for Vaccine Safety,
February 8, 2017
The Institute of
Medicine (IOM), now
called the National
Academy of Medicine
that the body of
rejection of a
between autism and
MMR vaccine and
MMR vaccine prevents
syndrome and its
associated cases of
Why this is an issue: Andrew Wakefield, a gastroenterologist at the
Royal Free Hospital
published a case
series in the
medical journal The
Lancet in 1998. In
this article he
symptoms, 8 of whom
associated with MMR
accounts by their
this did not prove
between the vaccine
and autism, the lead
author went far
beyond the paper’s
conclusions in a
press release and
with the media [4,5].
Public concern on
the topic grew
quickly. In 2010,
license to practice
medicine in the UK
was revoked by the
Medical Council and
his study was
retracted by The
Lancet as evidence
Wakefield was found
to have ordered
approval of the
the Legal Aid Board,
a group pursuing
action for allegedly
In addition, he had
applied for patents
for vaccines to
rival MMR vaccine.
It was also revealed
that, for most of
the children in the
either started well
before or long after
among many parents
Vaccines of interest: While the initial vaccine targeted by Dr.
Wakefield was MMR,
over time and as
that the MMR vaccine
was not associated
with autism spectrum
disorder (ASD), the
target shifted from
MMR vaccine to the
thimerosal as well
evidence: There have
studies exploring an
ASD and receipt of
MMR vaccine [12-17],
multiple vaccines [23,24],
in addition to the
include more than
studies from another
pair of authors [30-40],
all of which had
between MMR vaccine,
vaccination and ASD.
Proposed biological mechanism: The overlapping times of childhood
usual onset of ASD
symptoms have led to
speculations about a
the proposed links
attribute the cause
of ASD to vaccines.
that a dysregulated
immune response to
measles antigen in
the MMR vaccine led
“toxins” to enter
the blood stream and
enter the central
children. He claimed
support for this
because of his
alleged detection of
measles virus RNA in
bowel specimens of
with ASD .
referenced study was
found to be
fraudulent, and no
has been shown in
studies that used
trigger for ASD was
used to be present
in some vaccines,
although not in the
MMR vaccine. This
theory was based on
similarities in some
features of ASD and
mercury poisoning ;
however, the degree
similarities and the
plausibility of this
The IOM found no
vaccines and ASD [1,2].
1. IOM (Institute of Medicine). 2012. Adverse effects of
vaccines: Evidence and causality. Washington, DC: The National Academies
2. IOM (Institute of Medicine). 2004. Immunization
Safety Review:Vaccines and Autism. Washington, DC: The National Academies
3. Wakefield AJ, Murch SH, Anthony A, et al.
Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive
developmental disorder in children. Lancet 1998;351(9103):637-41.
4. Horton R. A statement by the editors of The Lancet.
5. Murch SH, Anthony A, Casson DH, et al. Retraction of
an interpretation. Lancet 2004;363(9411):750.
6. Eggertson L. Lancet retracts 12-year-old article
linking autism to MMR vaccines. CMAJ 2010;182(4):E199-200.
7. Retraction--Ileal-lymphoid-nodular hyperplasia,
non-specific colitis, and pervasive developmental disorder in children.
8. Deer B. Wakefield's "autistic enterocolitis" under
the microscope. BMJ 2010;340:c1127.
9. Deer B. How the case against the MMR vaccine was
fixed. BMJ 2011;342:c5347.
10. Deer B. Secrets of the MMR scare . How the vaccine
crisis was meant to make money. BMJ 2011;342:c5258.
11. Deer B. Secrets of the MMR scare. The Lancet's two
days to bury bad news. BMJ 2011;342:c7001.
12. Taylor B, Miller E, Farrington CP, et al. Autism and
measles, mumps, and rubella vaccine: no epidemiological evidence for a
causal association. Lancet 1999;353(9169):2026-9.
13. Taylor B, Miller E, Lingam R, et al. Measles, mumps,
and rubella vaccination and bowel problems or developmental regression in
children with autism: population study. BMJ 2002;324(7334):393-6.
14. Farrington CP, Miller E, Taylor B. MMR and autism:
further evidence against a causal association. Vaccine 2001;19(27):3632-5.
15. Madsen KM, Hviid A, Vestergaard M, et al. A
population-based study of measles, mumps, and rubella vaccination and
autism. N Engl J Med 2002;347(19):1477-82.
16. Smeeth L, Cook C, Fombonne E, et al. MMR vaccination
and pervasive developmental disorders: a case-control study. Lancet
17. Mäkelä A, Nuorti JP, Peltola H. Neurologic disorders
after measles-mumps-rubella vaccination. Pediatrics 2002;110(5):957-63.
18. Hviid A, Stellfeld M, Wohlfahrt J, Melbye M.
Association between thimerosal-containing vaccine and autism. JAMA
19. Verstraeten T, Davis RL, DeStefano F, et al; Vaccine
Safety Datalink Team. Safety of thimerosal-containing vaccines: a two-phased
study of computerized health maintenance organization databases. Pediatrics
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exposure in infants and developmental disorders: a retrospective cohort
study in the United kingdom does not support a causal association.
21. Croen LA, Matevia M, Yoshida CK, Grether JK.
Maternal Rh D status, anti-D immune globulin exposure during pregnancy, and
risk of autism spectrum disorders. Am J Obstet Gynecol 2008;199(3):234.e1-6.
22. Price CS, et al. Prenatal and infant exposure to
thimerosal from vaccines and immunoglobulins and risk of autism. Pediatrics
23. Uno Y, Uchiyama T, Kurosawa M, A, et al. The
combined measles, mumps, and rubella vaccines and the total number of
vaccines are not associated with development of autism spectrum disorder:
the first case-control study in Asia. Vaccine 2012;30(28):4292-8.
24. DeStefano F, Price CS, Weintraub ES. Increasing
exposure to antibody-stimulating proteins and polysaccharides in vaccines is
not associated with risk of autism. J Pediatr 2013;163(2):561-7.
25. IOM. 2001. Immunization Safety Review:
Measles-Mumps-Rubella Vaccine and Autism. Washington, DC: National Academy
26. Parker SK, Schwartz B, Todd J, Pickering LK.
Thimerosal-containing vaccines and autistic spectrum disorder: a critical
review of published original data. Pediatrics 2004;114(3):793-804.
27. Schultz ST. Does thimerosal or other mercury
exposure increase the risk for autism? A review of current literature. Acta
Neurobiol Exp (Wars) 2010;70(2):187-95.
28. Maglione MA, Das L, Raaen L, et al. Safety of
vaccines used for routine immunization of U.S. children: a systematic
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29. Taylor LE, Swerdfeger AL, Eslick GD. Vaccines are
not associated with autism: an evidence-based meta-analysis of case-control
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after thimerosal-containing vaccines: a brief communication. Exp Biol Med
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thimerosal on childhood neurodevelopmental disorders. Pediatr Rehabil
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33. Geier DA, Geier MR. An evaluation of serious
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34. Geier DA, Geier MR. A comparative evaluation of the
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36. Geier DA, Geier MR. An evaluation of the effects of
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38. Geier DA, Geier MR. An assessment of downward trends
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39. Young HA, Geier DA, Geier MR. Thimerosal exposure in
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40. Kern JK, Haley BE, Geier DA, et al. Thimerosal
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43. Hornig M, Briese T, Buie T, et al. Lack of
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44. Libbey JE, Coon HH, Kirkman NJ, et al. Are there
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45. D'Souza Y, Fombonne E, Ward BJ. No evidence of
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