Older people and childhood diseases

In his book The Human Body, Isaac Asimov writes about mumps:
“Most children get it at an early age. There are advantages in this, for it is a mild disease and leads to lifelong immunity; those unfortunate enough to escape it as children may catch it as adults, at which time it may be accompanied by unpleasant complications.” --p. 213, softbound edition; 1964.
Mumps is the only childhood disease that I “escaped.” When my younger brother was about 10, and I was 23, our Mom got a notice from his school that some kids there had been exposed to the mumps; of course, I was concerned. That was about forty years ago; I’m 64 now, and I think I should be concerned now–not just because of my age, but because I drive a friend’s 5-year-old daughter to and from a local grade school–other than driving, all I do is walk with her to the school gate, where my responsibility ends. I don’t touch her. Should I be concerned for my health if little “Betty” is exposed to the mumps?

If “Betty” has had her course of MMR vaccination, she will never get infected. You could get your own Mumps vaccination shot if you were really worried, or if your friends are anti-vaxxers.

You’re saying that the MMR vaccine is 100% effective?

There’s a decent chance that you were vaccinated for it or you had a very mild case and no one noticed.

We’ve been vaccinating against mumps pretty widely in the US since the 1950’s, although the early vaccines weren’t great. The good one, a variety of which is still used today, came out in the mid 1960’s. Before the vaccine, more than 80% of people got the mumps, but of those, only about 20-30% got the swollen parotid glands that most people associate with the mumps. Another 20% have no symptoms at all, but are infected and can spread the virus to others. The rest of them just has what seemed like a pretty bad cold. All of those people, symptomatic or not, are still immune to mumps today, even though they don’t know they ever had it. So many people in your age group had it, in fact, that the CDC guidelines for vaccination say you don’t need the MMR if you were born before 1957. There’s just no point.

If you are concerned, your doctor can draw some blood and send it to the lab where they can “check your titers” - look for antibodies to mumps which would indicate either you were vaccinated against it or you had it and your immune system “remembers” how to defend you against it.
But yes, to answer the actual question, yes, if it is indeed the case that you never had mumps and you were not vaccinated for it, and you are in frequent contact with an unvaccinated child, you should be concerned if there’s a mumps outbreak in their peer group. The complication that concerns us when adult men get mumps is that their testicles can be infected and swell and cause severe pain and infertility.

While the MMR is not 100% effective, it’s very effective. If she has been vaccinated, or if you have been vaccinated, then it’s a matter of prioritizing your worries. If one or both of you has been vaccinated, then you run a much greater risk of getting mumps from a recent immigrant, a person whose immune system doesn’t respond to the vaccine or is medically barred from getting the vaccine, a child who just got his second shot and is still working on developing full immunity or a random anti-vaxxer’s kid you meet in the supermarket. You simply cannot worry about such risks, other than supporting vaccination and education in your area.

Very few medical treatments are 1005 effective. But it’s somewhere in the high 90’s% effective, so the overwhelming odds are that it will be effective for you.

aA question might be about the side effects for an older adult – some small percentage of children have annoying side effects from the vaccine – would these be more likely/more severe in an older adult? Maybe someone with more medical knowledge can answer that.

Risk assessment - You are far more likely to die or be injured in a traffic accident while you are driving the girl to school, than you are to get mumps.

Indeed the odds are that you had a sub-clinical infection in your youth and are immune. Official guidance is that anyone born before 1957 is likely immune. If you wanted to further reassure yourself you could get yourself tested for the antibody.

You also benefit from herd immunity: not only Betty but pretty much everyone who might expose Betty have been vaccinated. Consequently there is little chance of Betty being exposed let alone of her exposing you. There have been two relatively recent years with significant outbreaks - 2006 and 2009. The total number of cases were in the several thousands each and were concentrated in the college populations. Other than that outbreaks are uncommon with a dozen or so cases. Herd immunity is key. The series is abut 88% effective for providing individual immunity. It gets us the rest of the way by that reduced risk of exposure. People who are vaccinated are still at (reduced but non-zero) risk of catching it if exposed. The odds of you being exposed are very very tiny, especially from a vaccinated Betty.

Mumps also is usually a disease that even adults recover from without serious complications. Recovery occurs in a few weeks. Yes testicular inflammation and pain (orchitis) can occur and fairly uncommonly serious complications like meningitis and encephalitis happen, rarely even death, but most cases are just uncomfortable.

The bigger vaccine related issue regarding older adults with exposure to and from children involves adults who care for their grandchildren potentially exposing them - that is the other way around than the op - and with pertussis (whooping cough). Adults are often not immune to andcan get very mild disease from whooping cough and barely know they are sick - just a nagging cough. But they can expose a baby who is not yet fully immunized who is at risk of getting severely ill from the disease. Grandparents should get a pertussis booster (Tdap) before visiting let alone babysitting a baby grandkid.

Oh, to the best of my knowledge the risks from vaccination are not particularly increased for an older adult. Occassional pain or discomfort at the site or a fever a week later.

Plus, even if Betty’s mumps vaccination didn’t take, she’d need to be around another person whose vax ALSO failed (or had not been given at all). And that person would have to have caught mumps from somewhere, and so forth. It’s the whole “herd immunity” thing.

You can look here and see all of the vaccinations states require children to have before they enter kindergarten.

I didn’t get mumps when I was a sprog, did have the MMR innoculation and still ended up getting it when I was 26 and babysitting for a friends kid who had it. I looked like a freaking chipmonk hording nuts for winter. :frowning:

Is there any harm in getting the vaccine if you are immune?

It seems to me that rather than paying for a doctor’s office visit, undergoing a blood draw, paying for a blood draw and lab analysis, taking another day off of work for another office visit, paying for another office visit, and then getting the vaccine, that it would be more straightforward to just get the vaccine if in doubt.

A reasonable approach. No, no harm. But again, odds are it is not needed.

I am wondering something. If Betty is effectively immunized, is it still possible that she could pass the mumps along? That is to say, I understand that she will have the antibodies to prevent herself from getting the mumps, but, she suppose she is around someone with an active mumps infection. Now, while Betty may not get sick, wouldn’t the virus(? or whatever causes mumps) have to be present before the antibodies kick in? Say, for example, its three days before she is mump virus-free, can she, in those three days still spread mumps?

No harm, but insurance may not pay for it in someone that sheet unless you have the titers to show it’s medically necessary. It’s not a terribly expensive vaccine if you want to pay out of pocket, though.

Generally speaking, no. For someone to be infectious, the bacteria or virus needs to reproduce to reasonably high levels. Antibodies will kick in before that much reproduction can happen.