Dear Editor.
Refer correspondence titled ‘Say no to MMR; Epidemiological reasons’ (MJAF1, 2000; 56: 275-6). We do not agree with the various contentions of the corespondent regarding vaccination for Mumps and Rubella.
Mumps vaccine was introduced in the US in 1967 and routine use was recommended in 1977 [1]. This led to a steady decrease in the incidence rate of cases. In 1995 only 906 cases of mumps were reported in the US as compared to 185,691 cases in 1967 [1]. A relative resurgence was seen in the mid 1980s when outbreaks occurred in high schools, college campuses and in workplaces [l]. However, even at its peak the incidence rate never rose beyond 7 per 100,000 population as compared to almost 90 per 100,000 population in the prevaccination era [2]. Thus even though there was an epidemiological shift there was no actual increase in incidence. As regards sterility, we submit that this will occur only as a consequence of bilateral orchitis and it has been uniformly agreed that sterility following mumps is rare [1, 3].
UK adopted a programme of selective immunisation as recommended by the correspondent. Adolescent school girls and women at high risk (nurses, teachers) were immunised with rubella vaccine [4]. However, despite an uptake rate of 90 percent it was found that 2.8 percent of young women were still susceptible to rubella [5]. The UK Government accepted that complete immunisation of the target population was not a realistic goal and therefore adopted universal childhood immunisation in 1988 [5].
We entirely agree that India should learn from the mistakes of other countries. India has a well developed programme of immunisation in childhood with high uptake rates. We should do our best to utilise this to attempt to eradicate these diseases from the country.
References
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