Mumps Vaccine Shortage
The shortage that began in the middle of 2008 continues. Having had no direct information from the manufacturer, Merck & Co Inc.we have now (November 2009) been told that Mumpsvax will no longer be available now or in the future.
Prior to this they announced that they intended to resume production after at least 2 years but clearly that position has now changed.
We are as concerned and troubled by this as you would be and are looking for alternative approved sources.
Questions answered:
- What does this mean for me or my child?
- How serious is mumps disease?
- What about the risk of infertility?
- How large is the waiting list?
- What alternative choices do we have?
- What if we have already partially completed the course?
- Are there any other manufacturers to source from?
- Could this shortage have been foreseen?
- How can I get more answers to other pressing questions in this regard?
What does this mean for me or my child?
If you or your child has never been vaccinated against mumps, the disease may strike at any time. If you or your child has received one dose but not been boosted, the chances of getting infected are much reduced and even if the disease does strike it is likely to be a milder attack.
A child in the household that is infected with mumps can pass the infection on to others in the home or school. It is particularly important to prevent such a child from coming in to contact with adult males or pregnant women if possible.
Having registered with Direct Remedies, you or your child will be placed on our waiting list for mumps vaccines. Efforts are continuing to obtain approval of single mumps vaccines from alternative manufacturers but the success or time-scale of this is not certain.
It is usually a mild illness with quite distinct symptoms of swelling and pain in the back of the cheeks where the salivary glands are located. A high fever with aches and flu-like symtoms can occur and last for around 1 week. (It is, for example in the same order of severity as childhood chickenpox.)
But, as with all the viral illnesses it does have a very small chance of causing brain inflammation (viral encephalitis) or inflammation of the coverings of the brain (viral meningitis). Deafness is a rare compllication of the disease. Males over 12 years of age can occasionally become sterile if the infection affects their testicles. This is extremely rare.
It has important public health implications as un-vaccinated litle children could pass the disease to adult men etc.
Please click on the link below for more information:
http://www.nhs.uk/Conditions/Mumps/Pages/Complications.aspx?url=Pages/What-is-it.aspx
What about the risk of infertility?
The testicles can be affected in about a quarter of males above 12 years of age who contract mumps infection. It is very painful and the infection can damage the cells that produce sperms. This can, in rare cases lead to a reduction in sperm count or extremely rarely to complete sterility or infertility.
How large is the waiting list?
There are approximately 3000 individuals on the waiting list at present collectively through our nationwide network of clinics (as at Nov 2009). Every month adds a further 80 to 120 to the list. If and when the vaccine supply resumes we shall address the longest waiting clients first and get through the list by putting on extra clinic sessions etc.
What alternative choices do we have?
There is no other single antigen (monovalent) mumps vaccine approved for importation and usage in the UK apart from MUMPSVAX. In the absence of this vaccine your choice has been restricted, at the current time, to obtaining mumps immunity only by getting the combined MMR vaccine through your GP.
As you know, the proposed link between the MMR and autism or bowel disease has not been proven. As your child gets older and more robust in general health, your initial fears about the combined MMR may dwindle. It is worth then considering obtaining a combined MMR vaccine (if the shortage persists). This is particularly relevant before your child is 12 years old if he is a boy. But also important for girls for reasons as outlined above.
What if we have already partially completed the course?
If you or your child has already received the measles jab and/or the rubella vaccine and the current scarcity persists, this may force you to consider obtaining the combined MMR in order to obtain protection against mumps. There is no added danger or 'overdose' from getting the un-necessary dose of measles/rubella in that combination.
The measles and rubella vaccines your child has received will be protecting them from these diseases while the availability issues are resolved and also buys them time to mature past the crucial second year of life when most anxieties regarding the effects of the combined MMR vaccine prevail.
There is no such thing as an overdosage with these vaccines after an interval of a few months. You may therefore proceed with the combined MMR as a booster or indeed as a first vaccine against mumps in this situation.
Are there any other manufacturers to source from?
There are many manufacturers of mumps vaccines worldwide. Of particular good repute are those from the EU, India and Japan. None of these vaccines are currently approved for importation to the UK by the MHRA (Medicine and Heathcare Products Regulatory Authority). This is mainly due to an increased incidence of vaccine related meningitis (in comparison with the now discontinued mumpsvax) or apparent lack of research that fullfills the UK standards.
Dr. Ratnasinghe and our partners are working hard at getting an approved good quality alternative.
Could this shortage have been foreseen?
Probably. There have been shortages of various vaccines worldwide in the past and present. Particular scarcities of Mumpsvax have occured previously on 3 occasions in the last 7 years. There was no reason to believe that the current shortage from 2008 was in any way different from the previous occasions but the demands placed on Merck & Co from other diseases and from various influential pressure groups need to be considered. How the current economic conditions affect Merck & Co and its choice of products etc is understandably closely guarded by them.
Direct Remedies Ltd has always tried to make it clear in the information supplied, that the vaccinations are subject to availability and that shortages can occur and production can be uncertain while not being directly under our control. If you feel that you have been misled or mis-informed in this regard please e-mail Dr.D.D.Ratnasinghe directly on ddr@directremedies.com
How can I get more answers to other pressing questions in this regard?
If the above information has not answered your queries adequately please e-mail our consultant paediatrician at ddr@directremedies.com or call the offices on 0845 130 4595.
