The purpose of this health alert network message is to provide updated guidance for measles, mumps, and rubella (MMR) vaccine during the current mumps outbreak, which started in Anchorage last summer [1, 2]. To date, 214 confirmed and 33 probable cases have been reported to the Alaska Section of Epidemiology (SOE), and there is no sign that the outbreak is slowing down. Because we are beginning to see cases identified in communities outside of Anchorage, it is becoming ever more difficult to determine who is at increased risk for acquiring mumps and thus who should receive a third dose of MMR vaccine. As such, per the updated recommendations below, any Alaska resident who would like additional protection against mumps during the current outbreak, regardless of where they live in Alaska, is now eligible to receive a third dose of the MMR vaccine.
Updated Vaccination Recommendations (superseding those from December 2017)
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Health care providers should ensure that all patients are up-to-date on their MMR vaccination per the routine Advisory Committee on Immunization Practices (ACIP) schedule.
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Two doses of MMR vaccine should be routinely administered to all children, starting with the first dose at age 12 through 15 months and the second dose at age 4 through 6 years before school entry.
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For persons who have received only one dose of MMR, a second dose should be given to all school-age children aged ≥4 years and select adults born during or after 1957 who are at high risk of mumps exposure (i.e., healthcare personnel, international travelers, and students at post-high school educational institutions).
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For persons who participate in any group setting (e.g., daycare, work, school, church) statewide where mumps is currently circulating (e.g., a recent case in a classmate or a coworker) OR for Anchorage residents who self-identify as being Native Hawaiian or other Pacific Islander:
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A second dose of MMR is recommended for persons who have had one dose of MMR that was administered at least 4 weeks ago; this includes children aged 1–4 years.
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A third dose of MMR is recommended for persons who have had a second dose that was administered at least 5 years ago.
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Any Alaska resident who would like to have additional protection against mumps during the current outbreak may receive a third dose of MMR vaccine if it has been at least 5 years since their second dose.
State-Supplied MMR Vaccine Availability
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All children who meet the state recommendations for an additional dose of MMR during the current outbreak are eligible to receive state-supplied MMR.
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Adults who meet the state recommendations for an additional dose of MMR during the current outbreak may receive state-supplied MMR if their insurance carrier participates in the Alaska Vaccine Assessment Program (AVAP), or if they are uninsured and their medical provider has opted-in to AVAP for uninsured adults. (https://akvaccine.org/)
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Adults who are not eligible for state-supplied MMR would need to purchase the vaccine or contact their carrier to see if it will be covered.
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Alaska Medicaid will cover recommended doses of MMR during this outbreak.
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Health care providers participating in AVAP should order sufficient quantities of MMR vaccine to assure an adequate supply.
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More information about state-supplied vaccine eligibility is available on the Immunization Program’s website:
Reminders:
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All patients should be counseled about self-isolation and be excluded from work or school for 5 days after parotitis onset.
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Patients should be informed that they may be contacted by public health for a follow-up interview.
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All suspect and confirmed mumps infections are reportable to the SOE at 907-269-8000 during business hours or by fax using the Infectious Disease Report Form (907-563-7868, 24-hours a day).
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Testing information through Public Health is available on the SOE Mumps Webpage: https://www.mumps.dhss.alaska.
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