Abstract
Measles, mumps and rubella (MMR) vaccine has been used for almost 30 years in the US, 20 years in Sweden and Finland, and over 10 years in most of the rest of Europe. During this time, it has brought about a dramatic reduction in the morbidity and mortality due to measles and mumps, as well as a considerable reduction in the number of babies with the congenital rubella syndrome.
In spite of extensive evidence confirming the efficacy and safety of the vaccine, concerns have recently been raised about a possible link with autism and bowel problems. These arose principally from a research group in the UK, but have now spread to other countries. In the UK this has caused a fall in the uptake of the vaccine with fears of possible outbreaks of measles and mumps in some groups of children. Over the last 3 years a number of studies have addressed this possible link between MMR and autism and inflammatory bowel disease. Studies from the US, UK, Sweden, and Finland have all failed to demonstrate a link. Amongst others, the American Academy of Pediatrics, the Royal College of Paediatrics and Child Health, the Institute of Medicine, and the World Health Organization have all considered the evidence and endorsed the continuing use of the vaccine. No regulatory body in the world has changed its policy as a result of this hypothesized link.
Professionals and parents can be assured that MMR is well tried and tested and one of the most successful interventions in healthcare.
Similar content being viewed by others
References
Data on file, Office for National Statistics, 2002
Data on file, Communicable Disease Surveillance Centres, 2002
Groseclose SL, Hall PA, Knowles CM, et al., on behalf of CDC. Summary of notifiable diseases, United States, 1999. MMWR Morb Mortal Wkly Rep 2001; 48(53): 1–104
Bottiger M, Christenson B, Taranger J, et al. Mass vaccination programme aimed at eradicating measles, mumps and rubella in Sweden: vaccination of school children. Vaccine 1983; 3: 113–6
Plotkin S, Wharton M. Mumps vaccine. In: Plotkin S, Orenstein W, editors. Vaccines. Philadelphia (PA): WB Saunders Company, 1999: 267–92
King GE, Markowitz LE, Patricia PA, et al. Clinical efficacy of measles vaccine during the 1990 measles epidemic. Pediatr Infect Dis J 1991; 10: 883–7
Department of Vaccines and Biologicals. WHO vaccine preventable diseases: monitoring system. 2000 global summary. Geneva: World Health Organization, 2000
Peltola H, Heinonen OP, Valle M, et al. The elimination of indigenous measles, mumps and rubella from Finland by a 12-year, two dose vaccination program. N Engl J Med 1994; 331: 1397–402
Wakefield AJ, Montgomery SM. Measles mumps rubella vaccine: through a glass darkly. Adverse Drug React Toxicol Rev 2000; 19: 265–83
Combined measles, mumps and rubella vaccines: response of the Medicines Control Agency and Department of Health to issues raised in papers published in Adverse Drug Reactions and Toxicological Reviews, Vol. 19, No. 4, 2000. London: Department of Health, 2001
Peltola H, Heinonen OP. Frequency of true adverse reactions to measles-mumps-rubella vaccine: a double-blind placebo-controlled trial in twins. Lancet 1986; I: 939–42
Ekbom A, Wakefield AJ, Zack M, et al. Perinatal measles infection and subsequent Crohn’s disease. Lancet 1994; 344: 508–10
Thompson NP, Montgomery SM, Pounder RE, et al. Is measles vaccination a risk factor for inflammatory bowel disease. Lancet 1995; 345: 1071–4
Nielsen LL, Nielsen NM, Melbye M, et al. Exposure to measles in utero and Crohn’s disease: Danish register study. BMJ 1998; 316(7126): 196–7
Feeney MCA, Winwood P, Snook J, for the East Dorset Gastroenterology Group. A case-control study of measles vaccination and inflammatory bowel disease. Lancet 1997; 350: 764–6
Chadwick N, Bruce IJ, Schepelmann S, et al. Measles virus DNA is not identified in inflammatory bowel disease using hybrid capture and reverse transcriptase followed by polymerase chain reaction. J Med Virol 1998; 55: 305–11
Davis RL, Kramarz P, Bohlke K, et al. Measles-mumps-rubella and other measles-containing vaccines do not increase the risk for inflammatory bowel disease. Arch Pediatr Adolesc Med 2001; 155: 354–9
Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998; 351: 1327–8
Chen RT, DeStefano F. Vaccine adverse events: causal or coincidental. Lancet 1998; 351: 611–2
Gilberg C, Heijbel H. MMR and autism. Autism 1998; 2: 423–4
Taylor B, Miller E, Farrington CP, et al. Autism and measles, mumps and rubella vaccine: no epidemiological evidence for a causal association. Lancet 1999; 353: 2026–9
Spitzer WO. A sixty day war of words: is MMR linked to autism [letter]. Adverse Drug React Toxicol Rev 2001; 20: 47–55
Farrington CP, Miller E, Taylor B. MMR and autism: further evidence against a causal association. Vaccine 2001; 19: 3632–5
Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics 2001; 108(4): E58
Taylor B, Miller E, Lingam R, et al. Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. BMJ 2002; 324: 393–6
Halsey N, Hyman SL, and the Conference Writing Panel. Measles-mumps-rubella vaccine and the autistic spectrum disorder: report from the New Challenges in Childhood Immunizations Conference convened in Oak Brook, Illinois, June 12–13 2000. Pediatrics 2001; 107: E84
Stratton K, Gable A, Shetty P, et al., editors. Immunization safety review: measles-mumps-rubella vaccine and autism. The Immunization Safety Review Committee, Institute of Medicine. Washington, DC: National Academy Press, 2001
Ghosh S, Armitage E, Wilson D, et al. Detection of persistent measles virus infection in Crohn’s disease: current status of experimental work. Gut 2001; 48: 748–52
Wakefield AJ. Testimony before Congressional Oversight Committee on Autism and Immunisation, April 6 2000 [online]. Available from URL: http://www.gpo.gov/congress/house [Accessed 2002 Jul 23]
Miller E, Goldacre M, Pugh S, et al. Risk of aseptic meningitis after measles, mumps and rubella vaccine in UK children. Lancet 1993; 341: 979–82
Davidkin I, Peltola H, Leinikki PMV. Duration of immunity induced by two-dose measles, mumps and rubella (MMR) vaccination: a 15-year follow-up in Finland. Vaccine 2000; 18: 3106–12
Ramsay M, Gay N, Miller E, et al. The epidemiology of measles in England and Wales: rationale for the 1994 national vaccination campaign. Commun Dis Rep CDR Rev 1994; 4: R141–6
Schlegel M, Osterwalder JJ, Galeazzi RL, et al. Comparative efficacy of three mumps vaccines during disease outbreak in Eastern Switzerland: cohort study [published erratum appears in BMJ 1999; 319 (7208): 477]. BMJ 1999; 319: 352
Uhlmann V, Martin CM, Sheils O, et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Mol Pathol 2002; 55: 84–90
Morris A, Aldulaimi D. New evidence for a viral pathogenic mechanism for new variant inflammatory bowel disease and development disorder [comment]. Mol Pathol 2002; 55: 83
Acknowledgments
Both authors have received funding from vaccine manufacturers, as well as other sources, to attend educational meetings and conduct research. They receive no personal income from such sources.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Elliman, D.A.C., Bedford, H.E. Measles, Mumps and Rubella Vaccine, Autism and Inflammatory Bowel Disease. Pediatr-Drugs 4, 631–635 (2002). https://doi.org/10.2165/00128072-200204100-00001
Published:
Issue Date:
DOI: https://doi.org/10.2165/00128072-200204100-00001