NOTE: as part of the ongoing review of issues in
following review appeared in the August, 1999 issue of Commun Dis Intell.
autism and inflammatory bowel disease:
Janaki Amin and Melanie Wong,
National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases,
Royal Alexandra Hospital for Children, Westmead, New South Wales
Commun Dis Intell, 1999 Aug, 23:8, 222
|Early last year we reported (1) on a study by
Wakefield and colleagues which suggested there may be an association between measles
containing vaccine, inflammatory bowel disease (IBD) and autism.(2)
The evidence for either association was very weak (1) and the study was
conducted on a highly selected group of subjects. Since then several epidemiological
investigations have found no evidence for any association with autism and/or IBD.(5,6,7,8,9)
Also, specific virological assays in patients with IBD, the proposed aetiological
link for autism after measles-mumps-rubella (MMR) vaccination, have not detected measles
virus.(3,4) Following the publication of the Wakefield study (2)
however, there has been a measurable decrease in the uptake of MMR in the United Kingdom
In June this year two further reports were published that provide no support for a causal link between measles vaccine and autism.(11,12) The Working Party on MMR Vaccine of the UK's Committee on Safety of Medicine's study (11) evaluated the reports of autism, Crohn's disease, and similar disorders developing after MMR or MR vaccination, collected by a firm of solicitors. A systematic review of these cases lead the Working Party to conclude that the information available (which was of variable quality, subject to selection bias and lacked a control group) did not support the suggested causal association between measles vaccine and autism or Crohn's disease.
The second report, by Taylor et al., (12) is a population-based study
that overcomes many of the limitations of the Working Party's study. Taylor's study
investigated 498 children with autism born since 1979 in the North Thames Region. These
children's measles vaccination status was determined from an independent register. The
investigators found that:
| vaccination coverage rates in cases did not
differ significantly from that for the region as a whole:
developmental regression was not clustered in the months after vaccination.
These results should alleviate concerns about the possibility of MMR causing autism or ISD and hopefully reassure parents and others as to the safety of MMR.
1 . Amin J, McIntyre PB, Heath TC. Measles vaccine, inflammatory bowel disease
and pervasive developmental disorder: is there cause for concem? Comrnun Dis Intell