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American Academy of Pediatrics
Article

Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta

Frank DeStefano, Tanya Karapurkar Bhasin, William W. Thompson, Marshalyn Yeargin-Allsopp and Coleen Boyle
Pediatrics February 2004, 113 (2) 259-266; DOI: https://doi.org/10.1542/peds.113.2.259
Frank DeStefano
*National Immunization Program, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Tanya Karapurkar Bhasin
‡Battelle Memorial Institute, Centers for Public Health Research and Evaluation, Atlanta, Georgia
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William W. Thompson
*National Immunization Program, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Marshalyn Yeargin-Allsopp
§National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia
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Coleen Boyle
*National Immunization Program, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Abstract

Objective. To compare ages at first measles-mumps-rubella (MMR) vaccination between children with autism and children who did not have autism in the total population and in selected subgroups, including children with regression in development.

Methods. A case-control study was conducted in metropolitan Atlanta. Case children (N = 624) were identified from multiple sources and matched to control children (N = 1824) on age, gender, and school. Vaccination data were abstracted from immunization forms required for school entry. Records of children who were born in Georgia were linked to Georgia birth certificates for information on maternal and birth factors. Conditional logistic regression was used to estimate odds ratios (ORs).

Results. The overall distribution of ages at MMR vaccination among children with autism was similar to that of matched control children; most case (70.5%) and control children (67.5%) were vaccinated between 12 and 17 months of age. Similar proportions of case and control children had been vaccinated before 18 or before 24 months. No significant associations for either of these age cutoffs were found for specific case subgroups, including those with evidence of developmental regression. More case (93.4%) than control children (90.6%) were vaccinated before 36 months (OR: 1.49; 95% confidence interval: 1.04–2.14 in the total sample; OR: 1.23; 95% confidence interval: 0.64–2.36 in the birth certificate sample). This association was strongest in the 3- to 5-year age group.

Conclusions. Similar proportions of case and control children were vaccinated by the recommended age or shortly after (ie, before 18 months) and before the age by which atypical development is usually recognized in children with autism (ie, 24 months). Vaccination before 36 months was more common among case children than control children, especially among children 3 to 5 years of age, likely reflecting immunization requirements for enrollment in early intervention programs.

  • autism
  • autism spectrum disorders
  • MMR vaccine
  • immunizations
  • epidemiology
  • Received April 24, 2003.
  • Accepted July 15, 2003.
  • Copyright © 2004 by the American Academy of Pediatrics

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Pediatrics
Vol. 113, Issue 2
1 Feb 2004
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Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta
Frank DeStefano, Tanya Karapurkar Bhasin, William W. Thompson, Marshalyn Yeargin-Allsopp, Coleen Boyle
Pediatrics Feb 2004, 113 (2) 259-266; DOI: 10.1542/peds.113.2.259

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Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta
Frank DeStefano, Tanya Karapurkar Bhasin, William W. Thompson, Marshalyn Yeargin-Allsopp, Coleen Boyle
Pediatrics Feb 2004, 113 (2) 259-266; DOI: 10.1542/peds.113.2.259
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Subjects

  • Infectious Disease
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    • Developmental/Behavioral Pediatrics
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Keywords

  • autism
  • autism spectrum disorders
  • MMR vaccine
  • immunizations
  • epidemiology
  • MMR, measles-mumps-rubella
  • IOM, Institute of Medicine
  • MADDSP, Metropolitan Atlanta Developmental Disabilities Program
  • DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition
  • ASD, autism spectrum disorder
  • MR, mental retardation
  • OR, odds ratio
  • CI, confidence interval
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