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Rubella Virus Infections
Published in Sunit K. Singh, Daniel Růžek, Neuroviral Infections, 2013
M. Jennifer Best, Susan Reef, Liliane Grangeot-Keros
Rubella vaccines cause few side effects in children, but rash, low-grade fever, irritability, lymphadenopathy, myalgia, paresthesia, and joint symptoms may occur 10-30 days after vaccination. Joint symptoms occur most frequently in postpubertal females (≤25%). Rubella vaccine is not associated with chronic joint disease. The first dose of MMRV may be associated with febrile seizures (Klein et al. 2010). Symptoms are rare after a second dose. MMR vaccines containing the Urabe strain of mumps have been associated with aseptic meningitis, but this is not found with the Jeryl Lynn strain of mumps (Department of Health 2010 a).
The Lancet Paper
Published in Michael Fitzpatrick, Mmr And Autism, 2004
In the subsequent discussion about the safety of MMR a number of issues arose (although none shed much light on the MMR-autism hypothesis). One set of concerns—promoted at first by the wider anti-immunisation movement— focused on the withdrawal in Britain in 1992 of two brands of MMR that used a mumps component derived from the Urabe strain of the virus. In 1988, before the intro-duction of MMR in Britain, a study in Canada and the UK reported the occurrence of aseptic meningitis following immunisation with the Urabe strain mumps vaccine, at a rate of between one in 100,000 to one in 250,000. Given that this rate of meningitis was much lower than that occurring with natural mumps (which MMR had been shown to prevent) it was preferable to proceed with the introduction of MMR. Furthermore, it was not, at that time, clear that any alternative vaccine was safer. However, although passive surveillance procedures showed a very low risk, a more intensive study in 1992 in the Nottingham area revealed a higher incidence of aseptic meningitis—at a rate of one in 3,000—following MMR (Miller et al 1993). Accordingly, the vaccine authorities decided to switch to using only brands of MMR containing the Jeryl Lynn strain of mumps (which had not been linked to cases of meningitis). In response to continuing claims of government perfidy in introducing MMR including Urabe (on the grounds that it was known to cause aseptic meningitis in rare cases), it has been pointed out that, if Jeryl Lynn had not been available, it would still have been preferable to carry on with MMR include Urabe as the benefit from reducing the risk of mumps far exceeded the risk of vaccine-related meningitis.
Waning immunity of one-dose measles-mumps-rubella vaccine to mumps in children from kindergarten to early school age: a prospective study
Published in Expert Review of Vaccines, 2018
Yuanbao Liu, Zhihao Liu, Xiuying Deng, Ying Hu, Zhiguo Wang, Peishan Lu, Hongxiong Guo, Xiang Sun, Yan Xu, Fenyang Tang, Feng-Cai Zhu
Although no cases were reported, these children seem to be a high-risk population for mumps infection. Once one child is infected, a mumps outbreak will inevitably occur. Therefore, a second dose of MMR is urgently needed in children at kindergarten age or older in China. It may be feasible for children to receive the second dose of MMR when receiving their vaccination certificate inspection before admission to kindergarten or primary school. However, the optimal age for the second MMR dose administration should be studied further. In the USA, the second dose of MMR is given at 4–6 years of age [1]. In Germany, France, and the UK, the two doses of MMR are given before 24 months and at 3 years of age, while in the Netherlands, a second MMR dose is administered at 9 years of age [16]. Completing two doses of MMR at an earlier age (such as before 24 months) [15,17,18] or within a short time interval [2] may lead to lower mumps GMC and a higher risk of mumps infection during teenage years due to waning immunity. However, a delayed second MMR administration (such as in the Netherlands) still cannot protect teenagers from mumps infection. For example, many mumps outbreaks have been reported in the Netherlands [4,6,19]. In addition, some scholars attributed mumps outbreaks in populations with high coverage of MMR to a mismatch between the genotype of the circulating wild-type mumps virus (most genotypes causing worldwide mumps outbreaks have the G genotype) and the vaccine strain Jeryl Lynn used worldwide, which has the A genotype. This is also an important issue in China because the dominant strains of mumps epidemics in China were the F and G genotypes [9,20], while the vaccine strain also came from the A genotype.