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PEDIATRICS Vol. 110 No. 5 November 2002, pp. 957-963

Neurologic Disorders After Measles-Mumps-Rubella Vaccination

Annamari Mäkelä, MD^*, J. Pekka Nuorti, MD and Heikki Peltola, MD^*

^* Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
Department of Infectious Disease Epidemiology, National Public Health Institute, Helsinki, Finland

--> Objective. The possibility of adverse neurologic events has fueled much concern about the safety of measles-mumps-rubella (MMR) vaccinations. The available evidence concerning several of the postulated complications is controversial. The aim of this study was to assess whether an association prevails between MMR vaccination and encephalitis, aseptic meningitis, and autism.

Methods. A retrospective study based on linkage of individual MMR vaccination data with a hospital discharge register was conducted among 535 544 1- to 7-year-old children who were vaccinated between November 1982 and June 1986 in Finland. For encephalitis and aseptic meningitis, the numbers of events observed within a 3-month risk interval after vaccination were compared with the expected numbers estimated on the basis of occurrence of encephalitis and aseptic meningitis during the subsequent 3-month intervals. Changes in the overall number of hospitalizations for autism after vaccination throughout the study period were searched for. In addition, hospitalizations because of inflammatory bowel diseases were checked for the children with autism.

Results. Of the 535 544 children who were vaccinated, 199 were hospitalized for encephalitis, 161 for aseptic meningitis, and 352 for autistic disorders. In 9 children with encephalitis and 10 with meningitis, the disease developed within 3 months of vaccination, revealing no increased occurrence within this designated risk period. We detected no clustering of hospitalizations for autism after vaccination. None of the autistic children made hospital visits for inflammatory bowel diseases.

Conclusions. We did not identify any association between MMR vaccination and encephalitis, aseptic meningitis, or autism.

Key Words: measles • mumps • rubella • MMR vaccine • immunization • adverse ef-fects • encephalitis • aseptic meningitis • autism • autistic dis-orders

Abbreviations: MMR, measles-mumps-rubella • MIBE, measles inclusion body encephalitis • SSPE, subacute sclerosing panencephalitis • CSF, cerebrospinal fluid • ICD, International Classification of Diseases

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Received for publication Jun 3, 2002; Accepted Jul 25, 2002.

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