BMJ 2002;324:393-396
( 16 February )
Brent Taylor
a Centre for Community Child Health,
Royal Free and University College Medical School, University College London
Royal Free Campus, London NW3 2PF, b Immunisation Division,
Public Health Laboratory Service, Communicable Disease Surveillance Centre,
London NW9 5EQ
Correspondence to: B Taylor [log in to unmask]
Objectives: To investigate whether measles, mumps,
and rubella (MMR) vaccination is associated with bowel problems and
developmental regression in children with autism, looking for evidence
of a "new variant" form of autism.
Design: Population study with case
note review linked to independently recorded vaccine data.
Setting: Five health districts in
north east London.
Participants: 278 children with
core autism and 195 with atypical autism, mainly identified
from computerised disability registers and born between
1979 and 1998.
Main outcome measures: Recorded
bowel problems lasting at least three months, age of reported
regression of the child's development where it was a feature, and
relation of these to MMR vaccination.
Results: The proportion of
children with developmental regression (25% overall) or bowel
symptoms (17%) did not change significantly (P value for trend
0.50 and 0.47, respectively) during the 20 years from
1979, a period which included the introduction of MMR
vaccination in October 1988. No significant difference was
found in rates of bowel problems or regression in children who
received the MMR vaccine before their parents became concerned about
their development (where MMR might have caused or triggered the
autism with regression or bowel problem), compared with those who
received it only after such concern and those who had not received
the MMR vaccine. A possible association between non-specific bowel
problems and regression in children with autism was seen but this
was unrelated to MMR vaccination.
Conclusions: These findings
provide no support for an MMR associated "new variant"
form of autism with developmental regression and bowel problems, and
further evidence against involvement of MMR vaccine in the
initiation of autism.
What is already known on this topic This postulated association along with media attention
has had a major adverse effect on public confidence in the vaccine Although population studies have shown no association
between autism and MMR vaccine it has been further postulated that various
environmental or genetic cofactors are required for the effect What this study adds Neither developmental regression nor bowel problems in
children with autism was associated with MMR vaccination No evidence was found for a "new variant" form
of autism |
Edward E.
Rylander, M.D.
Diplomat American
Board of Family Practice.
Diplomat American
Board of Palliative Medicine.