The United Kingdom Measles and Rubella Elimination Strategy, published in 2019, focuses on four components required to maintain elimination. These are to: achieve and sustain at least 95% coverage with two doses of measles, mumps and rubella (MMR) vaccine in the routine childhood programme; achieve at least 95% coverage with two doses of MMR vaccine in older age cohorts through opportunistic and targeted catch-up; strengthen measles and rubella surveillance through rigorous case investigation and testing at least 80% of all suspected cases with an Oral Fluid Test; and ensure easy access to high-quality, evidence-based information for health professionals and the public. This will improve mumps control and reduce outbreaks occurring.

The epidemiology of mumps in the UK has been impacted in several ways during the COVID-19 pandemic. The closures and public health measures in place in educational settings since March 2020 has led to the interruption of transmission of mumps and very few cases being reported. In England, there were two laboratory confirmed mumps infections between April and June 2021.

Actions already taken include a measles, mumps and rubella (MMR) catch-up vaccination programme for 10 and 11 year olds delivered through primary care, communications campaigns targeting festival goers and students and local initiatives addressing inequalities in vaccine uptake.

Public Health England provides information on the benefits and risks of the MMR vaccine to the public using National Health Service branded leaflets, some of which are available in multiple languages. The leaflets address common questions about the MMR vaccine and encourage parents to have their children vaccinated. The leaflets, designed for use in schools, healthcare centres, accident and emergency departments, hospital wards, walk-in centres and general practices, are available at the following link:

https://www.gov.uk/government/collections/immunisation#measles,-mumps-and-rubella-(mmr)

In England, there were 1,796 laboratory confirmed mumps cases reported in 2017, 1,061 in 2018 and 5,042 in 2019. The data is available at the following link:

https://www.gov.uk/government/publications/measles-confirmed-cases/confirmed-cases-of-measles-mumps-and-rubella-in-england-and-wales-2012-to-2013

Mumps activity in 2019 was the highest observed in a decade and the number of laboratory confirmed cases remained high in the first quarter (Q1) of 2020. This rise in mumps cases has been driven by outbreaks in universities and colleges. Many of the cases were seen in young adults born in the late nineties and early 2000s who missed out on the measles, mumps and rubella vaccine when they were children.

In Q1 of 2020 there were 3,088 laboratory confirmed mumps infections. Cases were reported in all regions of England, predominantly in young adults aged 15 to 34 years -2,533/3,088 or 82% - so the total number of laboratory-confirmed mumps cases in Q2 is likely to be an underestimate.

NHS England and NHS Improvement, the Department and Public Health England (PHE) are working with national and local stakeholders to raise awareness of the rise in mumps activity and promote uptake of the measles, mumps and rubella (MMR) vaccine, in particular to the age groups that are most affected - 15 to 25 year olds.

PHE is running a ‘Value of Vaccines’ campaign to help share messages and information on vaccination, which is available at the following link:

https://campaignresources.phe.gov.uk/resources/campaigns/94-value-of-vaccines/overview

There have been targeted communications for university students and festival goers in collaboration with Universities and Colleges Admissions Service which will continue to be amplified in the coming weeks. PHE provides information on the benefits and risks of the MMR vaccine to the public using National Health Service branded leaflets. The leaflets address common questions about the MMR vaccine. This information is designed for use by schools, healthcare centres, accident and emergency departments, hospital wards, walk-in centres and general practices.

In addition, NHS England is running an MMR catch-up programme for 10 and 11-year olds through general practices.

An increase in mumps activity was observed in England in the first quarter (Q1) of 2019 with 795 laboratory confirmed mumps infections. Cases were reported in all regions of England, predominantly in young adults aged 15 to 34 years (703/795, 88%). Almost half (352/795, 44%) of the cases in Q1 were in unvaccinated individuals. Whilst this is triple the total number of infections (247 cases) confirmed in England in Q1 of 2018, increases in mumps cases have been observed in previous years. In Q1 of 2013, a total of 980 cases were confirmed.

Further information is available to view at the following link:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/804024/hpr1819_mmr2.pdf

Although mumps can occur in fully vaccinated individuals, due to secondary vaccine failure, it is less likely to lead to complications requiring hospitalisation. While the mumps component of the Measles, Mumps and Rubella (MMR) vaccine is highly effective at protecting young children, immunity can wane over time. Therefore, older teenagers and adults who received two doses of MMR in childhood can still get mumps although this is generally mild compared to those who are unvaccinated.

Mumps is a notifiable disease and healthcare professionals are legally required to report all suspected cases to their local Health Protection Team. The number of confirmed cases of mumps in quarter 1 of each year from 2016 is shown in the following table.

Number of laboratory confirmed mumps cases in England for Quarter 1 (Q1) in 2016 - 19

Sources:

1. 2016: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/526457/hpr1816_mmr.pdf
2. 2017: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/616215/hpr1917_mmr.pdf
3. 2018: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/711941/1918_AA_mmr.pdf
4. 2019: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/804024/hpr1819_mmr2.pdf