Author Affiliations: Helsinki University Central Hospital, Hospital for Children and Adolescents (Dr Peltola); National Public Health Institute (Drs Davidkin, Valle, and Leinikki); and Department of Public Health, University of Helsinki (Drs Paunio and Heinonen), Helsinki, Finland.
Section Editor: Annette Flanagin, RN, MA,
Managing Senior Editor.
Many countries use trivalent measles-mumps-rubella (MMR) vaccine for
their mumps and rubella immunization programs.
In Finland, a national 2-dose MMR vaccination program for children,
free of charge and on a voluntary basis, was launched in 1982. Serological
confirmation of all suspected cases of mumps and rubella has been required
since 1987. Despite intensive surveillance, no persistent sequelae or deaths
attributable to vaccination have been detected. Indigenous mumps and rubella
were eliminated in 1996, but 4 imported cases of mumps and 2 of rubella occurred
from 1997 to 1999. Lack of secondary cases indicates sufficient immunity in
the community. Compared with an epidemic year, up to thousands of cases of
mumps meningoencephalitis and orchitis and around 50 cases of congenital rubella
syndrome are now avoided annually.
A 2-dose vaccine regimen in children during the last 17 years (1983-1999)
has interrupted circulation of the target viruses entirely. Finland is the
first country documented to be free of indigenous mumps and rubella (measles
was eliminated in 1996). Despite the ongoing possibility of imported disease,
major outbreaks probably can be avoided by maintaining high vaccination coverage
and the 2-dose policy.
Peltola H, Davidkin I, Paunio M, Valle M, Leinikki P, Heinonen OP. Mumps and Rubella Eliminated From Finland. JAMA. 2000;284(20):2643-2647. doi:10.1001/jama.284.20.2643