MMR and TDAP Vaccines in Young Adults

Do you have family members of college age? In recent years, there have been quite a few mumps outbreaks on college campuses and military compound.  From the end of July through September 2017, there were 26 cases of mumps reported in 140 military recruits from a military compound in Switzerland.  Vaccinations against measles, mumps and rubella outbreaks are combined in a single childhood vaccine called MMR.  Except for some parents who oppose vaccinations for their children, most children in the United States are vaccinated with MMR at an early age.

Measles vaccine gives us life long immunity.  This vaccine was developed by my father-in-law Dr. Samuel Katz while he was a medical researcher at Harvard in the 1950s.  It is not necessary for physicians to repeat the measles titer later in life, because of the “T-cell memory” in this vaccine.   Even if your measles titer is low, as Dr. Katz and my mother-in-law Dr. Cathy Wilfert explained to me, the titer rises quickly once you get exposed to someone with measles infection because of this T cell memory.

On the other hand, revaccination against Mumps is needed because its titer, or immunity, wanes over time.  There is no “T cell memory,” which explains why you can get mumps as an adult if you get exposed to those with mumps.  To test for the mumps titer is a waste of medical resources as the test is unnecessary and, incidentally, is much more costly than the vaccine.  There should be an automatic booster at college age.  In some unfortunate cases, Mumps can lead to inflammation of the ovaries (oophoritis), the testicles (orchitis), the brain (encephalitis) or the membrane covering the brain (meningitis).  Since physicians can not predict who will suffer those severe complications from Mumps, all of us should be revaccinated at college age.  

Rubella titer is among the routine tests in pregnancy.  If a pregnant woman is not immune to Rubella infection, she will get vaccinated shortly after her delivery.  Rubella immunity or titer can be tested before pregnancy, but the patient should not get pregnant for at least 3 months after the vaccination.  According to a CDC report, Rubella infection has been totally eliminated from the US 13 years ago.  From 2005-2015, there were only 8 cases of “congenital” Rubella, as result of non-immune pregnant patients giving births to children with Rubella complications/multiple malformations in the US, as compared to 20,000 cases annually in the 1960s.  It is still important, however, to be vaccinated against Rubella because people might travel abroad to one of the 195 countries which still report having rubella cases.  

DPT and TDAP are vaccines to prevent Diptheria-Pertussis-Tuberculosis.  DPT is given at a young age, while TDAP, an attenuated version with less potential side effects than DPT, is given from 7 years or older, as recommended by the CDC.  Although the CDC recommends a single shot of TDAP at 11 to 64 years of age, then Td only ( for tetanus and diphtheria) every ten years, some medical researchers including my parents in law would recommend TDAP since there has been an increased incidence of pertussis in adults in recent years.

If you have a son or daughter about to go to college or join the military, make sure to have their pediatrician or primary care doctor vaccinate them with TDAP and MMR.  Many pharmacies nowadays have medical clinics where these vaccines can be given.