What is Mumps vaccine?
There are two mumps containing vaccines available for use in the United States - MMRII1 - a combination measles-mumps-rubella(MMR) live virus vaccine and ProQuad2 - a combination measles-mumps-rubella-varicella (MMR-V) live virus vaccine. Both products are manufactured and distributed by Merck.
MMRII is licensed and recommended for individuals aged 12 months or older. It is a live attenuated virus vaccine propagated in chick embryo cells and cultured with Jeryl Lynn live attenuated virus mumps and Meruvax II, a live attenuated virus vaccine propagated in WI-38 human diploid lung fibroblasts.3 The WI-38 human diploid cell line was derived from the lung tissue of a three-month human female embryo.4 The growth medium used was salt solution and 10 percent calf (bovine) serum.5
ProQuad is licensed and recommended for individuals aged 12 months to 12 years of age. ProQuad (Measles, Mumps, Rubella and Varicella Virus Vaccine Live) is a combined, attenuated, live virus vaccine containing measles, mumps, rubella, and varicella viruses. ProQuad is a sterile lyophilized preparation of the components of M-M-R II (Measles, Mumps, and Rubella Virus Vaccine Live): Measles Virus Vaccine Live, and Varicella Virus Vaccine Live (Oka/Merck), the Oka/Merck strain of varicella-zoster virus propagated in MRC-5 cells. MRC-5 cells are derived from a cell line that was developed in 1966 from lung tissue taken from a 14 week aborted fetus and contains viral antigens.6
The growth medium for measles and mumps for both MMRII7 and ProQuad8 is a buffered salt solution containing vitamins and amino acids and supplemented with fetal bovine serum containing sucrose, phosphate, glutamate, and recombinant human albumin, and neomycin. The growth medium for rubella is a buffered salt solution containing vitamins and amino acids and supplemented with fetal bovine serum containing recombinant human albumin and neomycin. Sorbitol and hydrolyzed gelatin stabilizer are added to the individual virus harvests. In the ProQuad vaccine,9 the Oka/Merck strain of the live attenuated varicella virus, initially obtained from a child with wild-type varicella, then introduced into human embryonic lung cell cultures, adapted to and propagated in embryonic guinea pig cell cultures and finally propagated in human diploid cell cultures (WI-38) is added to the MMRII component.
According to Merck, both MMRII and ProQuad vaccines are screened for adventitious agents. Each dose of MMRII contains sorbitol, sodium phosphate, sucrose, sodium chloride, hydrolyzed gelatin, recombinant human albumin, fetal bovine serum, other buffer and media ingredients and neomycin.10 Each dose of ProQuad contains sucrose, hydrolyzed gelatin, sorbitol, MSG, sodium phosphate, human albumin, sodium bicarbonate, potassium phosphate and chloride, neomycin, bovine calf serum, chick embryo cell culture, WI-38 human diploid lung fibroblasts and MRC-5 cells.11 12
The MMRII vaccine product information insert states that the MMRII vaccine should be given one month before or one month after any other live viral vaccines.13 The ProQuad vaccine product information insert states that one month should lapse between administration of ProQuad and another measles containing vaccine such as MMRII and at least three months should lapse between ProQuad and any varicella containing vaccine.14
Currently, the CDC recommends that children receive two doses of a mumps containing vaccine, with the first dose between the ages 12-15 months, and the second dose between the ages 4-6 years.15 The CDC also recommends that individuals born after 1957 and have no laboratory evidence of immunity or documentation of vaccination should receive at least one dose of MMR vaccine.16 Two doses of MMR vaccine are also recommended for healthcare personnel, students entering college and other post-high school educational institutions, as well as international travelers.17
The CDC also recommends MMR vaccination for infants between 6 and 12 months of age who may be traveling internationally.18 However, both ProQuad19 and MMRII20 have been approved only for use in for children older than 12 months of age. The MMRII vaccine product insert states that effectiveness and safety of administration of MMRII has not been established in children between the ages of 6 and 12 months of age and if administered to this population, antibodies may not develop. According to the CDC, an infant vaccinated prior to 12 months of age would still require two additional doses of MMR vaccine.21
In October of 2017, following numerous outbreaks of mumps infections throughout the United States, most notably on college campuses, the CDC’s Advisory Committee on Immunization Practices (ACIP) recommended a third dose of a mumps containing vaccine be administered in the event of an outbreak.22
IMPORTANT NOTE: NVIC encourages you to become fully informed about Mumps and the Mumps vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.
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1 FDA Measles, Mumps and Rubella Virus Vaccine, Live May 16, 2017
2 FDA PROQUAD. May 16, 2017
4 Wadman M. Medical research: Cell Division. Nature Jul. 2013 498, 422–426
5 FDA Measles, Mumps and Rubella Virus Vaccine, Live May 16, 2017
8 FDA PROQUAD. May 16, 2017
10 FDA Measles, Mumps and Rubella Virus Vaccine, Live May 16, 2017
11 FDA PROQUAD. May 16, 2017
12 CDC Vaccine Excipient & Media Summary. (The Pink Book). Mar. 2018
13 FDA Measles, Mumps and Rubella Virus Vaccine, Live May 16, 2017
14 FDA PROQUAD. May 16, 2017
15 CDC Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Jun. 14, 2013; 62(RR04);1-34
19 FDA PROQUAD. May 16, 2017
20 FDA Measles, Mumps and Rubella Virus Vaccine, Live May 16, 2017
21 CDC Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Jun. 14, 2013; 62(RR04);1-34
22 CDC Recommendation of the Advisory Committee on Immunization Practices for Use of a Third Dose of Mumps Virus–Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak. MMWR Jan. 12, 2018; 67(1);33–38