Sarah Boseley, health
editor
Thursday November 7, 2002
The Guardian
New evidence of the safety of the measles, mumps and rubella vaccine is
published today in the shape of a study which found no link between children
being given the triple jab and the onset of autism.
The study, published in the New England Journal of Medicine, examined the
medical records of more than half a million children born in Denmark over
eight years. Of the 537,303 children born between January 1991 and December
1998, 440,655 (82%) were given the MMR vaccine, usually at around the age of
15 months.
Researchers found that 758 children had been diagnosed either with autism
or with autistic-spectrum disorders, but that the vaccinated children were
no more likely to have such a diagnosis than those who had not been
vaccinated.
The authors, Kreesten Meldgaard Madsen from the Danish Epidemiology
Science Centre in Aarhus and colleagues, conclude that "this study provides
strong evidence against the hypothesis that MMR vaccination causes autism".
The paper found not only that the risk of autism was similar in
vaccinated and unvaccinated children, but also that there was no sudden
surge of cases just after children received their MMR, or at any other time.
One of the main reasons for public concern, the authors write, is that
cases of autism have appeared to rise following the introduction of the MMR
vaccine for the whole population. In Denmark, however, they say the rise in
autism occurred from the mid to late 1990s, well after introduction of the
vaccine.
The Department of Health said it "welcomes this latest evidence which
finds no causal link between MMR and autism" and will be hoping it may
reassure some of the parents who have abstained from giving their children
the triple vaccine.
Senior doctors in Britain say there is no evidence for separating out the
three vaccines. In fact, said Adam Finn, a vaccines expert from the
University of Bristol medical school, combinations of vaccines have been
used for decades.
The DTP - diphtheria, tetanus and pertussis (whooping cough) -
combination has been used since the 1950s and even the polio vaccine is a
combination of three different strains. It has to be given in three separate
doses over three months so that the strains do not interfere with each
other.
Multiple vaccines were not only the past, said Professor Finn, but the
future. "A single, one-dose vaccine that you give to all babies at birth by
mouth that protects them against all childhood illnesses - that is the goal.
We are working to try to combine them wherever possible."
The immune system was able to deal with much greater challenges than a
few vaccines, he said. A study in the American journal Paediatrics in
January said a baby's immune system could cope with as many as 1,000
vaccines at once, if it were necessary.
Ironically, Prof Finn said, the MMR had virtually no side-effects,
whereas the polio vaccine, which parents are happy with, was responsible for
the only - if very rare - occurrences of polio in Britain.
Because there was a chance that one child a year at most might die or be
damaged as a result, the government would probably substitute an injected
version of inactive polio virus for the oral live virus in the near future.
But an injection which was safer than the oral dose might become a cause of
concern for parents, particularly if it was added in with the DTP, which now
contained the Hib vaccine.
David Ellerman, NHS immunisation coordinator for south London, said on
Radio 4's Today programme that multiple vaccinations in a single injection
were kinder to the child.
"Currently we give 11 injections by the time a child leaves school," he
said. "If we separate these out, just the ones we give now would be 27."