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Lack of association between measles-mumps-rubella vaccination and autism in children: a case-control study.
Authors
Mrozek-Budzyn D1, Kieł;;;tyka A, Majewska R.
Author information
Journal
Pediatr Infect Dis J. 2010 May;29(5):397-400. doi: 10.1097/INF.0b013e3181c40a8a.
Affiliation
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.
PMID 19952979 [PubMed - indexed for MEDLINE]
Lippincott Williams & Wilkins: Full text
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DeStefano_Vaccines_and_Autism.pdf
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Controlled epidemiologic studies have not found an association between MMR vaccination and autism. A retro- spective cohort study from Denmark is particularly persua- sive.15 The study contained data on over half a million children,including nearly 100,000 who had not been vaccinated with MMR. The relative risk associated with MMR was 0.92 (95% confidence interval (CI): 0.68–1.24) for autistic disorder and 0.83 (95% CI: 0.65–1.07) for other autism spectrum disorders. A large, population-based case- control study conducted by the Centers for Disease Control and Prevention (CDC) also did not find evidence to support an association between MMR and autism.16 The study included 624 case children in metropolitan Atlanta and 1,824 matched controls. Vaccination data were abstracted from immunization forms required for school entry. The overall distribution of ages at MMR vaccination among children with autism was similar to that of matched control children. Another large case–control study of 1,294 cases of pervasive developmental disorder and 4,469 controls from the UK General Practice Research Database (GPRD) found a relative risk of 0.86 (95% CI: 0.68–1.09) for MMR vaccine.17
The results of independent studies conducted after the publication of the original report of a possible association between MMR and autism provide compelling evidence against the hypothesis. More recently, concerns have been raised about possible biases in enrollment of participants in the study by Wakefield et al.18 and 10 of the original 13 authors published a formal retraction of the conclusions of the 1998 article.19 An Immunization Safety Review Commit- tee of the Institute of Medicine (IOM) reviewed the epidemiologic and other evidence on MMR vaccine and risk for autism spectrum disorders and concluded that the evidence favors rejection of a causal relationship.20"
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