Vaccine
September 15, 2026 · via Europe PMC
Impact of different MMR vaccination strategies on mumps incidence in Jiangsu, China: A 20-year interrupted time series analysis based on 180,000 cases.
Li M, Yuan D, Wang Z, +7 more, Wang B.
AI summary — for doctors, generated from the abstract only
In Jiangsu, China, a single-dose MMR policy failed to curb recurrent mumps outbreaks, while the 2020 switch to two doses was followed by a steady 1% monthly decline in incidence.
What was studied
An interrupted time series analysis of 240 months of statutory surveillance data from Jiangsu Province (2005-2024, 183,490 mumps cases) using negative binomial generalized linear models controlling for autoregression, meteorological non-linearity, population dynamics and COVID-19 intervention intensity, with age and regional stratification.
Key findings
- After the 2008 one-dose MMR policy, no significant long-term decline occurred (IRR 1.002, P=0.773) and 3-5 year outbreak cycles persisted
- After the July 2020 two-dose policy, incidence declined 1.0% per month (IRR 0.990, P=0.019)
- Declines were largest in the 5-9 (1.0% per month) and 10-14 (1.5%) age groups
- Adults 15 and over, not directly targeted, also declined 0.9% per month, suggesting herd immunity
- The two-dose policy reduced regional disparities, including compensatory outbreaks in northern Jiangsu
Clinical relevance
The analysis supports two-dose mumps vaccination schedules with real-world population data, though the policy change coincided with COVID-19 measures that the authors attempted to adjust for.
Who should care
Limitations
Ecological interrupted time series where the two-dose policy began in July 2020 alongside pandemic restrictions, so residual confounding by reduced social mixing is possible despite adjustment.
One dose was not enough to stop mumps cycles; two doses brought incidence steadily down, including in unvaccinated adults.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Although China upgraded its mumps vaccine schedule to two doses, quantitative evaluations of real-world, population-level effects remain limited. This study systematically evaluated the immediate and long-term impacts of 1-dose and 2-dose measles-mumps-rubella (MMR) vaccination strategies on mumps incidence in Jiangsu Province.
Methods
Statutory infectious disease surveillance data spanning 240 months from 2005 to 2024 in Jiangsu Province (183,490 cases) were collected. An interrupted time series (ITS) analysis was conducted using a generalized linear model (GLM) based on a negative binomial distribution. We evaluated the intervention effects of the vaccine policies while strictly controlling for autoregression, non-linear effects of meteorological factors, population dynamics, and the intensity of COVID-19 non-pharmaceutical interventions (NPIs). Stratified analyses by age group and geographical region were also performed.
Results
Following the introduction of the 1-dose MMR policy in 2008, no significant long-term downward trend in mumps incidence was observed across the province (IRR = 1.002, P = 0.773), and periodic outbreaks every 3 to 5 years persisted. Following the comprehensive implementation of the 2-dose MMR strategy in July 2020, the overall incidence exhibited a significant accelerated downward trend of 1.0% per month (IRR = 0.990, P = 0.019). Subgroup analyses revealed that the most heavily burdened 5-9 and 10-14 age groups experienced the most significant long-term declines (1.0% and 1.5% per month, respectively). Furthermore, the ≥15 years adult group, which was not directly targeted for vaccination, also showed a long-term reduction (0.9% per month), indicating a significant herd immunity effect. Additionally, the 2-dose policy successfully smoothed out regional incidence disparities, notably mitigating the compensatory outbreaks observed in Northern Jiangsu in 2019.
Conclusion
A 1-dose MMR immunization schedule is insufficient to interrupt periodic mumps outbreaks, and the transition to a 2-dose strategy was associated with a steady long-term decline in overall mumps incidence across Jiangsu Province, providing valuable real-world evidence to support the continuation and optimization of 2-dose MMR immunization schedules.
DOI
10.1016/j.vaccine.2026.129156
PMID
42743753
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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