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Abstract | Summary
| Original Article
Measles, mumps, and rubella vaccination
and bowel problems or developmental regression in children with
autism: population study.
Taylor B, Miller E, Lingam R, Andrews N, Simmons
A, Stowe J.
BMJ (British Medical Journal) 2002: 324 16 February;
393-6.
Bottom Line
Is developmental regression in children with autism linked
to the measles, mumps and rubella (MMR) vaccine and/or
bowel problems?
- An article that appeared in a British medical journal caused great alarm among some parents because it led them to believe that the MMR vaccine had definitely been found to cause autism.
- This study looked at the health records of 473 British children diagnosed with autism and looked for reports of regression after MMR vaccination. The study also looked at whether or not children diagnosed with autism had higher rates of bowel problems.
- The study found that there was no association between MMR and autism or between MMR and higher rates of bowel problems.
- It did find an increased rate of bowel problems in children who regressed, which has thus far remained unexplained.
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Question: Is there an association between the measles, mumps
and rubella (MMR) vaccination and bowel problems and developmental
regression in children with autism?
Background: There is ongoing public controversy surrounding
the measles, mumps and rubella (MMR) vaccine. Many parents are convinced
that their children developed "new variant" autism because
of an intestinal wall infection with the measles virus used to formulate
the MMR vaccine. This present study looked at the incidence of bowel
disease and regression in two groups of children with autism —
those who had had the vaccine and those who had not.
Design: Population study using individual doctors’
case notes of children diagnosed with autism, and their vaccination
records, obtained from an independent source.
Setting: Five health districts in north east London, England.
Participants: 473 children born between 1979 and 1998 in
the 5 health districts under study who were later diagnosed with
autism (278 with classical autism and 195 with atypical autism)
were identified through computerized registries of children with
disabilities.
Assessment of risk factors: Bowel problems of at least 3
months duration, age at reported regression, and the date of the
child’s MMR vaccination.
Main outcome measures: A report of bowel symptoms of at
least 3 months duration, the age of first report of regressive symptoms,
the date of first concerns about the child’s development, and
any association between these reports and the date of MMR vaccination.
Main Results: Overall, regression was reported by parents
in 118 (25%) of the 469 children for whom developmental information
was recorded. The symptoms of regression most frequently reported
were loss of speech or other language skills, or a change in behaviour.
Of these children, 43 of 191 children with classical autism (23%)
and 75 of the 278 children with atypical autism (27%) had symptoms
of regression. There was no statistically significant difference
between these rates. 81 (17%) of the children had a record of bowel
symptoms. Statistical analysis showed no association between the
MMR vaccination and regression or bowel problems. Children who showed
regression were more likely than the other children to have bowel
problems. There was, however, no relationship to the vaccination
in this group. There was no change in the number of children with
autism who also had bowel problems recorded over the 20-year period
from 1979 (when the MMR vaccine was introduced) until 1998.
Conclusions: This study did not find an association between
the MMR vaccine and bowel problems and regression in children with
autism. There was, however, a statistically significant increase
in the incidence of bowel problems in children with regression.
26% of children with regression versus 14% of children without regression
had bowel symptoms (p=0002).
There was no evidence to substantiate a claim for a "new variant"
form of autism caused by, or associated with, the MMR vaccine.
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