In October 2000 a letter was written to the editor of JAMA (The Journal of the American Medical Association) from the Ministry of Defense in Italy. The Italian Military wrote that they had decided to introduce the MMR vaccination containing the Schwarz measles, Urabe Am9 mumps and Wistar RA27/3 rubella strains, as mandatory in 1998 to examine the vaccines efficiency. (1) However, they were in for more than they bargained for because within one month of the soldiers receiving the vaccine the incidence of mumps had increased significantly. The letter states:
The recent (April 1998) introduction of mandatory vaccination of military recruits provided an opportunity to examine the effectiveness and adverse effects of MMR vaccine (containing Schwarz measles, Urabe Am9 mumps, and Wistar RA 27/3 rubella strains) in a military setting.
The letter continues by adding:
To assess the efficacy of the MMR vaccine and the Urabe Am9related reactogenicity, the incidence rates of MMR diagnosed in the Italian armed forces during 1999 (postvaccine period) were compared with those diagnosed during 1997 (prevaccine period).