Daily POEM: Once again, autism not linked to MMR vaccine

POEMs Research Summaries
Your Daily Update for the Latest Patient Oriented Evidence that Matters

Once again, autism not linked to MMR vaccine

Clinical Question
What is the risk of autism following measles, mumps, and rubella vaccination?


Bottom Line
This is the third—and largest—study conducted after the publication of a now-retracted case study of 12 children that led to the current conspiracy-laden pushback against the measles, mumps, and rubella (MMR) vaccine. This study, as did the other 2 studies, found no increased development of autism, even in children with risk factors or with a sibling with autism. As in most human endeavors, facts generally do not carry the day when it comes to changing opinion, but here's more evidence to use when parents are interested. (LOE = 2b)


Reference
Hviid A, Hansen JV, Frisch M, Melbye M. Measles, mumps, rubella vaccination and autism. A nationwide cohort study. Ann Intern Med 2019;170(8):513-520.


Study Design: Cohort (prospective)
Funding: Industry + govt
Setting: Population-based
Allocation: Unknown


Synopsis
The Danish patient registry allows for tracking of all people who remain in the country. These investigators enrolled all children (N = 657,461), at one year of age, born between the years 1999 and 2010 to Danish-born mothers. The children received the usual childhood vaccinations, including thimerosol-free MMR at 15 months (95.2% of children) and again at 12 years of age. (Note: In 2008, they changed the timing of the second vaccine to 4 years of age.) Over the course of the study, 6517 children were given a diagnosis of autism via comprehensive diagnostic evaluation—not by screening—by age 7 (incidence rate 129.7 per 100 000 person-years). At any time during the follow-up (from age 7 to age 14 years), there was no difference in the incidence of autism between vaccinated and unvaccinated children. Similarly, there was no increase in the likelihood of autism in children with a sibling with autism or in children with risk factors for developing autism.


Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University

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