A Third Dose of Measles-Mumps-Rubella Vaccine to Improve Immunity Against Mumps in Young Adults

Background. Waning of vaccine-induced immunity is considered to play a central role in the reemergence of mumps among vaccinated young adults. The aim of the present study was to investigate antibody responses and safety of a third dose of measles-mumps-rubella vaccine (MMR-3) in 150 young adults. Antibody levels were related to a surrogate of protection based on preoutbreak serum antibody levels in 31 persons with and 715 without serological evidence of mumps. Methods. Mumps virus-specific immunoglobulin G (IgG) antibody responses and mumps virus-neutralizing antibody responses (based on the focus-reduction neutralizing test) against both the Jeryl Lynn mumps virus vaccine strain (hereafter, the vaccine strain) and the MuVi/Utrecht.NLD/40.10 outbreak strain (hereafter, the outbreak strain) were determined, and vaccine safety was evaluated. Results. Four weeks following MMR-3 receipt, levels of IgG, anti-vaccine strain, and anti-outbreak strain antibodies increased by a factor of 1.65, 1.34, and 1.35, respectively. Although antibody levels decreased 1 year later, they were still above the baseline level by a factor of 1.37, 1.15, and 1.27, respectively. Based on the surrogate protective antibody cutoff, significantly more participants were protected against mumps virus infection up to 1 year after vaccination (ie, they had antibody levels above the presumed threshold for herd immunity). Conclusions. MMR-3 receipt increased antibody levels that may protect against mumps virus infection for longer than previously assumed and is expected to be a good and safe intervention for controlling a mumps outbreak.