MMR vaccine

from Wikipedia, the free encyclopedia

The MMR vaccine is a mixture of virulence weakened viruses that are injected to immunize against measles , mumps and rubella . In German-speaking countries, children are generally vaccinated when they are around one year old, with a second vaccination in their second year of life. If this vaccination scheme is adhered to, there is a protection of over 99% against these infectious diseases. Since 2010, vaccination has also been recommended in Germany for adults born after 1970 who were not vaccinated or only vaccinated once as a child. About 500 million cans have been used in over 60 countries since the earliest versions were introduced in the 1970s. As with all vaccines , long-term effects and effectiveness are subject to continuous research.

A combination vaccine has been available in Germany since 2006 , which also contains a vaccine component against chickenpox (varicella), which is now recommended by the permanent vaccination commission. These preparations are then called the MMRV vaccine .

Epidemiology

The number of measles cases fell sharply after the introduction of vaccination (USA data set)

Measles, mumps and rubella are highly infectious diseases. Before the widespread use of vaccines against these diseases, they were so common that almost everyone had contracted these diseases as a child. These infectious diseases were therefore among the childhood diseases , although adults can also be infected if there is no immunization . The term childhood illness suggests a certain harmlessness, but these illnesses can be accompanied by serious, even fatal, complications. With measles, complications including pneumonia and encephalitis occur in 20% to 30% of people . According to various literature sources, the death rate as a result of these complications is between 1: 10,000 and 2: 1000 (0.01-0.2%) of all measles sufferers in industrialized countries; in developing countries it can rise to 25%.

Mumps is another viral disease that was once typical of children. A well-known but rather rare complication is sterility in men and unilateral or bilateral hearing losses, which are usually permanent. Rubella was also a common disease before the extensive vaccination programs were set up.

The main risk of rubella is transmission from pregnant women to their children, which can lead to serious disabilities ( rubella embryo-fetopathy ).

The vaccines have significantly reduced the number of diseases. Because of vaccination, the incidence of these infectious diseases in countries with systematic vaccination programs has now fallen to less than one percent of the population. Measles are now considered to be eradicated all over the continent of America and Scandinavia. The WHO has also set the goal of eliminating measles and rubella by 2010 for the Europe region. This requires a vaccination coverage of at least 95% of the population. If this value is not reached, outbreaks and epidemics will occur again and again, as happened in 2005 and 2006 with measles in some regions of Germany. Studies of the effects of vaccination programs continue to show dramatic reductions in measles-induced mortality rates, such as in Africa.

Application and effects of the MMR vaccine

The MMR vaccine is a live vaccine and a mixture of a mumps vaccine , a measles vaccine, and a rubella vaccine . It was originally developed as a single vaccination against all three diseases. In Germany, the rubella vaccination was the last component in the form of the MMR vaccination from age 15 months for the first time in the vaccination calendar in 1984 . In 1991, the two-time MMR vaccination was introduced in the vaccination calendar by the STIKO (2nd dose from the age of 6), from 2001 the first MMR vaccination should finally take place between the 11th and 14th Month, the second vaccination in the 15th - 23rd Month. If a child is about to be admitted to a children's facility, the MMR vaccination can also take place before the age of twelve, but not before the age of nine, as maternal antibodies still present in the infant's blood during the first year of life can neutralize the vaccine viruses.

The MMR vaccine is injected intramuscularly or subcutaneously by trained personnel and usually causes an unnoticed, non-communicable infection including measles, mumps, and rubella. The human immune system forms antibodies against the diseases in question in 95–98% of those vaccinated . About 2–5% of children who receive only one vaccine dose of MMR do not develop antibodies (“ non-responders ” or vaccine failures). The cause of vaccination failure can be incorrectly stored vaccine, passive antibodies from the mother of the child or a weak immune system. For this reason, the vaccination gap should be closed with a second MMR vaccination. The second vaccination is not a booster vaccination, but a second vaccination (second attempt) for the primary vaccination failures. According to studies, over 99% develop immunity to these infectious diseases after a double MMR vaccination. This immunity is considered to be very long-lasting, very likely a lifetime without the need for a refresher. For example, it was shown in people who were vaccinated against measles, mumps and rubella that they largely have sufficiently high antibody titers even after 20 years .

In addition, the STIKO recommends vaccination for all adults born after 1970 in certain areas of activity, such as in medical facilities according to Section 23 of the Infection Protection Act (IfSG) or care facilities according to Section 71 of the Social Security Code (SGB XI). Women should be vaccinated twice for each of the three components of the vaccine (M – M – R); men should have a single vaccination to protect against rubella.

After reaching a vaccination rate of 95% of the population, the endemic viruses of measles and rubella can no longer circulate, i.e. the transmission and reproduction cycle ( chain of infection ) of the viruses is interrupted. This results in what is known as “ herd immunity ”: Even people who have no immunity (children under one year of age as well as immunosuppressed people who have not been vaccinated for other reasons) can no longer be infected with these pathogens. However, this herd immunity is repeatedly threatened by vaccination fatigue and vaccination opponents .

Trade names

In March 2006, Chiron withdrew the Morupar MMR vaccine due to higher rates of side effects compared to other MMR vaccines.

Side effects

Since the MMR vaccines are products that contain functioning viruses that are weakened in their virulence, adjuvants that lead to an unspecific enhancement of the immune response are not necessary.

Comparison of the complications of disease and after vaccination of measles, mumps and rubella (MMR). (Adapted from and)
Symptom / illness
Disease   complication rate  		 Complication rate
after vaccination 
measles MMR
Rash 98% 5%, attenuated
fever    98%, mostly high 3% to 5%, very rarely high
Febrile seizures 7 to 8% ≤ 1%
Decrease in blood platelets 1/3000 1 / 30,000 to 1 / 50,000
Encephalitis 1/1000 to 1 / 10,000 0
Lethality 1/500 to 3/1000 0
mumps MMR
Inflammation of the parotid gland 98% 0.5%
Inflammation of the pancreas 2% to 5% 0.5%
Inflammation of the testicles in adolescents  
and adult men		 20 to 50% 1 / 1,000,000
meningitis ≈ 15% 1 / 1,000,000
deafness 1 / 20,000 0
rubella MMR
Joint discomfort
in women		 40% to 70%, persistent 1 / 10,000, mostly
short and weak
Encephalitis 1/6000 0
Decrease in blood platelets 1/3000 1 / 30,000 to 1 / 50,000
Rubella embryopathy in
infection during pregnancy		 > 60% 0

As a side effect of local, as with all vaccinations vaccine reactions such as redness, pain and swelling occur at the injection site and are to be regarded as a harmless side effects. These reactions are largely due to the injection, not the MMR itself. An allergic reaction to ingredients in the serum, such as an allergy to neomycin, can also occur as a rare side effect . Furthermore, in twin studies with the MMR vaccine, it was found that 15-20% of all patients aged 14 to 18 months - regardless of whether MMR or placebo was used - suffered respiratory diseases ( runny nose , etc.) 7 to 9 days after vaccination . develop. It is assumed that these children are vaccinated at a point in time when they do not show any disease, and that about one week after the injection, corresponding usual cyclical diseases start at this age, but that they are not related to the MMR active ingredient.

Since the MMR vaccination is a vaccination with an attenuated live vaccine, attenuated symptoms of the three infectious diseases can develop in up to 5% of cases approx a few days, occasionally accompanied by a slight swelling of the salivary glands and swelling or pain in the joints. These vaccination symptoms are usually milder and last much shorter, and the dreaded complications of infections do not occur. So even though there are known side effects, the advantages outweigh a “natural” infection by far.

Since January 1, 2001, doctors in Germany have been subject to the "obligation to report suspected health damage beyond the usual extent of a vaccination reaction " anchored in the Infection Protection Act (IfSG) . According to Section 6, Paragraph 1, No. 3 of the IfSG, doctors and non-medical practitioners are obliged to report to the public health department if symptoms that occur after a vaccination that go beyond a vaccination reaction could be causally related to the vaccination. These are cases that are initially suspected of having a causal relationship with the vaccination - that means "not without further ado that a causal connection exists". The respective health department for its part forwards the report in a pseudonymized form to the competent regional authority and the Paul Ehrlich Institute . This reporting system is a so-called spontaneous detection system in order to identify early risk signals of side effects of vaccination that were not recorded during approval.

There are no known safety concerns about further MMR vaccination (s) with existing immunity to one of the components (“over-vaccination”).

Controversies over MMR

Individual vaccines are repeatedly brought into connection with various, mostly complex diseases (e.g. autism, allergy, diabetes) in the literature and the press. Even though numerous studies rate the use of the MMR vaccine as medically very effective, the vaccine was also the subject of controversial discussion.

The spectrum of criticism of the MMR vaccine ranges, as in the vaccination criticism in general, from specific topics about the timing, the vaccination strategy, its effectiveness, safety and the side effects of vaccinations in general to the basic vaccination criticism.

Basic vaccination criticism

In particular, the fundamental opposition to vaccination is not homogeneous and is partly accompanied by religious, alternative medical ( homeopathy , anthroposophic medicine, etc.) or esoteric backgrounds. Fear of vaccine damage, distrust of government institutions, of the pharmaceutical industry and evidence-based medicine, ignorance and uncertainty can all contribute to such views.

Accordingly, critical reports about the MMR vaccine or the principle of vaccinating against measles, mumps and rubella itself can usually be found in appropriate forums on the Internet and in books that are critical of vaccinations, some of which are also distributed by organized groups. This regularly leads to controversy as to whether the vaccination criticism is valid with regard to the stated state of the research results or alleged causal cause-effect relationships.

Controversies over effectiveness

In the controversy surrounding the MMR vaccine, critics stated that it was ineffective, since vaccinated and unvaccinated people would fall ill in almost equal parts or even more, and the improvement in hygiene and living standards alone led to a decline in these infectious diseases. Improvements in hygiene and living standards have undoubtedly lowered child mortality, but the direct effect of vaccinations against measles, mumps and rubella can be proven by epidemiological data: the incidence of all three infectious diseases fell shortly after the introduction of vaccinations. For example, prior to the introduction of measles vaccination in the United States in 1963, there were approximately 500,000 measles cases with 500 deaths annually (an estimated 3-4 million). A few years after its introduction, a 98% decrease in diseases was registered. Today, the USA, along with the entire continent of America, are considered measles-free.

The effectiveness of the MMR vaccination itself has been well documented; with regard to the measles component, it has an extraordinarily high success rate for drugs of 95% (after the first dose) and 96% (after the second dose). There are various reasons for the vaccination failure rate of 5% after the first vaccination, which are listed in the Effect section. The affected people are unprotected and can also become ill as a result. If, in an example population of 1000 people, 900 were vaccinated against measles once, it is to be expected that 45 of the vaccinated people will still get the disease - just like all 100 unvaccinated people, because the infectiousness of measles is almost 100%. (Measles epidemics in Hessen, Bavaria, Baden-Wuerttemberg and North Rhine-Westphalia 80-90% of patients were in fact in the recent unvaccinated, the other had been vaccinated only once MMR.) For better vaccination coverage , the relationship between vaccinated and changes Unvaccinated people: If 980 people have been vaccinated once, 49 sick people can be expected from this group, and the 20 unvaccinated people get sick again. Now more than twice as many people who have been vaccinated fall ill than those who have not been vaccinated. However, this is not proof of the ineffectiveness of the vaccination, rather 931 people were protected from illness. To reduce the vaccination failure rate, there is the revaccination.

The effectiveness of the mumps component is 72% (after the first dose) or 86% (after the second dose) for the Jeryl Lynn strain, compared to rubella it is 89%. The effectiveness of a contained varicella component (MMRV vaccine) is 95%.

In the case of complications from measles, mumps or rubella, critics also accused that it was only the MMR vaccination that turned once harmless childhood diseases into diseases with serious complications. This is justified by the fact that the increasing vaccination rate means that a person will not be infected until later in life and that the complications of these diseases will increase in old age. In connection with complications of these diseases in poorly vaccinated developing countries, malnutrition or corresponding previous damage is held responsible for them. The danger of infectious diseases is now perceived as harmless. However, historical reports from doctors show that the potential for danger was also present earlier - in the pre-vaccination era, measles mortality was highest in infants. At the same time, epidemiological studies from the USA show no difference in the mortality rate of measles sufferers before and after the introduction of measles vaccination. Indeed, in countries with higher vaccination coverage, the age of onset appears to be shifting. On the other hand, the number of reported diseases is falling due to increasing vaccination rates. For this reason, the complication rates of certain age groups are increasing proportionally, but the absolute number of diseases including complications has decreased dramatically. And even in developing countries with poorer vaccination coverage - at least in the case of measles - there is no connection between nutritional status and disease progression. However, it appears that the severity of the disease course depends on exposure to measles virus; This means that the primary course in one family (e.g. child infected at school) tends to be lighter than the secondary illnesses in the same family (siblings who were subsequently heavily exposed to the measles pathogen).

However, it could be shown that maternal antibodies from mothers who were “only” vaccinated against measles can be detected in the child's immune system in newborns with lower concentrations. By contrast, mothers who had measles as children give their children higher measles antibody levels. If infants have maternal antibodies or immunoglobulins, an asymptomatic course or a course with few symptoms can result - the patients are still infectious. Infants are therefore particularly at risk from measles until effective vaccination has been implemented. For this reason, the recommendation of the first MMR vaccination of children was brought forward from the original 15 months to 12 months of age in order to minimize the risk window. As long as measles has not been eradicated, however, it should be noted that the unvaccinated infant must be protected from measles contact - in the pre-vaccination era, measles mortality was highest in infants. The most effective protection of newborns can only be achieved through herd immunity ; H. the population has achieved such a high vaccination coverage that viruses are no longer transmitted endemically and even those who are not vaccinated are protected.

Controversies about causing disease

The MMR vaccine has been blamed for various diseases. In the controversy, MMR was among other things a cause of allergies and asthma . In the meantime, it has been clearly established that vaccinations do not cause allergies. It fits in with the fact that vaccination was compulsory in the GDR , but allergies were rare. A larger study across Germany even found a lower susceptibility to allergies in vaccinated children. The MMR vaccine was also discussed as a trigger for type 1 diabetes mellitus , an autoimmune disease . This hypothesis has also been refuted in numerous studies. There is also no evidence that encephalitis could be triggered after the MMR vaccination. Major controversy related to a particular publication also concerned the association with autism . This case will be discussed in more detail in the next section, the connection is now also considered very unlikely.

A particular complication after natural measles infection, subacute sclerosing panencephalitis (SSPE), was also discussed as a side effect of the MMR vaccine. SSPE causes generalized inflammation of the brain, some of which only leads to severe damage years after the actual measles infection and in any case ends fatally. Better monitoring of measles disease makes it clear that SSPE obviously occurs much more frequently than previously assumed and that babies are particularly at risk. The frequency of SSPE has been significantly reduced by the measles vaccination, but it has been claimed that the measles vaccine virus would also trigger this disease. In more detailed examinations of SSPE victims, however, only wild viruses were regularly found in the CNS , so that today an SSPE disease can be excluded by the MMR vaccine.

The rare outbreak of the disease (s) that were vaccinated against, listed in the Side Effects section, is also listed as a dangerous side effect by those who oppose the vaccination. What is omitted here is the fact that the same symptoms as in the "natural" disease occur in a weaker form and less often, for example fever or swollen salivary glands. Fever can be the trigger for febrile seizures or even epilepsy in neurologically susceptible children . The cause of the fever is not important, but anti-vaccination campaigners also blame the MMR vaccine. The MMR vaccine is not the cause here, but rather a trigger of predispositions. Susceptible children should still be vaccinated, as this avoids strong attacks of fever caused by the infectious diseases themselves.

Opponents of vaccination with insufficient specialist knowledge sometimes cite other alleged components in the vaccine as causing the disease, such as thimerosal or aluminum hydroxide . However, neither was included in the MMR (V) vaccine.

In the context of all of this controversy about the disease causing disease caused by the MMR vaccine, a number of lawsuits against vaccine manufacturers accused their products of various physical and cognitive disorders in children were brought in the United States during the 1980s and 1990s to have caused. Although inconclusive, these processes led to a drastic increase in the price of the vaccine, as the pharmaceutical companies wanted to enforce legal security through lobbying. In 1993, MSD Sharp & Dohme was the only company willing to sell MMR vaccines in the US or UK. Two other vaccines were withdrawn in the UK in 1992 and Japan in 1993 because of safety concerns about the strain of mumps used.

In September 1995 the British Legal Aid Board granted a number of families financial support to help them enforce their legal claims against the national health authorities and the vaccine manufacturers. The families claimed that their children died or became seriously ill as a result of the MMR vaccination. At a later point in time, these cases were recognized as hopeless and the aid ended. An interest group called JABS ( Justice, Awareness, Basic Support ) was set up to represent “vaccine-damaged” children.

The Wakefield case

The 1998 Lancet publication

In February 1998, a group headed by Andrew Wakefield published a report in the prestigious medical journal The Lancet, entitled Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children . The report analyzed the cases of twelve autistic children treated at the Royal Free Hospital in north London from 1996–1997. Symptoms affecting the bowel are described which, according to Wakefield, were evidence of an entirely new syndrome. He later referred to this as "autistic enterocolitis". Wakefield recommended further investigation into possible causes in the children's environment, including the MMR vaccine. The work suggests links between gastrointestinal symptoms and developmental disorders in these children that were allegedly linked to the MMR vaccination. The causal link that MMR vaccines led to autism, however, was not achieved. At a press conference prior to the publication of the work, however, Wakefield said he would think it would make sense to use single vaccines instead of the triple MMR vaccine until clarification. He also stated that eight of the twelve parents thought the vaccination was a likely cause, as the vaccination and the onset of symptoms were only days apart. He stated that he could no longer support the continued use of the combination vaccine without a detailed examination of the facts. In a video recording previously made for television, he called for the use of MMR to be suspended in favor of the individual vaccines.

The following controversy

The report, press conference and video unsettled the British population. The following debate became polarized, with both sides using Wakefield's research as arguments. He was publicly attacked, his critics questioning both the correctness and the ethics of his research. The government and medical agencies, such as the National Health Service (NHS), stressed that extensive epidemiological data would not show any link between MMR vaccinations and developmental disorders. Some parents refused to believe these denials, as state security statements had previously been discredited, as in the case of the BSE scandal. The government has been accused that the higher cost of individual vaccinations is the reason for their refusal. As a result, vaccination with MMR dropped from 92% (1996) to 84% (2002). For parts of London, it was suspected that only 60% of vaccinations were given with MMR, which is drastically below the threshold value necessary for herd immunity from measles. Even if there has not yet been a measles epidemic, doctors have already warned against such a disease due to the increasing number of infections.

One factor of controversy is that only the combination vaccine is available through the NHS. Parents who reject this vaccine only have the choice of either having the separate vaccinations carried out privately or not to vaccinate their children at all. The then Prime Minister Tony Blair had publicly defended the MMR vaccine, but gave no information about which vaccination his son Leo received.

The majority of doctors prefer the combination vaccine because it is less stressful for the child and parents are more likely to have one vaccine than three.

Epidemiological research on hundreds of thousands of children in numerous studies still shows no connection between MMR vaccination and autism. Critics of these studies, such as retired clinician John Walker-Smith, although a supporter of the triple vaccine, described epidemiology as a "blunt tool" that does not necessarily reveal such causal links. For example, it is difficult to find two populations of sufficient size that differ only in terms of vaccination.

Wakefield quit his job at the Royal Free Hospital in 2001 and emigrated to the United States. There he worked for a controversial private clinic until February 2010. His ongoing studies include work on possible immunological, metabolic and pathological changes caused by "autistic enterocolitis" as well as connections between intestinal diseases and neurological disorders in children and the possible connection between these disorders and influences such as Vaccines.

Alleged conflict of interest

In February 2004, journalist Brian Deer revealed that at the time the Lancet report went online , Wakefield was receiving £ 55,000 in third-party funding from attorneys seeking links between autism and the MMR vaccine. According to the Sunday Times article , some of the parents quoted were involved in lawsuits against manufacturers of the MMR vaccine. Although Wakefield stated that the third-party funding was published from the start, it was criticized that it was not made known to either the Lancet or the co-researchers. On February 20, 2004, the Lancet described Wakefields' study as "flawed" due to a "fatal conflict of interest" and stated that it should never have been published. Several of Wakefield's co-researchers also clearly criticized the lack of information on third-party funding. The General Medical Council , which is responsible for licensing doctors and monitoring medical ethics in the UK, is investigating.

Withdrawal of the Lancet report

As a result of Brian Deer's article, ten of the thirteen authors of the report formally resigned claims that they had found a link between autism and MMR. Deer continued his investigation in a British television documentary, MMR: What They Didn't Tell You , which aired on November 18, 2004. It was proven that Wakefield owns the patents for a competing product to MMR. In addition, the test results from his own laboratory disproved his claims.

Anti-vaccination lawyers paid £ 3.5 million

Further research by the English newspaper "Sunday Times" revealed that in the run-up to the deliberate publication, Wakefield and other protagonists had received up to £ 3.5 million from a law firm representing the parents of autistic children. Andrew Wakefield himself received half a million pounds. Two years before the controversial article appeared, he received the first partial payments. Furthermore, five other authors of the publication and also a reviewer who reviewed the publication for The Lancet at the time had received personal payments from the law firm.

Recent studies on autism

Epidemiological research shows an increase in autism over the past few decades. The cause is unclear; in many cases, it is assumed that the reason is not a real increase, but rather an improvement in the diagnosis and survey methodology. The diagnostic criteria for autism have been expanded in recent years, and children are now examined more specifically and at an earlier stage. A causal relationship between MMR and autism, on the other hand, can now be considered to be as good as impossible, as the studies cited below, in contrast to Wakefield's work, have shown very extensive studies.

  • In the wake of Wakefield's publication, there followed many studies examining the relationship between MMR and autism. In October 2003, a review article funded by the European Union was published which summarized and analyzed the results of 120 other studies and side effects of the MMR vaccine. The authors concluded:
    • The vaccine is associated with some positive and some negative effects
    • It is 'unlikely' that there was a link between MMR and autism, and
    • "The design and reporting of safety results in MMR vaccine studies ... are mostly inadequate."
  • In January 2005, after extensive research in a single Minnesota county, an eight-fold increase in the incidence of autism was reported. The period examined spans the early 1980s and ends in the late 1990s. Research has not found a link to MMR. The authors suspect that the increase can be explained by improved diagnosis of the disorder and changing definitions.
  • In March 2005, a study of 30,000 children born in a district of Yokohama concluded that the incidence of autism continued to rise (from 46–86 cases in 10,000 children to 97–161 in 10,000) despite the use of the MMR vaccine in Japan was discontinued in April 1993. The authors conclude: “The significance of these results is that MMR vaccination is most likely not a major cause of ASD as it does not explain the increase in the incidence of ASD over time and that MMR vaccine withdrawal in those Countries still using it are not expected to see a decrease in the incidence of ASD. ”Meanwhile, Wakefield contends that the increase in autism that the data shows would support his hypothesis. However, his views found little support.
  • In April 2020, the Cochrane Library published a review of 138 scientific studies and concluded, "There is no credible evidence behind the claims of the harmfulness of the MMR vaccine." Meanwhile, these authors also confirm that the design and reporting of safety-related results in MMR (V) vaccine studies are mostly adequate. Cochrane , in Oxford, England, is widely recognized by scholars as the highest independent reviewer of medical literature.
  • A study by American scientists with 96,000 participants, published in the JAMA magazine in 2015, also came to the conclusion that there is no harmful link between the MMR vaccine and the occurrence of autism. This long-term study included 1,929 children who had an older sibling with autism. These children are at greater risk of developing autism on their own. The result was that MMR vaccinations did not correlate with an increased risk of autism spectrum disorders - regardless of whether or not older siblings had an autistic disorder.
  • The health data on 650,000 Danish children showed that there were statistically no more cases of autism among the vaccinated children than among the unvaccinated children. This means that the risk of autism is not influenced by the vaccination. This study was published in 2019 in the journal Annals of Internal Medicine .

Withdrawal of the fake study from The Lancet 2010

On February 2, 2010, the study was completely withdrawn from the journal The Lancet and removed from the list of publications. The Lancet cites the results of an investigation by the British Medical Association as the reason for the withdrawal . The investigation came to the conclusion on January 28, 2010 that Wakefield had presented the research results in a "dishonest" and "irresponsible" way that "several elements" were "incorrect". According to media reports, the doctor patented his alternative, supposedly safe measles vaccine in 1997. In addition, his study was financially supported by a law firm that was planning to bring claims for damages against the vaccine manufacturers by allegedly affected parents. In May 2010, he was banned from working in the UK. However, he announced his appointment.

On January 7, 2011, the German Medical Journal reported on a new piece of work by reporter Brian Deer, in which he presented evidence that Wakefield had deliberately falsified test results for his study. For his 12-person study, Wakefield had chosen parents who had previously blamed vaccinations for their children's autism. Of the eight children reported in the study whose autism and bowel symptoms were allegedly caused by vaccinations, three were never affected by regressive autism, and the remaining five had developmental abnormalities before vaccination. After all, according to medical records, symptoms only manifested themselves months after the vaccination and not, as stated by Wakefield, days after the vaccination.

See also

literature

  • Susan Mayor: Authors reject interpretation linking autism and MMR vaccine . In: The BMJ . tape 328 , no. 7440 , 2004, 602, doi : 10.1136 / bmj.328.7440.602-c .
  • Clifford G. Miller: Unreliability of Scientific Papers as Evidence . In: The BMJ . tape 328 , no. 7440 , 2004, 602 ( online - statement on the article Authors reject interpretation linking autism and MMR vaccine ).

Web links

Individual evidence

  1. ↑ a b c d The chapters Measles (PDF; 615 kB), Mumps (PDF; 336 kB) and Rubella (PDF; 475 kB). In: Epidemiology & Prevention of Vaccine-Preventable Diseases - "The Pink Book" . Ninth edition. Public Health Foundation, pp. 131-170.
  2. ↑ German Green Cross for Health: Current STIKO recommendations ( Memento of the original from February 25, 2012 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / dgk.de
  3. ↑ Priorix-Tetra: Quadruple vaccine increases the chance of vaccination coverage, Deutsches Ärzteblatt 103 (51-52), 2006, p. A-3502
  4. ↑ Measles. Status 02/2015
  5. ↑ a b Measles in 2005 and outbreaks in Baden-Württemberg and North Rhine-Westphalia in the first half of 2006 . (PDF) In: Epidemiological Bulletin , July 7, 2006, No. 27, Robert Koch Institute
  6. ↑ Measles Mortality Reduction - West Africa, 1996-2002 . MMWR, Jan. 23, 2004/53 (02), pp. 28-30.
  7. ↑ Peter Aaby , Per Gustafson, Adam Roth, Amabelia Rodrigues, Manuel Fernandes, Morten Sodemann, Birgitta Holmgren, Christine Stabell Benn, May-Lill Garly, Ida Maria Lisse, Henrik Jensen: Vaccinia scars associated with better survival for adults. An observational study from Guinea-Bissau . In: Vaccine . tape 24 , no. 29-30 , 2006, pp. 5718-5725 , doi : 10.1016 / j.vaccine.2006.04.045 , PMID 16720061 .
  8. ↑ STIKO: STIKO recommendations 1984 . Robert Koch Institute, October 1, 1984 ( rki.de [accessed April 4, 2020]).
  9. ↑ STIKO: STIKO recommendations 1991 . Robert Koch Institute, August 1, 1991 ( rki.de [accessed April 4, 2020]).
  10. ↑ Epidemiological Bulletin 28/2001. In: RKI. July 13, 2001, pp. 204–205 , accessed April 4, 2020 .
  11. ↑ I. Davidkin et al .: Persistence of measles, mumps, and rubella antibodies in cohort of MMR-vaccinated: a 20-year follow-up . In: J Infect Dis . 197, No. 7, 2008, pp. 950-956 ( PMID 18419470 ).
  12. ^ A b Robert Koch Institute: Communication from the Standing Vaccination Commission at the Robert Koch Institute: Recommendation and scientific justification for the alignment of the professionally indicated measles, mumps, rubella (MMR) and varicella vaccinations . In: Epidemiological Bulletin . No. 2 , January 9, 2020, p. 3–22 ( rki.de [PDF]).
  13. ^ A b R. T. Chen: Vaccine risks: real percieved and unknown . In: Vaccine . 17, 1999, pp. 41-46, PMID 10559533 .
  14. ^ C. Meyer, S. Reiter: Vaccination opponents and vaccination skeptics - history, background, theses, handling . In: Bundesgesundheitsbl - Health Research - Health Protection , Springer Medicine Verlag . 47, 2004, pp. 1182-1188. doi : 10.1007 / s00103-004-0953-x . Retrieved February 8, 2015.
  15. ↑ a b c d e f g h i Carlo Di Pietrantonj et al .: Vaccines for measles, mumps, rubella, and varicella in children . In: The Cochrane Database of Systematic Reviews . tape 4 , April 20, 2020, p. CD004407 , doi : 10.1002 / 14651858.CD004407.pub4 , PMID 32309885 , PMC 7169657 (free full text).
  16. ↑ M. Virtanen, H. Peltola, M. Paunio, OP Heinonen: Day-to-day reactogenicity and the healthy vaccinee effect of measles-mumps-rubella vaccination . In: Pediatrics. 106, No. 5, 2000, p. E62 ( PMID 11061799 ).
  17. ↑ Are vaccine measles contagious and how is it diagnosed? In: RKI. June 4, 2020, accessed August 11, 2020 .
  18. ↑ Reporting obligation according to IfSG in Germany ( memento of October 17, 2005 in the Internet Archive ).
  19. ↑ ADR database. In: Paul Ehrlich Institute . Retrieved February 3, 2020 .
  20. ^ B. Keller-Stanislavsk: Vaccination complications and vaccination damage; from: Vaccination Compendium . Ed .: Heinz Spiess, Ulrich Heininger, Wolfgang Jilg. 8th edition. Georg Thieme Verlag, 2015, ISBN 978-3-13-498908-3 , p. 72 .
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  33. ↑ WJ Bellini et al .: Subacute sclerosing panencephalitis: more cases of this fatal disease are prevented by measles immunization than was previously recognized. In: J Infect Dis. 192, No. 15, 2005, pp. 1686-1693 ( doi: 10.1086 / 497169 , PMID 16235165 ).
  34. ↑ MMR legal aid funding challenge , The Guardian, Oct. 7, 2003.
  35. ^ AJ Wakefield et al .: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children . In: Lancet. 351, No. 9103, 1998, pp. 637-641, PMID 9500320 , generationrescue.org ( Memento of December 16, 2010 in the Internet Archive ) (PDF).
  36. ↑ Video of the Wakefield interview
  37. ↑ Vaccination News ( Memento of the original from September 13, 2005 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.vaccinationnews.com
  38. ↑ Raf Sanchez, David Rose: Dr Andrew Wakefield struck off medical register. In: The Times. dated May 25, 2010
  39. ^ B Deer: Revealed: MMR Research Scandal . The Sunday Times, London, Feb. 22, 2004
  40. ↑ MMR-autism link study . ( Memento of the original from September 14, 2005 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. staffnurse.com @1@ 2Template: Webachiv / IABot / www.staffnurse.com
  41. ^ Brian Deer: MMR doctors to face GMC hearing
  42. ^ Murch SH et al .: Retraction of an interpretation. Lancet. 2004; 363 (9411): 750 PMID 15016483 .
  43. ^ Brian Deer, The Wakefield Factor
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  46. ↑ a b WJ Barbaresi et al .: The incidence of autism in Olmsted County, Minnesota, 1976-1997: results from a population-based study . Arch Pediatr Adolesc Med. Jan. 2005, 159 (1), pp. 37-44 PMID 15630056 .
  47. ↑ Immunization Action Coalition: List of 17 studies on the possible relationship between MMR and autism, in: MMR vaccine does not cause autism. (PDF; 72 kB)
  48. ^ T Jefferson: Unintended events following immunization with MMR: a systematic review . In: Vaccine . 2003 Sep 8; 21 (25-26), pp. 3954-60 PMID 12922131 .
  49. ^ H Honda, Y Shimizu, M Rutter: No effect of MMR withdrawal on the incidence of autism: a total population study . In: J Child Psychol Psychiatry , 2005 Jun, 46 (6), pp. 572-579. PMID 15877763
  50. ↑ Japanese Study Is The Strongest Evidence Yet For A Link Between MMR And Autism ( Memento of March 7, 2005 in the Internet Archive ). The Red Flag, March 6, 2005.
  51. ↑ I Sample: Lingering fears of MMR-autism link dispelled . In: The Guardian , March 3, 2005.
  52. ↑ Christina Hucklenbroich: Study with children at risk: No connection between autism and vaccination. www.faz.net, April 26, 2015
  53. ^ Daniel Lingenhöhl: Measles - Mumps - Rubella: Even in Denmark, vaccination does not lead to autism. In: Spectrum of Science . March 5, 2019, accessed April 29, 2019 .
  54. ↑ Anders Hviid et al .: Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study . In: Annals of Internal Medicine . tape 170 , no. 8 , April 16, 2019, p. 513-520 , doi : 10.7326 / M18-2101 , PMID 30831578 .
  55. ↑ Lancet accepts MMR study "false" . BBC News Online; Retrieved February 2, 2010
  56. ↑ The official end of a research scandal . Spiegel Online ; Retrieved February 4, 2010.
  57. ↑ retraction - ileal lymphoid nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children . In: The Lancet , online , accessed February 4, 2010.
  58. ↑ Measles Vaccination and Autism: Late End of a Medical Scandal. stern.de
  59. ↑ British autism doctor banned from the profession . Spiegel Online , May 24, 2010
  60. ^ BMJ: Autism study was a fake . ( Memento of the original from January 13, 2011 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. In: Deutsches Ärzteblatt @1@ 2Template: Webachiv / IABot / www.aerzteblatt.de
  61. ↑ a b Alice Park: Study Linking Vaccines to Autism Is “Fraudulent” . In: Time . January 6, 2011, ISSN  0040-781X ( time.com [accessed March 24, 2020]).