Immunization Issues

Over the past several years, there have been allegations by a small number of researchers that the MMR (Measles, Mumps, and Rubella) vaccine causes autism.1 The Institute of Medicine (IOM) subsequently rejected a causal relationship between the measles-mumps-rubella vaccine and autistic spectrum disorder.2 Various epidemiologic studies have supported the IOM’s report.

A number of media reports implied that, to be safe, parents should have their children immunized against these diseases one at a time (i.e., on three separate occasions, as long as one year apart).

Understandably, many parents are concerned and want to know if this is sound advice. We believe it is not good advice. In fact, we believe it is potentially dangerous advice that increases a child’s risk of being needlessly harmed by serious diseases that can be effectively and safely prevented.

Consider the following facts:

• There is no credible evidence that the MMR vaccine causes autism. The fact is that experts have concluded that there is no evidence of a relationship between MMR vaccine and autism.23 

• The causes of autism are not yet fully understood, but the best available evidence indicates that autism is a disorder that begins before birth, and possibly as early as the first trimester of pregnancy. Although autism begins before birth, its symptoms are usually first noticed between the ages of 12 and 18 months, around the same age when MMR vaccine is given. Understandably, this timing has led some parents of autistic children, and even some researchers, to assume that the immunization caused the symptoms. No matter how plausible this relationship may seem, epidemiological studies investigating the hypothesis have yielded no evidence that MMR vaccine causes autism.

• Giving children the three vaccines individually is no safer than giving them in combination. In fact, giving the vaccines individually increases a child’s risk of getting one of these vaccine preventable diseases by delaying immunization. The MMR vaccine, like all combination vaccines, was developed to reduce discomfort, and more importantly, to ensure that children are fully protected from these serious diseases at the earliest possible opportunity. The combination vaccine also lessens the likelihood that a dose will be missed, reduces the costs of vaccination to the family, and reduces the number of visits to the doctor.

• The components of the MMR combination vaccine—measles vaccine, mumps vaccine, and rubella vaccine—are available in limited supply for people who cannot receive one of the components for medical reason, such as severe allergy to a vaccine component. But giving otherwise healthy children one vaccine at a time leaves them needlessly unprotected from the other two serious infectious diseases, precisely at the time in life when they are most vulnerable. These children’s risk of getting the diseases during the time between shots may be small, yet the risk is REAL. At present, we have low rates of measles, mumps, and rubella in the U.S. thanks to immunization efforts. However, we know from experience in the U.S. a decade ago, and more recently in other countries such as the Netherlands and Ireland, that when people stop immunizing, measles outbreaks will recur and some children will again die as a result.

• Measles, mumps, and rubella can lead to very serious complications and permanent physical damage or death. Measles can lead to pneumonia, seizures, encephalitis (inflammation of the brain), permanent brain damage, and death. Mumps can lead to deafness, meningitis (infection of the lining of the brain and spinal cord), orchitis (inflammation and painful swelling of the testicles or ovaries), and, rarely, death. Children with rubella may spread the infection to pregnant women, which places the unborn child at great risk of serious birth defects.

Keep your child and community safe by giving your child the MMR combination vaccine. Giving each vaccine separately is likely to increase the real risk of these diseases while offering no benefit in return.

For more information visit MMR - The facts.

References

• 1. Wakefield et al. Ileal-Lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet, 1998; 351: 637-41. Ten of the thirteen authors of the study retracted in February 2004 from the interpretation that MMR causes autism.  See also The lessons of MMR.
• 2. a. b. Institute of Medicine (IOM) Committee Rejects Causal Relationship Between Measles-Mumps-Rubella Vaccine and Autism Spectrum Disorder, April 23, 2001.
• 3. Wilson K, Mills E, Ross C, McGowan J, Jadad A.  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 2003;157:628-634.