The WHO recommends use of the mumps vaccine primarily on economic grounds:

High-quality mumps vaccines generally confer substantial protection and will reduce the costs associated with patient care and lost working days due to mumps. WHO therefore recommends the use of such vaccines in all countries with well-functioning childhood vaccination programmes, provided that sustained high-level coverage is afforded and that reduction of mumps is a public health priority.”

and:

In view of the moderate morbidity and the low mortality of this disease, its socioeconomic impact is essential when deciding on the priority of mumps vaccination in national immunization programmes. Assessment of that impact requires careful evaluation of disease burden and costs associated with purchase of the vaccine and vaccination, including the economic impact of possible adverse effects.”

The WHO also states that mumps vaccine should only be considered in countries that already have measles and rubella vaccination strategies, since those illness are considered to be a higher priority. It is recommended that “National decisions to implement large-scale mumps immunization should be based on careful cost-benefit analyses, including the comparative analysis of mumps control versus the control of other vaccine-preventable diseases in the countries concerned.”

So it is clear that mumps vaccination is low priority. Mumps vaccination is portrayed by the WHO as a “nice-to-have”, an add-on to existing vaccination programmes. If you are doing measles and rubella, you might as well add mumps and call it MMR… because then parents will need to take fewer days off work to care for their sick children and so the economy will benefit.

The mumps vaccine is considered very safe. It does have a number of side effects, notably meningitis and parotitis (i.e. mumps). These are not thought to cause any long term damage.

However, it is acknowledged that mumps itself is generally a very mild illness which only rarely causes serious complications in childhood cases. It causes complications more frequently when it occurs in adults. Given this, it is worth noting that the immunity provided by mumps vaccines appears to wane. The WHO warns that mumps vacciantion campaigns can, particularly if coverage is less than about 80%, cause an “unfortunate” shift so that although overall mumps cases may reduce there is a greater incidence in adolescents and adults, who are more likely to suffer complications.

In short, there does not appear to be any real medical need for a vaccination against mumps – only a potential economic benefit in reducing the incidence of the disease. My own conclusion on the mumps vaccine must be similar, then, to my conclusion on rubella vaccines. Only more so…

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