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Immunization Issues

Vaccines and Autism

Updated: 09/20/2004

Thimerosal does not cause autism; nor does the MMR vaccine. This is the conclusion reached by The Institute of Medicine's Immunization Safety Review Committee in its report, Vaccines and Autism. (1)

The report states that "the body of epidemiological evidence favors rejection of a causal relationship between the MMR vaccine and autism" as well as a "rejection of a causal relationship between thimerosal-containing vaccines and autism."

The hypothesis that the MMR vaccine was associated with autism was originally proposed in a highly publicized series of case reports published in The Lancet in 1998. (2) The authors suggested that the onset of the symptoms of autism with gastrointestinal problems was temporally associated with the receipt of the MMR vaccine.

The IOM committee confirmed that this study by Wakefield and colleagues did not provide evidence that the MMR vaccine could cause autism. Indeed, in 2004, ten of the thirteen authors of that study formally retracted their suggestion of a possible link between MMR vaccine and autism. (3)

In a previous report in 2001, (4) the IOM’s committee had rejected any causal relationship between the MMR vaccine and autism at the population level—that means the MMR vaccine did not cause autism in the general population. However, the available evidence at that time was not sufficient to exclude the possibility that MMR could contribute to autism in a small number of children with a genetic predisposition to that disorder.

More recent epidemiological studies, which are assessed in the new IOM report, have consistently shown no evidence that the MMR vaccine was associated with autism. (5)

The IOM report described two studies by Geier (6) which had reported an association between MMR and autism as “characterized by serious methodological flaws and their analytic methods were nontransparent making their results uninterpretable, and therefore non-contributory with respect to causality.”

In other words, the studies by Geier could not establish a causal relation between MMR and autism because of their methods—such as using statistical measures incorrectly and omitting facts about their research approach. Similar problems were found in six other studies by Geier (7) and one study by Blaxill (8), which reported findings of an association between thimerosal-containing vaccines and autism. In addition, Geier’s expertise in neurological disorders has been questioned. (9)

Five large studies in Sweden, Denmark, the United States and the United Kingdom consistently found no evidence of an association between thimerosal and autism. (10) For that reason, the IOM’s committee favored rejection of a causal relationship between thimerosal-containing vaccines and autism.

This rejection differs from the conclusion of a 2001 report (11) by the same committee on thimerosal-containing vaccines and neurodevelopmental disorders.

The 2001 report stated that at that time the evidence was inadequate to accept or reject a causal relationship between thimerosal and the disorders of autism, attention deficit, and speech and language delay. The evidence now favors rejection of a relationship between thimerosal and autism. The current report did not evaluate the other disorders.

The IOM committee recommended that immunization schedules remain unchanged.

The IOM committee also recommended that research funding for autism be channeled towards more productive areas, such as the better understanding of the genetic causes of autism. (12)


1. Institute of Medicine. Immunization Safety Review: Vaccines and Autism. Washington, DC: National Academies Press 2004.

2. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, and Walker-Smith JA. (1998). Ileal-lymphoid-modular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet, 351(9103), 637-641.

3. Murch SH, Anthony A, Cassen DH, et al. (2004) Retraction of an interpretation. Lancet, 363: 750.

4. Institute of Medicine. Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism. Washington, DC: National Academies Press 2001.

5. Wilson K, Mills E, Ross C, McGowan J, Jadad A (2003). Association of Autistic Spectrum Disorder and the Measles, Mumps, and Rubella Vaccine: A Systematic Review of Current Epidemiological Evidence. Archives of Pediatric and Adolescent Medicine, 157:628-634.

Smeeth L, Cook C, Fombonne E, et al (2004). MMR vaccination and pervasive developmental disorders: a case-control study.  Lancet, 364(9438):963-969.

6. Geier M, Geier D 2003. Pediatric MMR Vaccination Safety. International Pediatrics, 18: 108-113.

Geier M, Geier D 2004. A comparative evaluation of the effects of MMR immunization and mercury doses from thimerosal-containing childhood vaccines on the population prevalence of autism. Medical Science Monitor, 10(3): PI33-39

7. Geier MR, Geier DA. Thimerosal in childhood vaccines, neurodevelopment disorders and heart disease in the United States. J Am Physicians Surg. 2003;8:6-11 (See AAP's review of the article)

8. Blaxill M (2001). Presentation to Immunization Safety Review Committee. Rising Incidence of Autism: Association with Thimerosal. Washington DC.

9. U.S Court of Federal Claims. Office of Special Masters. October 9, 2003 (See footnote 1 on page 3).

10. Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, and Simpson D (2003). Autism and thimerosal-containing vaccines: Lack of consistent evidence for an association. American Journal of Preventive Medicine, 25(2): 101-6.

Madsen KM, Lauritsen MB, Pedersen CB, Thorsen P, Plesner A, Andersen PH, and Mortensen PB (2003). Thimerosal and the Occurrence of Autism: Negative Ecological Evidence from Danish Population-Based Data. Pediatrics 112: 604-6.

Verstraeten T, Davis RL, DeStefano F, Lieu TA, Rhodes PH, Black SB, Shinefield H, and Chen RT (2003). Safety of Thimerosal-Containing Vaccines: A Two-Phased Study of Computerized Health Maintenance Organization Databases. Pediatrics 112(5): 1039-48.

Parker SK, Schwartz B, Todd J, and Pickering LK (2004). Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original DataPediatrics, 114:793-804.

11. Institute of Medicine. Immunization Safety Review: Thimerosal-Containing Vaccines and Neurodevelopmental Disorders. Washington, DC: National Academies Press 2001.

12. Muhle B, Trentacoste SV, Rapin I (2004). The Genetics of autism. Pediatrics  113: e472-86.

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