Does COVID-19 pandemic impacted mumps outbreaks: Time to consider vaccination strategies

INTRODUCTION Mumps is a communicable disease caused by the mumps virus, which belongs to a group of paramyxoviruses. The patient will present with parotitis, i.e., inflammation of the parotid gland associated with other mild symptoms such as headache, fever, muscle ache, loss of appetite, and fatigue but serious complications can occur if left untreated. After the availability of the mumps vaccine in 1967, the number of cases was reduced. From 1999 to 2019, on average 50,000 cases were reported to the World Health Organization annually.[1] Mumps is a vaccine-preventable disease still it has caused a significant disease burden where the vaccine coverage rate is low.[2] Vaccines against mumps infection which can be given singly or combined such as measles, mumps, and rubella (MMR) or MMR varicella. MMR is a live attenuated virus vaccine. One dose of MMR vaccine gives 78% and two 88% protection against mumps. In cases of outbreak, an extra dose can be given to at-risk groups, to improve protection against mumps disease and related complications.[3] We all know that there was a drastic change in our lifestyle because of COVID-19 pandemic. It disturbed routine health-care services globally. It is also evidenced that in London, MMR coverage fell from 83.6% to 82.4% in the COVID-19 period from 2019 to 2021. Few studies also reported that the quality of routine vaccination worsened during the pandemic compared with a prepandemic period.[4] One more study demonstrated that in the pediatric age group, mumps are one of the major causes of single-sided sensorineural hearing loss. As a consequence of the COVID-19 pandemic, a prolonged drop in childhood vaccination occurred. The study also stated that a rapid recovery of vaccination coverage helps in decreasing the disease burden.[2] There are a few outbreaks like in 2016–2017 in Arkansas and also recently there is a rise in cases of mumps in a few areas of Mumbai.[5] In Brazil, few studies have evaluated the impact of the COVID-19 pandemic on the vaccination of children and adolescents, which made it compulsory to consider the MMR vaccine. In the US also, it has dropped to 40% in the COVID-19 era which was evidenced by a fall in routine pediatric vaccine orders and doses administered.[6] In 2021, 1567 cases of mumps were reported to ECDC by 27 European Union/European Economic Area Member States, with an overall notification rate of 0.4 cases per 100,000 population. This was significantly lower than the notification rates reported during the previous 4 years (range 1.7–4.2).[7] Nowadays, worsened childhood vaccination coverage has become a public health problem as a consequence of the COVID-19 pandemic. Hence, now the primary goal is achieving herd immunity by prioritizing quality improvement and catch-up campaigns.[4] All these studies and reports teach us the importance of vaccination and consideration for policymakers and public health leaders. Hence, there will be improved access to and acceptance of vaccination.[8] Therefore, even in the event of a pandemic or epidemic, the immunization program for children should remain unaffected and should be given top priority. Author contributions Dr. Jyoti Ajagunde: study conception and design, Dr. Chanda Vyawahare: final manuscript preparation, Dr. Rajashri Patil: draft manuscript preparation, Dr. Hrishikesh Gilankar: preparation of draft as per guidelines. All authors reviewed and approved the final version of the manuscript. Data availability statement Data sharing not applicable to this article as no datasets were generated and/or analyzed during the current study. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.