Cases of mumps are continuing to rise in the U.S., and as in years past, college campuses have been hotbeds for outbreaks of this viral illness.

Today the Centers for Disease Control and Prevention (CDC) issued formal recommendations to stem the spread of mumps. The CDC is now advising a third dose of the measles, mumps, rubella (MMR) vaccine for people deemed to be at high risk, such as college students during a campus outbreak. 

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In 2016 about half of the mumps outbreaks were on college campuses. According to the CDC, more than 6,000 cases were reported last year, by far the most in a decade. And the number of cases this year isn't far behind. 

“This provides institutions—schools, colleges, and the like—that are experiencing mumps outbreaks and their local public-health departments to use a third dose of MMR as one of the ways to curb the outbreak,” says William Schaffner, M.D., an infectious disease specialist at Vanderbilt University in Nashville and medical director of the National Foundation for Infectious Diseases.

So should your college student­­­ get a mumps booster? Here’s the expert advice. 

College Kids at Higher Risk

Outbreaks of this illness, which causes symptoms such as fever, headaches, muscle aches, appetite loss, and puffy cheeks and jaw, seem to occur more easily in places like college campuses, where students often live in close quarters.

“Close prolonged contact facilitates the spread of the virus," says Janell Routh, M.D., a pediatrician and medical officer with the CDC’s mumps team.

It's important to note that most of the college students who contracted mumps in the past couple of years were fully vaccinated, which means they received the recommended two childhood doses of the MMR vaccine.

And while the traditional childhood vaccine is about 88 percent effective against mumps, today's recommendations note that it’s “insufficient for preventing mumps outbreaks in prolonged, close-contact settings, even where coverage with two doses of MMR vaccine is high.”

This may be in part because mumps immunity from the MMR vaccine appears to wane over time, says Routh.

Who Should Consider the Booster

Some colleges and communities where mumps outbreaks have occurred have offered an MMR booster to certain groups. A recent New England Journal of Medicine study found that University of Iowa students who received this additional dose during a mumps outbreak were much less likely to contract the illness from their peers.

The CDC’s recommendations note that it’s not yet clear how much a third vaccine dose can reduce the size of a mumps outbreak—or even how long its protection will last. “We know it provides some benefit, but we haven’t been able to measure exactly how much,” Schaffner says.

And not every college student should get a third dose of MMR, even during a campus outbreak, Schaffner notes.

Those considered at high risk might include only the residents of a particular dorm or members of a certain student group. No evidence has shown that wider-ranging vaccination efforts—for instance, giving a booster to every college student in the country—reduce mumps cases. Ultimately, local public-health officials will determine who should get an MMR booster during an outbreak.

If your son or daughter goes to a school where an outbreak has recently occurred and you’re concerned, Schaffner says, ask your child if the health center at his or her school is offering the booster. Check with your local health department if your child is at home or if there's a community outbreak. Ask how to get the shot if you or your child or other family members are thought to be at risk.

In addition, ask whether the school is taking steps such as short-term quarantine of those who are ill and educating students about good hand-washing practices.

Now that the CDC has made an official recommendation on the third dose, insurance companies will probably begin to cover it. But this could take some time, so in the interim, you may have to pay out of pocket. (According to the CDC, the average price is about $71.) 

Even without a booster, Routh says, you and your family can reduce the risk of mumps by doing the following:

Make sure all of you are up to date on the MMR. If you or a family member missed a dose as a young child, check with your doctor about how to get caught up.

Practice good hygiene. Scrubbing your hands regularly with soap and water can go a long way in keeping mumps from spreading. It’s especially important during the winter, Routh says, when people spend more time indoors and in close proximity to each other. And because mumps can spread through saliva, don’t share food, utensils, drinks, lipstick, or other items that might carry the virus.

Watch for symptoms. The classic symptom of mumps is facial swelling. But “fever, headache, general malaise—are all important things to be attuned to, not just for mumps, but for other viral illnesses,” Routh says. If you think that you or another family member have mumps, see a doctor, and remind your college kid to do the same if he or she has symptoms while at school.

Don’t worry if someone gets the mumps. Even with waning immunity, those who received the two MMR shots in childhood but still come down with the mumps are less likely to experience potentially serious complications, such as deafness or swelling of the brain or spinal cord, Schaffner says. And most people recover fully from mumps within a few weeks.