Published online March 2, 2009
PEDIATRICS Vol. 123 No. 3 March 2009, pp. 771-778 (doi:10.1542/peds.2008-0013)

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ARTICLE

Allergic Disease and Atopic Sensitization in Children in Relation to Measles Vaccination and Measles Infection

Helen Rosenlund, MSc^a,b, Anna Bergström, PhD^a, Johan S. Alm, MD, PhD^c,d, Jackie Swartz, MD^e, Annika Scheynius, MD, PhD^f, Marianne van Hage, MD, PhD^g, Kari Johansen, MD, PhD^h, Bert Brunekreef, PhD^i,j, Erika von Mutius, MD^k, Markus J. Ege, MD^k, Josef Riedler, MD^l, Charlotte Braun-Fahrländer, MD^m, Marco Waser, PhD^m, Göran Pershagen, MD, PhD^a,n and the PARSIFAL Study Group

^a Institute of Environmental Medicine
^b Centre for Allergy Research
^c Section of Pediatrics, Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
^d Section of Pediatrics, Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden
^e Vidar Clinic, Järna, Sweden
^f Clinical Allergy Research Unit
^g Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
^h Department of Virology, Swedish Institute for Infectious Disease Control, Solna, Sweden
ⁱ Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
^j Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, Netherlands
^k Dr von Hauner Children's Hospital, University of Munich, Munich, Germany
^l Children's Hospital, Schwarzach, Austria
^m Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland
ⁿ Department of Occupational and Environmental Health, Stockholm County Council, Stockholm, Sweden

OBJECTIVE. Our aim was to investigate the role of measles vaccination and measles infection in the development of allergic disease and atopic sensitization.

METHODS. A total of 14 893 children were included from the cross-sectional, multicenter Prevention of Allergy–Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle study, conducted in 5 European countries (Austria, Germany, the Netherlands, Sweden, and Switzerland). The children were between 5 and 13 years of age and represented farm children, Steiner-school children, and 2 reference groups. Children attending Steiner schools often have an anthroposophic (holistic) lifestyle in which some immunizations are avoided or postponed. Parental questionnaires provided information on exposure and lifestyle factors as well as symptoms and diagnoses in the children. A sample of the children was invited for additional tests, and 4049 children provided a blood sample for immunoglobulin E analyses. Only children with complete information on measles vaccination and infection were included in the analyses (84%).

RESULTS. In the whole group of children, atopic sensitization was inversely associated with measles infection, and a similar tendency was seen for measles vaccination. To reduce risks of disease-related modification of exposure, children who reported symptoms of wheezing and/or eczema debuting during first year of life were excluded from some analyses. After this exclusion, inverse associations were observed between measles infection and "any allergic symptom" and "any diagnosis of allergy by a physician." However, no associations were found between measles vaccination and allergic disease.

CONCLUSION. Our data suggest that measles infection may protect against allergic disease in children.

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Key Words: allergic disease • atopic sensitization • measles infection • measles vaccination • Steiner-school children • farm children

Abbreviations: CI—confidence interval • IgE—immunoglobulin E • MMR—measles, mumps, and rubella • OR—odds ratio • PARSIFAL—Prevention of Allergy–Risk Factors for Sensitization in Children Related to Farming and Anthroposophic Lifestyle

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Accepted Jun 16, 2008.

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