Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12–13, 2000

Abstract

ABSTRACT. Background. Parents and physicians are understandably concerned about the causes and treatment of autism, a devastating disease that affects the entire family. Although much has been learned about autism, there are many gaps in our knowledge about what causes the disorder and how it can be prevented. Autistic symptoms occur along a spectrum, often referred to as autistic spectrum disorder (ASD). Concern has been raised about a possible association between measlesmumps-rubella (MMR) vaccine and inflammatory bowel disease (IBD) and ASD, especially autism with regression. Also, increased requests for educational services related to ASD have raised concerns about possible increases in the incidence of ASD.Methods. On June 12-13, 2000, the American Academy of Pediatrics (AAP) convened a conference titled "New Challenges in Childhood Immunizations" in Oak Brook, Illinois. At this conference, parents, practitioners, and scientists presented information and research on MMR vaccine and ASD. Attendees included representatives from select AAP committees and sections as well as federal and other organizations that address related issues. The multidisciplinary panel of experts reviewed data on what is known about the pathogenesis, epidemiology, and genetics of ASD and the available data on hypothesized associations with IBD, measles, and MMR vaccine. Supplemental information was requested from authors who have proposed the hypotheses and other experts in relevant areas.Results. Autism is a complex disorder of uncertain and probably multiple etiologies. Genetic predisposition to ASD may involve as many as 10 genes. Many experts believe that the abnormal brain development in autism occurs before 30 weeks' gestation in most instances. In utero rubella is a known cause of autism. Animal model data support the biologic plausibility that exposure to yet unrecognized infectious or other environmental agents could cause ASD.Several factors may contribute to apparent increases in incidence of ASD in recent years. Most data indicate increased recognition and reporting as primary factors, but the epidemiologic data are insufficient to determine if there has been a true increase in the incidence of ASD. Increased reporting of ASD in recent years has occurred long after the introduction of MMR vaccine in the United States in 1971 and widespread use of this vaccine in the 1970s for routine immunization of children at 12 to 15 months of age. Appropriate detailed studies are needed to define the true incidence and prevalence of ASD. Epidemiologic studies in Europe indicate no association between MMR vaccine and ASD.Some children with ASD have gastrointestinal symptoms, but an increased rate of any specific gastrointestinal disorder in children with ASD has not been established. Studies to detect evidence of measles virus in intestinal tissue specimens from patients with IBD or autism with gastrointestinal symptoms have not used uniform techniques. Several laboratories have found no evidence of measles viruses in tissue specimens f...

No Evidence for A New Variant of Measles-Mumps-Rubella–Induced Autism

“…First, combined with the mounting negative epidemiologic evidence, the lack of evidence for a new phenotype of MMR-induced autism strongly argues against any change in existing MMR immunization programs, a conclusion also reached in recent reviews by ad hoc committees. 42,43 Second, it no longer should be acceptable that investigators who still argue for a MMR-autism link fail to provide precise and replicable clinical and developmental data on their autism samples, thereby maintaining a degree of ambiguity and confusion that is damaging to both the public health and the science.…”

Anatomy of a health scare: Education, income and the MMR controversy in the UK

“…That list contains an additional eight studies which are Kaye et al (2001), Farrington et al (2001), Taylor et al (2002), Black et al (2002, Donald and Muthu (2002), Madsen et al (2002), Miller et al (2003, and Smeeth et al (2004). 5 There have also been a number of research reviews that have rejected any causal link between the MMR and autistic spectrum disorders, most notably by the US Institute of Medicine of the National Academies (2001,2004), the American Academy of Pediatrics (Halsey et al 2001), the UK Medical Research Council (2001), and by Demicheli et al (2005) for the Cochrane Library. 5 The list of main studies rejecting a causal link was compiled from the summaries of the research provided by the NHS and the BBC.…”

The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children

“…[25][26][27][28][29][30] In addition, it is imperative that health professionals and the public realize that congenital rubella can cause autism and that measles and mumps can cause significant disability, including encephalitis. 31,32 …”