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Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study

Anders Hviid, Jørgen Vinsløv Hansen, Morten Frisch, Mads Melbye
Annals of Internal Medicine 2019 March 5

Background: The hypothesized link between the measles, mumps, rubella (MMR) vaccine and autism continues to cause concern and challenge vaccine uptake.

Objective: To evaluate whether the MMR vaccine increases the risk for autism in children, subgroups of children, or time periods after vaccination.

Design: Nationwide cohort study.

Setting: Denmark.

Participants: 657 461 children born in Denmark from 1999 through 31 December 2010, with follow-up from 1 year of age and through 31 August 2013.

Measurements: Danish population registries were used to link information on MMR vaccination, autism diagnoses, other childhood vaccines, sibling history of autism, and autism risk factors to children in the cohort. Survival analysis of the time to autism diagnosis with Cox proportional hazards regression was used to estimate hazard ratios of autism according to MMR vaccination status, with adjustment for age, birth year, sex, other childhood vaccines, sibling history of autism, and autism risk factors (based on a disease risk score).

Results: During 5 025 754 person-years of follow-up, 6517 children were diagnosed with autism (incidence rate, 129.7 per 100,000 person-years). Comparing MMR-vaccinated with MMR-unvaccinated children yielded a fully adjusted autism hazard ratio of 0.93 (95% CI, 0.85 to 1.02). Similarly, no increased risk for autism after MMR vaccination was consistently observed in subgroups of children defined according to sibling history of autism, autism risk factors (based on a disease risk score) or other childhood vaccinations, or during specified time periods after vaccination.

Limitation: No individual medical chart review was performed.

Conclusion: The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination. It adds to previous studies through significant additional statistical power and by addressing hypotheses of susceptible subgroups and clustering of cases.

Primary Funding Source: Novo Nordisk Foundation and Danish Ministry of Health.


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Joel Blackburn wrote:


There is no thimerosal in it. My god. The multidose vial is the only one and it's minimal. Keep trying though. Have you heard of the semmelweis reflex? You have it bad!

Matthew Alexander wrote:


Jon Murphy - probably not placebo controlled because of the ethics of doing that, and they are investigation effect of MMR vs no MMR on rates of autism; not the efficacy of the MMR vaccine. Vaccines work. Not vaccinating half a population for a decade or 2 would cause a population-wide long term health problems and suffering from preventable causes, and have no deeper understanding of autism rates.

Jon Murphy wrote:


Funding source gives appearance of questionable intent regarding desired outcome. This is still not saline placebo controlled trial to compare outcomes though reviews carry lower evidence base than RPCT it is still some evidence.

Alanoud Altrad wrote:


Not a single dose of vaccine should be tested but the whole regimen compared to non vaccinated

John Welden wrote:


So, if thimerosol is the culprit then this study proves nothing.

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