lion doses of measles, mumps, and measles-mumps vaccines and MMR were sold. Two of these patients had hydroceles. The other four patients recovered after 2 to 3 days "with only slight inconvenience to the vaccinee" (p. 447).

There have been 11 reports in VAERS (submitted between November 1990 and July 1992) of orchitis, or possible orchitis, following vaccination with MMR (10 reports) or mumps vaccine (1 report). The ages of the vaccinees ranged from 19 months to 26 years, with a median age of 12 years. The interval from immunization to the onset of symptoms was noted for nine patients and ranged from 1 to 34 days, with a median of 16 days. Six patients recovered, and no outcome was reported for five patients. Five cases were bilateral, and four cases were unilateral (all on the left side); for two cases the laterality was not specified. Seven patients were stated to have orchitis. The diagnosis was questionable in four patients. In one case the patient had been seen in the past for problems with his testicles. Following immunization he had three episodes of testicular swelling and pain, with each episode lasting about 2 hours. In another case, a urologist diagnosed torsion versus mild epididymitis and could not rule out the possibility that the condition was related to MMR. In another case, the patient did not have swollen testicles when examined on two occasions by a physician, although he was reported by his mother to have swollen testicles and swollen legs. In another, the patient had a swollen left testicle that was not red or hot to the touch and was diagnosed as having "testis disease."

In 1976, Borsche reported that after about 1,000 vaccinations with monovalent mumps vaccine, no side effects were noted.

A study of live attenuated mumps vaccine (Rubini strain) in monkeys, 13 adult males, and 60 children aged 15 to 24 months revealed no inflammation, swelling, or pain of the testes (Gluck et al., 1986).

Controlled Observational Studies

Penttinen and colleagues (1968) found that the frequency of orchitis as a complication of mumps was two to three times lower among recipients of mumps vaccine than among nonvaccinated servicemen. Furthermore, they found that the rate of orchitis was 25 times lower among the vaccinees than among nonvaccinated men, suggesting that the vaccine afforded protection from mumps orchitis.

Controlled Clinical Trials

Schwarz and colleagues (1975) looked for, but did not find, orchitis in 1,232 children who received MMR (Jeryl Lynn strain or a placebo).

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