Autism and measles, mumps, and rubella vaccine: No epidemiological evidence for a causal association

Brent Taylor*, Elizbeth Miller, C. Paddy Farrington, Maria Christina Petropoulos, Isabelle Favot-Mayaud, Jun Li, Pauline A. Waight

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    563 Citations (Scopus)

    Abstract

    Background. We undertook an epidemioiogical study to investigate whether measles, mumps, and rubella (MMR) vaccine may be causally associated with autism. Methods. Children with autism born since 1979 were identified from special needs/disability registers and special schools in eight North Thames health districts, UK. Information from clinical records was linked to immunisation data held on the child health computing system. We looked for evidence of a change in trend in incidence or age at diagnosis associated with the introduction of MMR vaccination to the UK in 1988. Clustering of onsets within defined postvaccination periods was investigated by the case-series method. Findings. We identified 498 cases of autism (261 of core autism, 166 of atypical autism, and 71 of Asperger's syndrome). In 293 cases the diagnosis could be confirmed by the criteria of the International Classification of Diseases, tenth revision (ICD10: 214 [82%] core autism, 52 [31%] atypical autism, 27 [38%] Asperger's syndrome). There was a steady increase in cases by year of birth with no sudden 'step-up' or change in the trend line after the introduction of MMR vaccination. There was no difference in age at diagnosis between the cases vaccinated before or after 18 months of age and those never vaccinated. There was no temporal association between onset of autism within 1 or 2 years after vaccination with MMR (relative incidence compared with control period 0.94 [95% CI 0.60-1.47] and 1.09 [0.79-1.52]). Developmental regression was not clustered in the months after vaccination (relative incidence within 2 months and 4 months after MMR vaccination 0.92 [0.38-2.21] and 1.00 [0.52-1.95]). No significant temporal clustering for age at onset of parental concern was seen for cases of core autism or atypical autism with the exception of a single interval within 6 months of MMR vaccination. This appeared to be an artifact related to the difficulty of defining precisely the onset of symptoms in this disorder. Interpretation. Our analyses do not support a causal association between MMR vaccine and autism. If such an association occurs, it is so rare that it could not be identified in this large regional sample.

    Original languageEnglish
    Pages (from-to)2026-2029
    Number of pages4
    JournalThe Lancet
    Volume353
    Issue number9169
    DOIs
    Publication statusPublished - 12 Jun 1999

    Bibliographical note

    Funding Information:
    We thank Nick Andrews (CDSC) for his help with statistical analysis, Andrew Lloyd Evans (neurodevelopmental paediatrician) and Sarah Willenberg (speech therapist) for advice, and loanna Kontagianni and Ekundayo Ajani-Obe for help with piloting and data collection. The study was funded by the Medicines Control Agency.

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