Mumps:

Questions and Answers

i n fo r m at i o n a b o u t t he d i s ea s e a n d vacc i n e s

What causes mumps? weeks. Approximately half of patients with orchitis

Mumps is caused by a virus. have some degree of testicular atrophy, but sterility
is rare.
How does mumps spread? Inflammation of the ovaries (oophoritis) and/or
Mumps spreads from person to person via droplets breasts (mastitis) can occur in females who have
of saliva or mucus from the mouth, nose, or throat of reached puberty. An increase in spontaneous abortion
an infected person, usually when the person coughs, (miscarriage) has been found among women who
sneezes, or talks. The virus may also be spread developed mumps during the first trimester of
indirectly when someone with mumps touches items pregnancy in some studies but not in others;
or surfaces without washing their hands and then however, there is no evidence that mumps causes
someone else touches the same surface and rubs birth defects. Deafness, in one or both ears, can
their mouth or nose. Mumps is less contagious than occur in approximately one per 20,000 reported
measles or chickenpox. cases of mumps.

How long does it take to show signs of mumps Is there a treatment for mumps?
after being exposed? There is no cure for mumps, only supportive
The incubation period of mumps is usually 16–18 treatment (e.g., pain control, bed rest, fluids, and
days, but can range from 12–25 days. fever reduction).

What are the symptoms of mumps? How is mumps diagnosed?

Individuals with mumps usually first feel sick with Mumps is diagnosed by a combination of symptoms
nonspecific symptoms like headache, loss of appetite, and physical signs and laboratory confirmation of the
and low-grade fever. The most well-known sign of virus, as not all cases develop characteristic parotitis
mumps is parotitis, the swelling of the salivary glands, and not all cases of parotitis are caused by mumps.
or parotid glands, below the ear. Parotitis occurs only
in 31% to 65% of individuals infected with mumps. How long is a person with mumps contagious?
From 15% to 27% of people with mumps have no People with mumps are usually considered most
signs or symptoms of illness; others may have respira- infectious from a few days before until 5 days after
tory symptoms or only nonspecific symptoms such as the onset of parotitis. Therefore, CDC recommends
headache, loss of appetite, and low-grade fever. isolating mumps patients for 5 days after their glands
begin to swell.
How serious is mumps?
In children, mumps is usually a mild disease. What should be done if someone hasn't been
Adults may have more serious disease and more vaccinated with MMR is exposed to mumps?
complications. Although vaccinating after an exposure to mumps
will not prevent infection as a result of that exposure,
What are possible complications from mumps? vaccination can provide protection against future
Before a vaccine was available, mumps accounted for mumps exposures, as well as protection against
about 10% of viral meningitis reported in the United measles and rubella.
States. This complication is now rare. Up to10% How common is mumps in the United States?
of post-pubertal males experience orchitis (testicular
inflammation) as a complication of mumps. This may Due to good immunization coverage, mumps is now
involve pain, swelling, nausea, vomiting, and fever, rare in the United States. An estimated 212,000
with tenderness of the area possibly lasting for cases occurred in 1964, while only 229 cases were

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reported in 2012. Cases began to increase in 2014, Who should get this vaccine?
peaking with more than 6,000 cases reported in All children, adolescents, and adults born in 1957 or
both 2016 and 2017. Many of the large outbreaks later without a valid contraindication should have
occurred on college campuses among people who documentation of vaccination or other evidence
had received 2 doses of MMR; illness in fully vacci- of immunity. Additionally, some healthcare personnel
nated cases was typically milder than in unvaccinated who were born before 1957 may also need proof of
cases. Based on evidence of a relatively short-term vaccination or other evidence of immunity.
boost in protection against mumps following an addi-
tional dose of MMR, ACIP recommended that a third What kind of “evidence of immunity” can
dose of MMR be administered to people identified by substitute for MMR vaccination?
public health authorities as being at risk during an
Evidence of immunity can be shown by having
outbreak.
laboratory evidence of immunity to measles, mumps,
Can someone get mumps more than once? and/or rubella or laboratory confirmation of disease.
People who have had mumps are usually protected However, if a person doesn’t have evidence of immu-
for life against another mumps infection. However, nity to all three diseases (e.g., measles, mumps, and
second occurrences of mumps do rarely occur. rubella), they would still need to get vaccinated with
MMR since the vaccine is not available as a single
When did vaccines for measles, mumps, and antigen product in the U.S.
rubella become available?
At what age should the first dose of MMR be
The first measles vaccines (an inactivated and a
given?
live virus product) became available in 1963, both
of which were largely replaced by a further attenuated The first dose of MMR should be given on or after the
live virus vaccine that was licensed in 1968. child’s first birthday; the recommended age range is
The mumps vaccine first became available in 1967, from 12–15 months. MMR can be given to children
followed by the rubella vaccine in 1969. These as young as 6 months of age who are at high risk of
three vaccines were combined in 1971 to form the exposure, such as during international travel or a
measles-mumps-rubella vaccine (MMRII by Merck). community outbreak. However, doses given before
A vaccine that combines both MMRII and varicella 12 months of age are not counted toward the 2-dose
(chickenpox) vaccines, known as MMRV, became series for MMR (see special situations in www.cdc.
available in 2005. gov/vaccines/schedules/hcp/imz/child-adolescent.
html#note-mmr).
A second MMR (Priorix by GSK) was licensed and
recommended in 2022. There is no difference in rec-
When should children get the second MMR shot?
ommendations between Priorix and MMRII (Merck)
brands of MMR. Priorix may be used in any situation The second dose is usually given when the child is 4–6
where MMR vaccination is recommended. Despite years old, or before he or she enters kindergarten or first
minor differences in manufacturing (MMRII contains grade. However, the second dose can be given earlier
gelatin, Priorix does not), the two vaccines may be as long as there has been an interval
considered functionally identical and interchangeable. of at least 28 days since the first dose.
Single antigen measles, mumps, and rubella vaccines How effective is this vaccine?
are no longer available in the U.S.
The first dose of MMR is 97% effective against rubella,
What kind of vaccine is it? 93% against measles, and 78% against mumps. Two
doses are 97% effective against measles and 88%
MMR contains live, attenuated (or weakened) strains of
effective against mumps. The second dose of MMR is
the measles, mumps, and rubella viruses.
intended to produce immunity in those who did not
respond to the first dose, but a very small percentage of
How is this vaccine given?
people may not be protected even after a second dose.
MMRII (Merck) is a shot that can be given subcutane-
ously (in the fatty layer of tissue under the skin) or
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intramuscularly in the deltoid muscle. Priorix (GSK) is
only given subcutaneously.

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Mumps: Questions and Answers (continued) page 3 of 4

Which adolescents and adults should receive general population. Making sure that all employees are
the MMR vaccine? immune to these diseases protects both the employee
and the patients with whom he or she may have
All unvaccinated adolescents without a valid contrain-
contact. All people working in a healthcare facility in any
dication to the vaccine should have documentation of
capacity should have documentation of vaccination or
two doses of MMR. All adults born in or after 1957
evidence of immunity, including full- or part-time
should also have documentation of vaccination or
employees, medical or non-medical, paid or volunteer,
other evidence of immunity.
students, and those with or without direct patient
Adults born before 1957 are likely to have had measles responsibilities.
and/or mumps disease as a child and are generally (but
Facilities should consider vaccinating with MMR
not always) considered not to need vaccination.
vaccine healthcare personnel born before 1957 who
Which adults need two doses of MMR? lack laboratory evidence of measles, mumps, and
rubella immunity or laboratory confirmation of
Certain adults are at higher risk of exposure to previous disease. These facilities should vaccinate
measles, mumps, and/or rubella and may need a healthcare personnel with MMR during an outbreak
second dose of MMR unless they have other evidence of any of the diseases, regardless of birth year.
of immunity; this includes adults who
• a re students in postsecondary educational Who recommends this vaccine?
institutions (for measles and mumps) The Centers for Disease Control and Prevention
• are healthcare personnel (for measles and mumps) (CDC), the American Academy of Pediatrics (AAP), the
• live in a community experiencing an outbreak American Academy of Family Physicians (AAFP), the
or recently exposed to the disease (for measles and American College of Obstetricians and Gynecologists,
mumps) and the American College of Physicians (ACP) have all
recommended this vaccine.
• p
 lan to travel internationally (for measles and
mumps) How safe is this vaccine?
• r eceived inactivated (killed) measles vaccine or Hundreds of millions of doses of measles, mumps, and
measles vaccine of unknown type during 1963– rubella vaccine prepared either as separate vaccines or
1967. They should be revaccinated with two doses as the combined MMR vaccine have been given in the
of MMR vaccine. United States, and its safety record is excellent.
• w
 ere vaccinated before 1979 with either killed
mumps vaccine or mumps vaccine of unknown type What side effects have been reported with this
and are at high risk for mumps infection (e.g., vaccine?
persons who are working in a healthcare facility). Fever is the most common side effect, occurring in
They should be considered for revaccination with 5%–15% of vaccine recipients. About 5% of people
2 doses of MMR. develop a mild rash. When they occur, fever and
rash usually appear 7–12 days after vaccination.
Do college students need a third dose of MMR? About 25% of adult women receiving MMR develop
Not routinely. However, in 2018 CDC recommended temporary joint pain, a symptom related to the rubella
that people previously vaccinated with 2 doses of component of the combined vaccine. Joint pain only
mumps vaccine (e.g., MMR), who are identified occurs in women who are not immune to rubella at the
by public health authorities as being part of a group time of vaccination. MMR may cause thrombocytope-
or population at increased risk for mumps because nia (low platelet count) at the rate of about 1 case per
of an outbreak, should receive a third dose of MMR. 30,000–40,000 vaccinated people. Cases are almost
always temporary and not life-threatening. More
Why do healthcare personnel need vaccination severe reactions, including allergic reactions, are rare.
or other evidence of immunity to measles, Other severe problems (e.g., deafness, permanent brain
mumps, and rubella? damage) occur so rarely that experts cannot be sure
People who work in medical facilities are at much whether they are caused by the vaccine or not.
higher risk for being exposed to disease than is the
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Mumps: Questions and Answers (continued) page 4 of 4

If a child develops a rash after getting the MMR Does the MMR vaccine cause autism?
vaccine, is he contagious? No. There is no scientific evidence that any vaccine
Transmission of the vaccine viruses does not occur causes autism. The question about a possible link
from a vaccinated person, including those who develop between MMR and autism has been extensively
a rash. No special precautions (e.g., exclusion from reviewed by independent groups of experts in the U.S.
school or work) need be taken. including the National Academy of Sciences’ Institute
of Medicine. These reviews have concluded that there
Who should NOT receive MMR? is no association between MMR and autism.
Anyone who had a severe allergic reaction (e.g., For a summary of the issues on this topic, please read
anaphylaxis) following the first dose of MMR should “Vaccines and Autism” on the website of the Vaccine
not receive a second dose. Anyone knowing they are Education Center at Children’s Hospital of Philadelphia.
allergic to an MMR component (e.g., gelatin, neomycin This discussion can be accessed at www.chop.edu/
in MMRII) should not receive this vaccine. centers-programs/vaccine-education-center/vaccines-
As with all live virus vaccines, people known to be and-other-conditions/vaccines-autism.html
pregnant should not receive the MMR vaccine. The parent-led Autism Science Foundation offers an
Recipients capable of pregnancy should be counseled excellent literature review on their website at https://
to avoid pregnancy for 4 weeks following vaccination. autismsciencefoundation.org/autism-and-vaccines-
Those who are breast-feeding can be vaccinated. read-the-science/
Children and other household contacts of pregnant
For more information, visit CDC’s “Autism and
people should be vaccinated according to the
Vaccines” web page at www.cdc.gov/vaccinesafety/
recommended schedule.
concerns/autism.html
Severely immunocompromised people should not be
given MMR. This includes people with conditions Can the live virus in the vaccine cause measles,
such as congenital immunodeficiency, AIDS, leukemia, mumps, and/or rubella?
lymphoma, generalized malignancy, and those receiv-
Because the measles, mumps, and rubella viruses
ing treatment for cancer with drugs, radiation, or large
in the MMR vaccine are weak versions of the disease
doses of corticosteroids. Household contacts of
viruses, they may cause a very mild case of the disease
immunocompromised people should be vaccinated
they were designed to prevent.
according to the recommended schedule.
Although people with AIDS or HIV infection with signs What if someone who is pregnant inadvertently
of serious immunosuppression should not be given got the MMR vaccine?
MMR, people with HIV infection who do not have People are advised not to receive any live virus
laboratory evidence of severe immunosuppression can vaccine during pregnancy as a safety precaution based
and should be vaccinated against measles. For more on the theoretical possibility of a live vaccine causing
information on who should not get MMR, including disease (e.g., rubella virus leading to congenital rubella
precautions, see www.cdc.gov/vaccines/vpd/mmr/ syndrome [CRS]).
public/index.html#
Because a number of people have inadvertently
Can individuals with egg allergy receive MMR? received this vaccine while pregnant or soon before
conception, the Centers for Disease Control and
Yes. In the past it was believed that people who were
Prevention has collected data about the outcomes
allergic to eggs would be at risk of an allergic reaction
of their births. From 1971–1989, no evidence of
from the vaccine because the vaccine is grown in tis-
CRS occurred in the 324 infants born to 321 pregnant
sue from chick embryos. However, recent studies have
people who received rubella vaccine while pregnant
shown that this is not the case. Either brand of MMR
and continued pregnancy to term. As any risk to the
may be given to egg-allergic individuals without prior
fetus from rubella vaccine appears to be extremely
testing or use of special precautions.
low or zero, individual counseling of women in this
situation is recommended.

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