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Editorials |16 April 2019

Further Evidence of MMR Vaccine Safety: Scientific and Communications Considerations Free

Saad B. Omer, MBBS, MD, PhD; Inci Yildirim, MD, PhD, MSc

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It has been 20 years since, in a subsequently retracted study, Wakefield and colleagues (1) reported on 12 children with developmental delay, 8 of whom were diagnosed with autism within 4 weeks of receiving the measles, mumps, rubella (MMR) vaccine. Despite substantial limitations, the study received wide publicity, and the claims published in the article contributed to damaging confidence in the safety of the MMR vaccine, leading to a sharp drop in vaccination rates in the United Kingdom and, possibly, in other countries.

Since the publication of the initial report by Wakefield and colleagues, and despite many subsequent studies not finding an association between MMR vaccine and autism, public concerns regarding a potential link between MMR vaccine and the development of autism have persisted. In one of the largest studies to date, Madsen and colleagues (2) conducted a retrospective analysis of 537 303 children born in Denmark between 1991 and 1998, representing 2 129 864 person-years, to assess a potential link between autism and receipt of MMR vaccine. They concluded that MMR vaccine was not associated with development of autism and that the risk for autism in the group of vaccinated children was the same as that in unvaccinated children. This study also demonstrated that there was no association between the child's age at the time of vaccination or the time since vaccination and the development of autism. Moreover, in a recent meta-analysis involving 5 large cohort studies (n = 1 256 407 children) and...

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2019 American College of Physicians

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