Federal advisory group recommends catch-up vaccination program for mumps

The Public Health Agency suggested students talk to their family doctor or public health unit about their immunization status and the vaccine recommendation.

Dr. Jeff Scott, chief medical officer of health for Nova Scotia, the Canadian jurisdiction hit hardest by the outbreak, said his province is moving ahead with catch-up programs designed to protect health-care workers, university students in Nova Scotia (whether they come from the province or not), Nova Scotians attending university outside the province and Grade 12 students.

"In Nova Scotia we're determined as much as possible to get the risk groups covered as quickly as possible," Scott said.

"But logistically it will take time. And mumps will continue to occur."

Since the outbreak began in mid-February there have been at least 690 cases reported in nine provinces. The lion's share - more than 540 - have occurred in Nova Scotia, but New Brunswick has also been hit hard.

While officials in some other provinces have questioned whether funding a catch-up vaccination round for mumps is a pressing public health priority, their counterparts in Nova Scotia have been run off their feet trying to deal with the outbreak.

In particular, hospitals in Halifax suffered severe disruptions earlier in the outbreak, with exposed health-care workers having to go into extended periods of isolation. Pulling those resources out of the staffing pool resulted in surgery delays and other strains on the health-care system.

"Certainly when you're faced with an outbreak of mumps in your jurisdiction you're more likely to move ahead with some of the enhancing programs," Tam said.

"Because the impact and cost of dealing with a mumps outbreak is not insignificant - in terms of health-care resources, impact on the Nova Scotian public health system and the health-care system. ... It can be quite disruptive."

The committee of experts advised catch-up vaccinations for virtually anyone in what is considered the vulnerable age group - roughly 10 to 12 years old at one end and about 40 years of age at the other.

There is a high likelihood that anyone born before 1970 - when the mumps vaccine hit the market - had mumps and is immune to the disease.

But from the early 1970s till about the mid-1990s, immunization programs only gave one dose of mumps vaccine on the assumption it was sufficient to protect. It has since been learned that a single dose is not sufficient for all. In fact, of 284 mumps cases in this outbreak for whom a vaccination history is known, 75 per cent had received one dose of mumps vaccine in childhood.

The advisory committee recommends two doses for infants and children, though that's more of a theoretical change than a real one. The mumps vaccine is delivered in a combined form with vaccines for measles and rubella. Because measles requires two doses, young children are already getting two doses of mumps vaccine.

It recommends high school and university students who haven't had mumps should have two doses.

For health-care workers and members of the military, it recommends that those born after 1970 have two doses of vaccine unless they have had the disease. Even those born before 1970 should have one dose as a precaution, unless they have evidence they had mumps, the committee suggests.

But the committee's recommendations are only that. It's up to each province and territory to decide whether to act on the advice.

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