University of Michigan
Department of Pediatrics
Evidence-Based Pediatrics Web Site

Question

• Is there any association between MMR vaccine and neurologic disorders such as encephalitis, meningitis, or autism?
  

Clinical Bottom Lines

1. A retrospective study showed no association between MMR vaccination and neurologic disorders such as encephalitis, meningitis, and autism.1
   
2. The study showed a protective effect of the vaccination against encephalitis and aseptic meningitis.

Summary of Key Evidence

1. In the retrospective study, vaccination data on 535,544 children, ages 1-7, vaccinated between November 1982 and June 1986 in Finland were linked individually with data from a nationwide hospital discharge register for hospitalizations for encephalitis, aseptic meningitis, and autism.1
2. Results showed no significant increase in hospitalizations for encephalitis or aseptic meningitis within 3 months postvaccination with MMR (p=0.28 and 0.57, respectively).
3. Results showed no significant clustering of hospitalizations for autism after vaccination.
4. Results showed a decrease in encephalitis and aseptic meningitis of unspecified cause in study period suggesting a protective effect of the MMR vaccine.
   

Additional Comments

• Other studies support findings in this study including study by Fombonne, et al. in Pediatrics Oct 2001 which showed no evidence for a new variant of measles-mumps-rubella-induced autism.4
• Other neurologic disorders studied include Guillain-Barre syndrome, which has been shown to not be causally associated with MMR vaccination in studies.
• There have been case studies which have shown clustering of encephalitis or aseptic meningitis associated with specific strains of MMR vaccines since withdrawn from use.
• There have been no reports of cases of subacute sclerosing panencephalitis from vaccine strains.
  
  

Citation

1. Makela A. Nuorti JP. Peltola H. Neurologic disorders after measles-mumps-rubella vaccination. Pediatrics 2002;110(5):957-63.
   
2. Campbell, et al. Routine Childhood Immunizations. Primary Care Clinics in Office Practice. Vol 28. No 4. December 2001
   
3. Miller. MMR Vaccine: Review of Benefits and Risks. Journal of Infection Vol 44. January 2002
   
4. Fombonne,et al. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics. 2001 Oct
   
5. Patja, et al. Risk of Guillain-Barre syndrome after measles-mumps-rubella vaccination. Journal of Pediatrics. 2001 Feb
   
6. Dourado, et al. Outbreak of aseptic meningitis associated with mass vaccination with a urabe-containing measles-mumps-rubella vaccine: implications for immunization programs. American Journal of Epidemiology 2000 Mar
7. Weibel, et al. Acute encephalopathy followed by permanent brain injury or death associated with further attenuated measles vaccines. Pediatrics. March 1998
   
   

CAT Author: Amy Doil, MD

CAT Appraisers: Jon Fliegel, MD

Date appraised: December 9, 2002