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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