Monday, January 20, 2014

Recent papers on vaccination and autism



Lack of Association Between Measles-Mumps-Rubella Vaccination and Autism in Children A Case-Control Study
Authors/Editors/Inventors:
Mrozek-Budzyn, Dorota (Author) Reprint Author ; Kieltyka, Agnieszka (Author) ; Majewska, Renata (Author)
Source:
Pediatric Infectious Disease Journal. Vol. 29 (5). MAY 10 2010. 397-400
Abstract:
Objective: The first objective of the study was to determine whether there is a relationship between the measles-mumps-rubella (MMR) vaccination and autism in children. The second objective was to examine whether the risk of autism differs between use of MMR and the single measles vaccine.Design: Case-control study.Study Population: The 96 cases with childhood or atypical autism, aged 2 to 15, were included into the study group. Controls consisted of 192 children individually matched to cases by year of birth, sex, and general practitioners.Methods: Data on autism diagnosis and vaccination history were from physicians. Data on the other probable autism risk factors were collected from mothers. Logistic conditional regression was used to assess the risk of autism resulting from vaccination. Assessment was made for children vaccinated (1) Before diagnosis of autism, and (2) Before first symptoms of autism onset. Odds ratios were adjusted to mother's age, medication during pregnancy, gestation time, perinatal injury and Apgar score.Results: For children vaccinated before diagnosis, autism risk was lower in children vaccinated with MMR than in the nonvaccinated (OR: 0.17, 95% CI: 0.06-0.52) as well as to vaccinated with single measles vaccine (OR: 0.44, 95% CI: 0.22-0.91). The risk for vaccinated versus nonvaccinated (independent of vaccine type) was 0.28 (95% CI: 0.10-0.76). The risk connected with being vaccinated before onset of first symptoms was significantly lower only for MMR versus single vaccine (OR: 0.47, 95% CI: 0.22-0.99).Conclusions: The study provides evidence against the association of autism with either MMR or a single measles vaccine.


The combined measles, mumps, and rubella vaccines and the total number of vaccines are not associated with development of autism spectrum disorder: The first case-control study in Asia
Authors/Editors/Inventors:
Uno, Yota (Author) Reprint Author ; Uchiyama, Tokio (Author) ; Kurosawa, Michiko (Author) ; Aleksic, Branko (Author) ; Ozaki, Norio (Author)
Source:
Vaccine. Vol. 30 (28). JUN 13 2012. 4292-4298
Abstract:
Objective: The aim of this study was to investigate the relationship between autism spectrum disorder (ASD) and general vaccinations, including measles-mumps-rubella (MMR) vaccine, in Japanese subjects, a population with high genetic homogeneity.Patients and methods: A case-control study was performed. Cases (n = 189) were diagnosed with ASD, while controls (n=224) were volunteers from general schools, matched by sex and birth year to cases. Vaccination history and prenatal, perinatal, and neonatal factors from the Maternal and Child Health handbook, which was part of each subject's file, were examined. To determine the relationship between potential risk factors and ASD, crude odds ratios (ORS) and 95% confidence intervals (95% CIs) were calculated, and the differences in mean values of the quantitative variables between cases and controls were analyzed using an unpaired t-test. Moreover, MMR vaccination and the effect of the number of vaccine injections were investigated using a conditional multiple regression model.Results: For MMR vaccination, the OR was 1.04 (95% CI, 0.65-1.68), and no significant differences were found for the other vaccines. For all of the prenatal, perinatal and neonatal factors, there were no significant differences between cases and controls. Furthermore, regarding the presence of ASD, MMR vaccination and the number of vaccine injections had ORs of 1.10 (95% CI, 0.64-1.90) and 1.10 (95% CI, 0.95-1.26), respectively, in the conditional multiple regression model; no significant differences were found.Conclusions: In this study, there were not any convincing evidences that MMR vaccination and increasing the number of vaccine injections were associated with an increased risk of ASD in a genetically homogeneous population. Therefore, these findings indicate that there is no basis for avoiding vaccination out of concern for ASD. (C) 2012 Elsevier Ltd. All rights reserved.


Hepatitis B Vaccination of Male Neonates and Autism Diagnosis, NHIS 1997-2002
Authors/Editors/Inventors:
Gallagher, Carolyn M. (Author) Reprint Author ; Goodman, Melody S. (Author)
Source:
Journal of Toxicology and Environmental Health Part A. Vol. 73 (24). 2010. 1665-1677
Abstract:
Universal hepatitis B vaccination was recommended for U.S. newborns in 1991; however, safety findings are mixed. The association between hepatitis B vaccination of male neonates and parental report of autism diagnosis was determined. This cross-sectional study used weighted probability samples obtained from National Health Interview Survey 1997-2002 data sets. Vaccination status was determined from the vaccination record. Logistic regression was used to estimate the odds for autism diagnosis associated with neonatal hepatitis B vaccination among boys age 3-17 years, born before 1999, adjusted for race, maternal education, and two-parent household. Boys vaccinated as neonates had threefold greater odds for autism diagnosis compared to boys never vaccinated or vaccinated after the first month of life. Non-Hispanic white boys were 64% less likely to have autism diagnosis relative to nonwhite boys. Findings suggest that U.S. male neonates vaccinated with the hepatitis B vaccine prior to 1999 (from vaccination record) had a threefold higher risk for parental report of autism diagnosis compared to boys not vaccinated as neonates during that same time period. Nonwhite boys bore a greater risk.


Response to Measles-Mumps-Rubella Vaccine in Children with Autism Spectrum Disorders
Authors/Editors/Inventors:
Gentile, Ivan (Author) ; Bravaccio, Carmela (Author) Reprint Author ; Bonavolta, Raffaele (Author) ; Zappulo, Emanuela (Author) ; Scarica, Sabrina (Author) ; Riccio, Maria Pia (Author) ; Settimi, Alessandro (Author) ; Portella, Giuseppe (Author) ; Pascotto, Antonio (Author) ; Borgia, Guglielmo (Author)
Source:
In Vivo (Attiki). Vol. 27 (3). MAY-JUN 2013. 377-382
Abstract:
Background/Aim: The etiology of autism spectrum disorders (ASD) is unknown. The measles-mumps-rubella (MMR) vaccination has been in the past implicated in ASD pathogenesis. The aim of our study was to evaluate the rate of seropositivity and the levels of antibodies against MMR antigens in a cohort of children with ASD compared to control children. Patients and Methods: In a cohort of children with ASD and same-age healthy controls, we measured levels and seropositivity of antibodies against MMR. Results: A total of 60 children, 31 with ASD and 29 controls were enrolled. The seropositivity rate and levels of all the three antibodies were similar in cases and controls. Conclusion: Children with ASD have a similar level and seropositivity rate of antibodies against the MMR vaccine to same-age controls. As persistent infections are typically associated with high antibody levels, our results support the arguments against a role of MMR vaccination as a causal factor or co-factor in development of ASD.



A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the US Population
Authors/Editors/Inventors:
DeLong, Gayle (Author) Reprint Author
Source:
Journal of Toxicology and Environmental Health Part A. Vol. 74 (14). 2011. 903-916
Abstract:
The reason for the rapid rise of autism in the United States that began in the 1990s is a mystery. Although individuals probably have a genetic predisposition to develop autism, researchers suspect that one or more environmental triggers are also needed. One of those triggers might be the battery of vaccinations that young children receive. Using regression analysis and controlling for family income and ethnicity, the relationship between the proportion of children who received the recommended vaccines by age 2 years and the prevalence of autism (AUT) or speech or language impairment (SLI) in each U.S. state from 2001 and 2007 was determined. A positive and statistically significant relationship was found: The higher the proportion of children receiving recommended vaccinations, the higher was the prevalence of AUT or SLI. A 1% increase in vaccination was associated with an additional 680 children having AUT or SLI. Neither parental behavior nor access to care affected the results, since vaccination proportions were not significantly related (statistically) to any other disability or to the number of pediatricians in a U.S. state. The results suggest that although mercury has been removed from many vaccines, other culprits may link vaccines to autism. Further study into the relationship between vaccines and autism is warranted.

The MMR vaccination and autism controversy in United Kingdom 1998-2005: Inevitable community outrage or a failure of risk communication?
Authors/Editors/Inventors:
Burgess, David C. (Author) Reprint Author ; Burgess, Margaret A. (Author) ; Leask, Julie (Author)
Source:
Vaccine. Vol. 24 (18). MAY 1 2006. 3921-3928
Abstract:
Background: The report of an hypothesised link between measles-mumps-rubella (MMR) vaccination and autism in 1998 became a major public health issue in the United Kingdom (UK), leaving most experts surprised by the overwhelming influence it had on public opinion about MMR vaccination. Coverage rates fell dramatically, and did not start to recover until 2004. Could this public reaction have been predicted?Methods: We used Sandman's model of components predicting community outrage to assess the MMR controversy.Results: The controversy fulfilled all of Sandman's 12 primary components and six of the eight additional components.Conclusions: The Sandman model provided a useful framework to analyse this controversy and explained a significant portion of the community reaction and subsequent fall in vaccination coverage rates. (c) 2006 Elsevier Ltd. All rights reserved.

Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: Population study
Authors/Editors/Inventors:
Taylor, Brent (Reprint author) ; Miller, Elizabeth (Author) ; Lingam, Raghu (Author) ; Andrews, Nick (Author) ; Simmons, Andrea (Author) ; Stowe, Julia (Author)
Source:
BMJ. Vol. 324 (7334). 16 February, 2002. 393-396
Abstract:
Objectives: To investigate whether measles, mumps, and rubella (MMR) vaccination is associated with bowel problems and developmental regression in children with autism, looking for evidence of a "new variant" form of autism. Design: Population study with case note review linked to independently recorded vaccine data. Setting: Five health districts in north east London. Participants: 278 children with core autism and 195 with atypical autism, mainly identified from computerised disability registers and born between 1979 and 1998. Main outcome measures: Recorded bowel problems lasting at least three months, age of reported regression of the child's development where it was a feature, and relation of these to MMR vaccination. Results: The proportion of children with developmental regression (25% overall) or bowel symptoms (17%) did not change significantly (P value for trend 0.50 and 0.47, respectively) during the 20 years from 1979, a period which included the introduction of MMR vaccination in October 1988. No significant difference was found in rates of bowel problems or regression in children who received the MMR vaccine before their parents became concerned about their development (where MMR might have caused or triggered the autism with regression or bowel problem), compared with those who received it only after such concern and those who had not received the MMR vaccine. A possible association between non-specific bowel problems and regression in children with autism was seen but this was unrelated to MMR vaccination. Conclusions: These findings provide no support for an MMR associated "new variant" form of autism with developmental regression and bowel problems, and further evidence against involvement of MMR vaccine in the initiation of autism.


A population-based study of measles, mumps, and rubella vaccination and autism
Authors/Editors/Inventors:
Madsen, Kreesten Meldgaard (Reprint author) ; Hviid, Anders (Author) ; Vestergaard, Mogens (Author) ; Schendel, Diana (Author) ; Wohlfahrt, Jan (Author) ; Thorsen, Poul (Author) ; Olsen, Jorn (Author) ; Melbye, Mads (Author)
Source:
New England Journal of Medicine. Vol. 347 (19). November 7, 2002. 1477-1482
Abstract:
Background: It has been suggested that vaccination against measles, mumps, and rubella (MMR) is a cause of autism. Methods: We conducted a retrospective cohort study of all children born in Denmark from January 1991 through December 1998. The cohort was selected on the basis of data from the Danish Civil Registration System, which assigns a unique identification number to every live-born infant and new resident in Denmark. MMR-vaccination status was obtained from the Danish National Board of Health. Information on the children's autism status was obtained from the Danish Psychiatric Central Register, which contains information on all diagnoses received by patients in psychiatric hospitals and outpatient clinics in Denmark. We obtained information on potential confounders from the Danish Medical Birth Registry, the National Hospital Registry, and Statistics Denmark. Results: Of the 537,303 children in the cohort (representing 2,129,864 person-years), 440,655 (82.0 percent) had received the MMR vaccine. We identified 316 children with a diagnosis of autistic disorder and 422 with a diagnosis of other autistic-spectrum disorders. After adjustment for potential confounders, the relative risk of autistic disorder in the group of vaccinated children, as compared with the unvaccinated group, was 0.92 (95 percent confidence interval, 0.68 to 1.24), and the relative risk of another autistic-spectrum disorder was 0.83 (95 percent confidence interval, 0.65 to 1.07). There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder. Conclusions: This study provides strong evidence against the hypothesis that MMR vaccination causes autism.


Vaccine risk perception among reporters of autism after vaccination: Vaccine adverse event reporting system 1990-2001
Authors/Editors/Inventors:
Woo, Emily Jane (Author) Reprint Author ; Ball, Robert (Author) ; Bostrom, Ann (Author) ; Shadomy, Sean V. (Author) ; Ball, Leslie K. (Author) ; Evans, Geoffrey (Author) ; Braun, Miles (Author)
Source:
American Journal of Public Health. Vol. 94 (6). June 2004. 990-995
Abstract:
Objectives. We investigated vaccine risk perception among reporters of autism to the Vaccine Adverse Event Reporting System (VAERS). Methods. We conducted structured interviews with 124 parents who reported autism and related disorders to VAERS from 1990 to 2001 and compared results with those of a published survey of parents in the general population. Results. Respondents perceived vaccine-preventable diseases as less serious than did other parents. Only 15% of respondents deemed immunization extremely important for children's health; two thirds had withheld vaccines from their children. Conclusions. Views of parents who believe vaccines injured their children differ significantly from those of the general population regarding the benefits of immunization. Understanding the factors that shape this perspective can improve communication among vaccine providers, policymakers, and parents/patients.


Balancing Vaccine Science and National Policy Objectives: Lessons From the National Vaccine Injury Compensation Program Omnibus Autism Proceedings
Authors/Editors/Inventors:
Keelan, Jennifer (Author) ; Wilson, Kumanan (Author) Reprint Author
Source:
American Journal of Public Health. Vol. 101 (11). NOV 2011. 2016-2021
Abstract:
The US Court of Federal Claims, which adjudicates cases for the National Vaccine Injury Compensation Program, has been confronted with more than 5000 cases submitted on behalf of children with autism spectrum disorders, seeking to link the condition to vaccination. Through a test case process, the Omnibus Autism Proceedings have in every instance found no association between autism spectrum disorders and vaccines. However, vaccine advocates have criticized the courts for having an overly permissive evidentiary test for causation and for granting credence to insupportable accusations of vaccine harm.In fact, the courts have functioned as intended and have allowed for a fair hearing of vaccine concerns while maintaining confidence in vaccines and providing protection to vaccine manufacturers. (Am J Public Health. 2011;101:2016 2021. doi:10.2105/AJPH.2011.300198)

Autism and measles, mumps, and rubella vaccine: No epidemiological evidence for a causal association
Authors/Editors/Inventors:
Taylor, Brent (Reprint author) ; Miller, Elizabeth (Author) ; Farrington, C. Paddy (Author) ; Petropoulos, Maria-Christina (Author) ; Favot-Mayaud, Isabelle (Author) ; Li, Jun (Author) ; Waight, Pauline A. (Author)
Source:
Lancet (North American Edition). Vol. 353 (9169). June 12, 1999. 2026-2029
Abstract:
Background We undertook an epidemiological study to investigate whether measles, mumps, and rubella (MMR) vaccine may be causally associated with autism. Methods Children with autism born since 1979 were identified from special needs/disability registers and special schools in eight North Thames health districts, UK. Information from clinical records was linked to immunisation data held on the child health computing system. We looked for evidence of a change in trend in incidence or age at diagnosis associated with the introduction of MMR vaccination to the UK in 1988. Clustering of onsets within defined postvaccination periods was investigated by the case-series method. Findings We identified 498 cases of autism (261 of core autism, 166 of atypical autism, and 71 of Asperger's syndrome). In 293 cases the diagnosis could be confirmed by the criteria of the International Classification of Diseases, tenth revision (ICD10: 214 (82%) core autism, 52 (31%) atypical autism, 27 (38%) Asperger's syndrome). There was a steady increase in cases by year of birth with no sudden "step-up" or change in the trend line after the introduction of MMR vaccination. There was no difference in age at diagnosis between the cases vaccinated before or after 18 months of age and those never vaccinated. There was no temporal association between onset of autism within 1 or 2 years after vaccination with MMR (relative incidence compared with control period 0.94 (95% CI 0.60-1.47) and 1.09 (0.79-1.52)). Developmental regression was not clustered in the months after vaccination (relative incidence within 2 months and 4 months after MMR vaccination 0.92 (0.38-2.21) and 1.00 (0.52-1.95)). No significant temporal clustering for age at onset of parental concern was seen for cases of core autism or atypical autism with the exception of a single interval within 6 months of MMR vaccination. This appeared to be an artifact related to the difficulty of defining precisely the onset of symptoms in this disorder. Interpretation Our analyses do not support a causal association between MMR vaccine and autism. If such an association occurs, it is so rare that it could not be identified in this large regional sample.

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