Recent field data on Mumps outbreaks yields big questions about the vaccine efficacy.

Vaccinations are a hot topic in our society for a number of reasons.

Some have very strong opinions. This post isn't about opinion, or even vaccine side effects --It's about clinical pharmacology and real field data on the efficacy of the Mumps vaccine.

This is from the MMRII package insert by Merck

Efficacy of measles, mumps, and rubella vaccines was established in a series of double-blind controlled field trials which demonstrated a high degree of protective efficacy afforded by the individual vaccine components.7-12 These studies also established that seroconversion in response to vaccination against measles, mumps, and rubella paralleled protection from these diseases.13-15

When you drill down into the citations, you essentially get a lot of studies that measure the amount of antibodies produced by the body in response to the vaccine. The core assumption underlying all of this is that presence and amount of antibodies is a positive correlation to wild disease resistance.

I always pay attention when there are outbreaks, especially in the US, where MMR vaccination rates are estimated to be greater than 95%

source story for recent Mumps outbreak

28 cases of mumps reported, all but one had at least 1 dose of MMR but based on vaccine prevalence, the implication based on age is at least 50% would have the 2 dose regime. Also mentioned in the article is a previous outbreak of over 6000+ cases, and 80% were vaccinated. The ages were not cited in that reference.

Why then, are they getting the disease?

What part of the chain of scientific reasoning has broken? Does the immunity fade away?
Post edit

Following vaccination, antibodies associated with protection can be measured by neutralization assays, HI, or ELISA (enzyme linked immunosorbent assay) tests. Neutralizing and ELISA antibodies to measles, mumps, and rubella viruses are still detectable in most individuals 11 to 13 years after primary vaccination.16-18 See INDICATIONS AND USAGE, Non-Pregnant Adolescent and Adult Females, for Rubella Susceptibility Testing.

Damn. Missed that on primary approach.

Individuals planning travel outside the United States, if not immune, can acquire measles, mumps, or rubella and import these diseases into the United States. Therefore, prior to international travel, individuals known to be susceptible to one or more of these diseases can either receive the indicated monovalent vaccine (measles, mumps, or rubella), or a combination vaccine as appropriate. However, M-M-R II is preferred for persons likely to be susceptible to mumps and rubella; and if monovalent measles vaccine is not readily available, travelers should receive M-M-R II regardless of their immune status to mumps or rubella.34-36

double damn. Sux. Probably need to withdraw the post.

If so, when? That's not mentioned anywhere on the vaccine package insert. Question to people that trust vaccines....What should Merck do about this field data showing shockingly low efficacy rates?

1. Suppress or twist the data for the good of the herd
2. Reexamine the premise of antibody correlation with immunity
3. Propose to give a 3rd or 4th dose to babies.
4. other

What say you, ATS?

reply to post by InverseLookingGlass


Quick and dirty answer?

The virus that causes Mumps is mutating.

The vaccine is effective against a version that is being replaced.

Viruses mutate. Vaccines cannot adjust for the mutation.

It is easy to twist data to make it show what you desire it to show. Parameters should always be observed when evaluating the evidence. It is nice to see others actually verifying the reliability of the evidence presented to us, I like the feeling that I am not alone.

beezzer
reply to post by InverseLookingGlass

 

Quick and dirty answer?

The virus that causes Mumps is mutating.

The vaccine is effective against a version that is being replaced.

Viruses mutate. Vaccines cannot adjust for the mutation.

Pow right in the kisser.
Seems the most logical answer, the flu mutates why can't mumps. Or the black plague for that matter.

beezzer
reply to post by InverseLookingGlass

 

Quick and dirty answer?

The virus that causes Mumps is mutating.

The vaccine is effective against a version that is being replaced.

Viruses mutate. Vaccines cannot adjust for the mutation.

Actually that does make some sense Beez.. Either way stories of outbreaks in a vaccinated population does not bode well on many different levels..

They will blame it all on the anti-vac crowd,
Perhaps someone will actually test the new strain, see if it is new. I'd like to see the data.
Hopefully before it hits some sort of epidemic proportions.

Listen all Viruses mutate, in fact my old Lab director PHD Chemist working in Bio-tech nowadays told me "this:"

In nature one source material, say a specific like Lomatium spp, has any number of anti-viral etc compounds. We have a propensity in Western pharmacology to reduce things to their least common denominator IE single constituent extracts-single constituent analogs. When a virus is presented with one opponent long enough (just like any sports team, or boxer) it mutates to overcome the obvious resistance to its replication.

It is a theory of mine that in keeping with more broad-based applications of anti-viral, or anti-biotic materials meaning using whole complex plants etc...containing multiple compounds we can slow , or in some cases stop rapid mutations of virus' etc...I believe MERSA may well be stopped through the use of tinctured extracts of Usnea lichen for one amongst 100s I can think of.

I can take out any flu in hours to 4 days depending upon when the person begins treatment. using a selection 3-4 full spectrum plant extracts...never failed.

AzureSky
They will blame it all on the anti-vac crowd,
Perhaps someone will actually test the new strain, see if it is new. I'd like to see the data.
Hopefully before it hits some sort of epidemic proportions.

and I utterly agree here, its the new way in our modern society: Blame everyone that doesn't accept lemming mentality and actually think for themselves.

InverseLookingGlass
Vaccinations are a hot topic in our society for a number of reasons.

Some have very strong opinions. This post isn't about opinion, or even vaccine side effects --It's about clinical pharmacology and real field data on the efficacy of the Mumps vaccine.

This is from the MMRII package insert by Merck

Efficacy of measles, mumps, and rubella vaccines was established in a series of double-blind controlled field trials which demonstrated a high degree of protective efficacy afforded by the individual vaccine components.7-12 These studies also established that seroconversion in response to vaccination against measles, mumps, and rubella paralleled protection from these diseases.13-15

When you drill down into the citations, you essentially get a lot of studies that measure the amount of antibodies produced by the body in response to the vaccine. The core assumption underlying all of this is that presence and amount of antibodies is a positive correlation to wild disease resistance.

I always pay attention when there are outbreaks, especially in the US, where MMR vaccination rates are estimated to be greater than 95%

source story for recent Mumps outbreak

28 cases of mumps reported, all but one had at least 1 dose of MMR but based on vaccine prevalence, the implication based on age is at least 50% would have the 2 dose regime. Also mentioned in the article is a previous outbreak of over 6000+ cases, and 80% were vaccinated. The ages were not cited in that reference.

Why then, are they getting the disease?

What part of the chain of scientific reasoning has broken? Does the immunity fade away?
Post edit

Following vaccination, antibodies associated with protection can be measured by neutralization assays, HI, or ELISA (enzyme linked immunosorbent assay) tests. Neutralizing and ELISA antibodies to measles, mumps, and rubella viruses are still detectable in most individuals 11 to 13 years after primary vaccination.16-18 See INDICATIONS AND USAGE, Non-Pregnant Adolescent and Adult Females, for Rubella Susceptibility Testing.

Damn. Missed that on primary approach.

Individuals planning travel outside the United States, if not immune, can acquire measles, mumps, or rubella and import these diseases into the United States. Therefore, prior to international travel, individuals known to be susceptible to one or more of these diseases can either receive the indicated monovalent vaccine (measles, mumps, or rubella), or a combination vaccine as appropriate. However, M-M-R II is preferred for persons likely to be susceptible to mumps and rubella; and if monovalent measles vaccine is not readily available, travelers should receive M-M-R II regardless of their immune status to mumps or rubella.34-36

double damn. Sux. Probably need to withdraw the post.

If so, when? That's not mentioned anywhere on the vaccine package insert. Question to people that trust vaccines....What should Merck do about this field data showing shockingly low efficacy rates?

1. Suppress or twist the data for the good of the herd
2. Reexamine the premise of antibody correlation with immunity
3. Propose to give a 3rd or 4th dose to babies.
4. other

What say you, ATS?

edit on 20-3-2014 by InverseLookingGlass because: bullocks

The coverage rate in Ohio where the outbreak occurred is only 87% for MMR not 95%. There actually are a few states with less coverage than Ohio but very few with 95% or above.
www.cdc.gov...

I'd suggest that rather than looking at it from a pharmacological viewpoint this should be viewed as an epidemiological issue.

Oh, the field data shows low effectiveness, not low efficacy.
They mean very different things and you seem to have them confused.

reply to post by InverseLookingGlass


Coming back in on this one with crow plated up and steaming hot.

I jumped the gun and the majority of the premise of the post blew up. The answers to my own questions were (mostly) addressed in the MMRII package insert.

I requested to withdraw the post and got denied. If the OP flow is twisty, it's because of the corrections I added. It's factually corrected but regrettable on my part. c'est la vie.

Oh, the field data shows low effectiveness, not low efficacy. They mean very different things and you seem to have them confused

reply to post by Pardon?


yes but...... you're right.

When talking in terms of efficacy vs. effectiveness, effectiveness relates to how well a treatment works in the practice of medicine, as opposed to efficacy, which measures how well treatment works in clinical trials or laboratory studies.[1]

When I was a kid (80's) we weren't even vaccinated against the mumps and we were supposed to catch it.

I got it, no biggie.

Are the vaccine manufacturers using 'new mumps' cultures, or something from 1960? And are the diagnoses accurate, or best guesses by pediatricians who rarely see mumps in their training? Are there other diseases out there that could mimic mumps enough to be confusing?

After working in the medical field for 30+ years, and being mis-diagnosed myself plenty of times by docs with a full 10 minutes or so to go over a complicated medical history, see me as the patient, and ask limited questions, and after having been given numerous times medications that I had warned them in no uncertain terms that I was sensitive to, I somehow doubt the stats from beginning to end.

The biggest thing I've found out about the 'medical profession' from docs to pharmaceutical companies is, they don't know what the hell they're doing most of the time, and they're more dangerous than driving anywhere near the local college bar at closing time. But they've got white coats on and stethoscopes wrapped around their necks along with an imperious attitude, so trust them...

I think before people start getting carried away thinking there are new strains of mutant mumps viruses or that the doctors have got it wrong is to look properly at the numbers involved.

There are 28 confirmed cases as of now out of a total university population of over 60,000 (not including the immediate surrounding population)
(undergrad.osu.edu...).
All but one were vaccinated (as far as can be told, people often get confused as to whether they have or have not been vaccinated and it doesn't say whether all of these have had the required 2 shots).
That means, at the moment, 0.05% of the people who are (at least partially) vaccinated have contracted mumps.
That means, at the moment, 99.95% haven't contracted mumps.
Seems pretty effective to me.

Had mumps....in my balls....it hurt....a lot!!

beezzer
reply to post by InverseLookingGlass

 

Quick and dirty answer?

The virus that causes Mumps is mutating.

The vaccine is effective against a version that is being replaced.

Viruses mutate. Vaccines cannot adjust for the mutation.

That was what I was going to suggest if you didn't. Given what I know of what my husband does - make vaccines. They test efficacy based on antibody response, not on how well it actually keeps you from getting sick because that means actually trying to infect someone. Can you imagine the outrage at those kinds of trials? They run those trials in animals when they're testing new product to prove that it works. (This is animal pharma, btw)

Also, when you are making a vaccine, it is designed to make an antibody to a specific pathogen. The antibody targets the surface of that pathogen and binds to it so the immune system's cells will recognize and attack the pathogen quicker keeping you from getting sick, but the more a virus mutates, the more it's surface receptors change making it harder for those antibodies to bind to it. That means the vaccine will be less effective until it eventually can't bind at all, making it completely useless. That's why they have to use new flu strains every year hoping the produced antibodies will be able to bind to at least some of the pathogens to stop you from getting sick.

If this is a different strain of mumps, the antibodies produced by the vaccine won't work as well. We're lucky they work at all, assuming they do. These are things that will have to be determined by studying these cases.

Is the vaccine bad, or has mumps mutated?

I sent an email to ask my husband and here's what he said:

When you are making vaccines, don’t you test vaccine efficacy by testing antibody response (i.e. the presence of antibody in titer). You don’t actually test how well it keeps anything from getting sick in proven product. Depends on the test. Sometimes we quantitate the antigen in question, sometimes we see how well serums from vaccinates react to the live virus, and yes sometimes we see how well an animal is protected from the actual disease. It depends on the age of the federal regs and if we have an exemption to perform something different. In general the industry wants to get away from actual animal testing to avoid costs + variability + animal welfare issues as well as to gather actual hard numbers.

In the second question, his knowledge is sketchier because it's more R&D and he's always been QC and Regulatory. He said he knows for sure that the master seed stuff is correct, but he's sketchier on the rest.

Also, when you make them, you use in-house stocks, not wild pathogens, so if say the mumps virus were mutating, our existing vaccine effectiveness could well be dropping not because the vaccine is bad but because the pathogen it’s targeting isn’t the same one causing mumps – slightly different strain – making it less effective. Correct, we use a constant master seed that has been shown to be virulent. But we have to perform regular testing to confirm the master seed still protects against variants in the fields. Sometimes there is a different strain that it will still protect against. When we can prove the protection still holds true we call them a new ‘claim.’ We are expected to defend the claim with numbers and studies before we can advertise the new protections. It is not unusual for an older vaccine license to be terminated because of the variation in the field, or simply because the market was flooded with the protection and the disease has been all but eradicated.