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Hu W, Jia N, Meng W, Zhou T, Wang R, Xiong Y, Luan C, Zhang S. Safety analysis of a live attenuated mumps vaccine in healthy adolescents in China: A phase 4, observational, open-label trial. PLoS One 2023; 18:e0291730. [PMID: 37733724 PMCID: PMC10513284 DOI: 10.1371/journal.pone.0291730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023] Open
Abstract
Mumps is an acute infectious disease, which was well controlled in the past, but recently it has resurged in some areas. This study aimed to evaluate the safety profile of the live attenuated mumps vaccine after large-scale vaccination. We conducted an observational, open-label phase 4 trial in Shaanxi, China from October 2020 to March 2021. Eligible participants were freshmen of junior high school who were not above 14 years old. Adverse events following immunization (AEFI) monitoring was carried out by active and passive surveillance. Safety follow-ups were conducted during the study participation. Overall, 10057 subjects were enrolled in the active surveillance analysis. A total of 214 subjects reported adverse reactions with an incidence of 2.13% (214/10057). Most adverse reactions were grade 1, and the incidence of grade 1 adverse reactions was 1.44% (145/10057); 0.60% for grade 2 (60/10057); and 0.09% for grade 3 (9/10057). The majority of adverse reactions were solicited (1.73%, 174/10057). Injection-site pain was the most frequently reported local adverse reaction (0.71%, 71/10057), followed by redness (0.29%, 29/10057). The most common systemic adverse reactions were nausea (0.19%, 19/10057) and fever (0.16%, 16/10057). For passive AEFI surveillance, 57 AEFI cases were reported, with an incidence of 19.28/100000 (57/287608). And most AEFI cases were common adverse reactions (66.67%, 38/57). In total, the live attenuated mumps vaccine evaluated in this trial has a favorable safety profile and can be used for large-scale inoculation.
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Affiliation(s)
- Weijun Hu
- Immunization Programme Institute, Vaccine Clinical Evaluation Center, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Ningning Jia
- Clinical Research and Development Center, Sinovac Biotech Co., LTD, Beijing, China
| | | | - Tiantian Zhou
- Immunization Programme Institute, Vaccine Clinical Evaluation Center, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Ruize Wang
- Immunization Programme Institute, Vaccine Clinical Evaluation Center, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | | | - Chunfang Luan
- Research and Development Center, Sinovac (Dalian) Vaccine Technology Co., LTD, Dalian, China
| | - Shaobai Zhang
- Immunization Programme Institute, Vaccine Clinical Evaluation Center, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
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Li D, Zhang H, You N, Chen Z, Yang X, Zhang H, Zhou Y, Zheng N, Pan W. Mumps serological surveillance following 10 years of a one-dose mumps-containing-vaccine policy in Fujian Province, China. Hum Vaccin Immunother 2022; 18:2096375. [PMID: 35950847 DOI: 10.1080/21645515.2022.2096375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Since 2008, Fujian province provided measles-rubella (MR) vaccine at 8 months followed by measles-mumps-rubella (MMR) vaccine at 18 months a one-dose mumps-containing-vaccine (MuCV) schedule. Several mumps outbreaks have occurred recently in Fujian. Serological surveillance can assess population immunity to mumps and identify risk factors for mumps. METHODS We conducted a cross-sectional serosurvey of mumps IgG antibodies in the general population of Fujian Province in 2018 and compare results with a similar study conducted in 2009, when the routine schedule had no MuCV. We analyzed changes in mumps epidemiology after implementation of a one-dose MuCV vaccination strategy. RESULTS Mumps seroprevalence was 78.6% (95% CI: 77.4-79.8), and the geometric mean concentration (GMC) of mumps antibodies was 245.8 IU/ml (95% CI:237.3-255.1). MuCV vaccination at 18 months resulted in increased seroprevalence and GMCs. Seroprevalence and GMCs varied by age, gender, and number of doses received. Except for children under 18 months, seroprevalence and GMCs were lowest among 10-15-year-olds. Each year after introduction of the one-dose MuCV vaccination policy, the highest incidence of mumps was among 4-6-year-olds and 9-15-year-olds, gradually shifting to older age groups. CONCLUSION A one-dose mumps-containing vaccine schedule does not provide sustained and stable mumps immunity in Fujian. To reduce the risk of mumps, we recommend supplementary vaccination of children without a history of receiving at least one MuCV dose or who are seronegative at 10-15 years of age.
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Affiliation(s)
- Dong Li
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Hairong Zhang
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Na You
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China.,Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhifei Chen
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Xiuhui Yang
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Hangsu Zhang
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yong Zhou
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Ningxuan Zheng
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Weiyi Pan
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
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A Multi-Age-Group Interrupted Time-Series Study for Evaluating the Effectiveness of National Expanded Program on Immunization on Mumps. Vaccines (Basel) 2022; 10:vaccines10101587. [PMID: 36298452 PMCID: PMC9610758 DOI: 10.3390/vaccines10101587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
The national Expanded Program on Immunization (EPI) in China has covered vaccines for measles, mumps, and rubella, among children aged 18–24 months since September 2008. However, no previous studies have quantified the effectiveness of the EPI on mumps incidence. There are methodological challenges in assessing the effect of an intervention that targets a subpopulation but finally influences the whole population. In this study, monthly data on mumps incidence were collected in Guangzhou, China, during 2005–2019. We proposed a multi-age-group interrupted time-series design, setting the starting time of exerting effect separately for 14 different age groups. A mixed-effects quasi-Poisson regression was applied to analyze the effectiveness of the EPI on mumps incidence, after controlling for long-term and seasonal trends, and meteorological factors. The model also accounted for the first-order autocorrelation within each age group. Between-age-group correlations were expressed using the contact matrix of age groups. We found that 70,682 mumps cases were reported during 2005–2019, with an annual incidence rate of 37.91 cases per 100,000 population. The effect of EPI strengthened over time, resulting in a decrease in the incidence of mumps by 16.6% (EPI-associated excess risk% = −16.6%, 95% CI: −27.0% to −4.7%) in September 2009 to 40.1% (EPI-associated excess risk% = −40.1%, 95% CI: −46.1% to −33.3%) in September 2019. A reverse U-shape pattern was found in age-specific effect estimates, with the largest reduction of 129 cases per 100,000 population (95% CI: 14 to 1173) in those aged 4–5 years. The EPI is effective in reducing the mumps incidence in Guangzhou. The proposed modeling strategy can be applied for simultaneous assessment of the effectiveness of public health interventions across different age groups, with adequate adjustment for within- and between-group correlations.
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Wang D, Nie T, Pan F, Wang Y, Wang J, Qin W. Loss of protective immunity of two-dose mumps-containing vaccine over time: concerns with the new strategy of the mumps immunization program in China. Hum Vaccin Immunother 2021; 17:2072-2077. [PMID: 33545016 DOI: 10.1080/21645515.2020.1861877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: Currently, children aged 6-9 years have the highest incidence rate of mumps in China. Although China has introduced a two-dose schedule of measles-mumps-rubella vaccine into routine immunization (at 8 months and 18 months), the incidence rate of mumps in high-risk populations might not decrease due to waning immunity. Here we report a mumps outbreak supporting this hypothesis.Methods: The descriptive epidemiological method was used to summarize the overall characteristics of the course of the outbreak. We conducted a retrospective cohort study to evaluate the vaccine effectiveness (VE) of mumps-containing vaccine (MuCV).Results: A total of 78 cases were identified during the outbreak and the estimated vaccination coverage was 84.7%. Of 454 vaccinated students, 335 (73.8%) had received one-dose MuCV, 93 (20.5%) two-dose, and 26 (5.7%) three-dose. The VEs for both the one-dose (-17.0%, 95%CI: -120.3-38.2%) and two-dose groups (-10.0%, 95%CI: -138.0-48.8%) were not performed well, whereas the VE for the three-dose group was 100%. However, we found that the overall VE was 74.2% (95% CI: 9.7-92.6%) for students vaccinated within 5 years. We also observed that there was a broadly linear increase in mumps infection risk in both one-dose and two-dose group when the time since last dose vaccination was more than 5 years.Conclusions: The overall VE for both one-dose and two-dose MuCV was discouraging, but it appeared to be moderately effective within 5 years after vaccination. Further surveillance and seroepidemiological data are needed to understand the impact of the new vaccination strategy on mumps in China.
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Affiliation(s)
- Danni Wang
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China
| | - Tingyue Nie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Fan Pan
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - Yao Wang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - Jian Wang
- Department of Infectious Disease Control, Yu'an District Center for Disease Control and Prevention, Lu'an, China
| | - Wei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
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Ma J, Wang P, Tang J, Zheng L, Li S, Huo Y. Epidemiological and Phylogenetic Analysis of Mumps Virus Isolated from 2016 to 2019 in Henan Province, China. Jpn J Infect Dis 2020; 74:187-192. [PMID: 33132301 DOI: 10.7883/yoken.jjid.2020.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Routine vaccination has proven to be highly effective in reducing the incidence of mumps. However, sporadic cases and/or mumps outbreaks have been reported in children and adolescents younger than 15 years of age, particularly among those aged 5-9 years. To explore the characteristics of such outbreaks in the Henan Province, clinical data of patients infected with mumps virus (MuV) were collected, and the isolated strains were phylogenetically analyzed. Of the total 426 samples analyzed, MuV RNA targeting the small hydrophobic (SH) gene was detected in 153 samples. MuV-positive cases in age groups <5 years, 5-9 years, 10-15 years, 16-19 years, and ≥20 years accounted for 1%, 17%, 12%, 2%, and 4% of the total number of cases, respectively. Phylogenetic analysis based on the SH gene sequences indicated that all of the isolated strains were of genotype F, and isolates in the same subcluster and with identical SH gene sequences tended to be derived from the same community or municipalities when analyzed alongside epidemiological data. In conclusion, the incidence of mumps in the Henan Province was high. The data provided in this study might promote further research in the clarification of the specific causes of mumps outbreaks, which can facilitate the implementation of effective prevention and control measures.
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Affiliation(s)
- Jie Ma
- The Sixth People's Hospital of Zhengzhou, China
| | | | - Jing Tang
- The Sixth People's Hospital of Zhengzhou, China
| | - Lijun Zheng
- The Sixth People's Hospital of Zhengzhou, China
| | - Sanjing Li
- The Sixth People's Hospital of Zhengzhou, China
| | - Yuqi Huo
- The Sixth People's Hospital of Zhengzhou, China
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