From the Guidelines
Yes, a patient with low mumps IgM antibody levels may still need the MMR (measles, mumps, rubella) vaccine, as low IgM levels typically indicate either no recent mumps infection or that the patient has not been effectively immunized against mumps 1. The MMR vaccine is recommended for adults born after 1957 who don't have evidence of immunity, which includes laboratory confirmation of adequate antibody levels.
Key Considerations
- The standard MMR vaccination consists of two doses given at least 28 days apart, with both doses recommended for adults with no documentation of prior vaccination.
- If the patient has received one dose previously, a second dose should be administered, as two doses of measles vaccine are necessary to develop adequate population immunity to prevent measles outbreaks among school-aged and older persons 1.
- The vaccine is contraindicated in pregnant women, severely immunocompromised individuals, and those with severe allergic reactions to vaccine components.
- Low IgM levels alone don't confirm immunity; IgG antibody levels are more reliable for determining long-term protection.
Recommendations for Healthcare Providers
- Check both antibody types (IgM and IgG) and vaccination history before making recommendations.
- Proper immunization helps prevent mumps outbreaks and their potential complications like orchitis, meningitis, and hearing loss.
- For healthcare workers (HCP) born in 1957 or later without evidence of immunity to measles, mumps, or rubella, a 2-dose series at least 4 weeks apart should be administered for measles or mumps immunity and at least 1 dose of MMR should be administered for rubella immunity 1.
From the Research
MMR Vaccine and Mumps Immunoglobulin M (IgM) Level
- The MMR vaccine is recommended for children and adults to prevent measles, mumps, and rubella 2.
- The vaccine is typically administered in two doses, with the first dose given at 12-15 months of age and the second dose at 4-6 years of age 2.
- For adults, two doses of the MMR vaccine are recommended for those at high risk of exposure and transmission, and one dose for other adults aged 18 years and older 2.
Mumps Immunoglobulin M (IgM) Level and Vaccine Response
- A study found that after primary MMR vaccination, IgM and IgG antibody levels against mumps were positive in 68.9% and 95.3% of children, respectively 3.
- Another study found that anti-mumps antibody levels remained relatively stable over a 10-year follow-up period, and a second dose of MMR vaccine had a boosting effect on anti-mumps antibody titers and seropositivity rates 4.
- However, a study also found that young adults immunized with MMR vaccine in childhood had decreased humoral immunity to mumps, with lower IgG concentrations and lower frequencies of circulating mumps-specific memory B cells compared to measles and rubella 5.
Implications for Vaccine Administration
- The Centers for Disease Control (CDC) recommend 2 documented doses of the MMR vaccine for adequate measles, mumps, and rubella immunity for all children and most adults 6.
- If a patient has a lower than normal Mumps Immunoglobulin M (IgM) level, it may indicate that they are not immune to mumps, and vaccination with the MMR vaccine may be necessary 2, 6.
- However, the decision to administer the MMR vaccine should be based on individual circumstances and consultation with a healthcare professional, taking into account the patient's medical history, vaccination history, and current immune status 2, 6.