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PEDIATRICS Vol. 112 No. 1 July 2003, pp. 206

Measles-Mumps-Rubella Vaccine and Autism

Michael E. Mullins, MD
Washington University School of Medicine
St Louis, MO 63110

To the Editor.—

The recent article by Makela et al1 provides no meaningful data on any possible association between the measles-mumps-rubella (MMR) vaccine and autism. This manufacturer-supported study is biased toward a negative result.

Using hospital admissions is designed to underestimate the occurrence of autism. Even when a child receives a diagnosis, it usually does not involve a hospital admission. The authors merely state that hospital admission is "common" in Finland without giving any quantification. In a recently published, albeit flawed, Danish study of MMR and autism, only 6.9% of children with autism ever required hospitalization for autism during the 9 years of the study.2 The mean ages of diagnosis were 51 months and 63 months for autism and other autistic spectrum disorders, respectively.

With few unvaccinated children, it is impossible to test any hypothesis regarding any effect of MMR. Further, the incidence of autism in the study period was much lower (at least 5-fold lower in the recent Danish study)2 than it is today, so the study has less power to detect a difference if any difference actually exists.

This study affords no comfort to parents and no guidance to pediatricians regarding whether any relationship exists between MMR and autism. Although a definitive causal association between MMR and autism remains unproven, this flawed study cannot disprove it.

REFERENCES

  1. Makela A, Nuorti JP, Peltola H. Neurologic disorders after measles-mumps-rubella vaccination. Pediatrics.2002; 110 :957 –963[Abstract/Free Full Text]
  2. Madsen KM, Hviid A, Vestergaard M, et al. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med.2002; 347 :1477 –1482[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2003 by the American Academy of Pediatrics




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