| Mumps is caused by mumps virus (MuV) and is an acute respiratory infectious disease with worldwide distribution. In1990, the China government made mumps a notifiable disease [1]. In2004, the China immunization program began conducting case reporting using a web-based, real time reporting system [2]. Reported incidence rates have been approximately22per100,000total population, but the incidence rate was as high as89.91per100,000in2009in one province [3-7]. The number of reported mumps outbreaks was436,327, and194for2008,2009, and2010, respectively [3]. Because of the many outbreaks and high incidence rates, it is important to strengthen and improve mumps prevention and control in China.Mumps vaccine (MuV) is known to be the most effective way to prevent mumps. Currently, three types of mumps-containing vaccine are used in China:monovalent mumps vaccine, measles-mumps (MM) vaccine, and measles-mumps-rubella (MMR) vaccine. However, reported vaccine effectiveness (VE) of mumps containing vaccines has varied substantially. The China Expanded Program on Immunization recommends MR (Measles and Rubella Combined Vaccine) at8months of age and MMR at18to24months of age, which provides one routine dose of mumps vaccine. However, the China program has not completely developed its mumps immunization strategy. We conducted this research to analysis the epidemiological characteristics of mumps in China during2010-2012, and evaluate VE of mumps vaccines and to help provide a scientific basis for improvement of mumps immunization strategies.We analyzed data of mumps cases from national notifiable disease reported system by descriptive epidemiology. The reported incidence of mumps was approximately22per100,000, the incidence peaks were April to July and November to January, and the highest incidence of mumps was in aged5to9years old. The male to female ratio was1.61:1. The incidence rates were varied among different provinces, in recent years the cases were mostly focus on the northwest region of China.We conducted this meta-analysis to evaluate VE of mumps vaccines, The overall VE for mumps containing vaccine (either one dose or two doses) was85%(95%CI76%-90%) for cohort studies and88%(95%CI82%-92%) for case control studies. Using random effects meta-regression we found significant differences in some study covariates; for instance, VE varied by population (VE=88%in day care vs.69%in pupil, p=0.008) and emergency versus routine immunization (VE=80%for routine immunization vs.95%for emergency immunization, p=0.041). However, these results must be interpreted with caution due to the low number of studies in subgroups, with the permutation test giving non-significant results that indicated that the results may be due to chance.We conducted1:2matched case control study to evaluate VE of mumps vaccines. The VE of mumps containing vaccine for one dose was84.6%(95%CI62.1%-93.8%). The points estimate of pooled VE Presents the tendency of decreasing with age increasing. The point estimate of pooled VE for combined vaccine was higher than monovalent vaccine. The point estimate of pooled VE for different vaccination time decreased with age increasing. However,there was no statistical difference between those groups.In conclusion, our results suggested that mumps containing vaccine provided good protection from mumps infection. Further studies of VE on mumps vaccine with larger sample sizes sufficient for important subgroup analyses are needed. Consistent with the WHO position paper on mumps, we recommend that China should implement a two-dose mumps vaccination schedule as early as possible.In order to gain better control of mumps and reduce the number of mumps outbreaks, we suggest that all young children need a first dose before entering day care and receive a second dose before primary school. |
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