the range of those in previous reports of first- and second-dose MMR vaccine studies.CONCLUSIONS:This is the first study to assess the impact of a third MMR vaccine dose for mumps outbreak control. The decline in incidence shortly after the intervention suggests that a third dose of MMR vaccine may help control mumps outbreaks among populations with preexisting high 2-dose vaccine coverage.



[PubMed - as supplied by publisher]