Individuals who have previously received 2 doses of a mumps-containing vaccine should receive a third dose if they are identified by public health authorities as being part of a group at increased risk for acquiring mumps, according to a new recommendation issued by the Advisory Committee on Immunization Practices (ACIP).

The recommendation was based on a review of available evidence which showed that a third dose of measles, mumps, rubella (MMR) vaccine was safe and effective for preventing mumps. The studies were all conducted in outbreak settings among populations with high coverage with 2 doses of MMR vaccine. 

According to the new guidance, when an outbreak is identified, public health officials should identify the groups most at risk, determine whether vaccination is appropriate, and provide recommendations to healthcare providers. Individuals who have had close contact with an infected person and who have had prolonged exposure to droplets or saliva would be considered at risk.

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“The purpose of the recommendation is to improve protection of persons in outbreak settings against mumps disease and mumps-related complications,” the authors concluded. “At this time, evidence is limited and is not sufficient to fully characterize the effect of a third dose of MMR vaccine on reducing the size or duration of an outbreak, nor are any data available to demonstrate the duration of additional protection conferred by a third dose.” 

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Marin M, Marlow M, Moore KL, Patel M. 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 Morb Mortal Wkly Rep 2018;67:33–38

This article originally appeared on MPR