MMR: Where are we now?

¹ GOSH, United Kingdom
² Institute of Child Health,, United Kingdom

^* To whom correspondence should be addressed. E-mail: ellimd{at}gosh.nhs.uk.

Accepted 12 June 2007

	Abstract

The combined MMR vaccine was introduced to UK in 1988 and uptake of the vaccine rose rapidly to a high of 92%. In 1992, brands containing the Urabe strain of the mumps vaccine virus were withdrawn after it was noted to be associated with an increased risk of aseptic meningitis.[1] This did not appear to have a deleterious effect on uptake. In 1995 a paper was published suggesting a link between measles vaccines and the development of bowel disorders in adulthood.[2] This was associated with a small decline in uptake of MMR vaccine. In 1998 the same group of researchers published observations of 12 children with pervasive developmental disorders and bowel disease and suggested that the latter may have led to the former.[3] In 8 children, the history of onset of symptoms coincided with receipt of MMR vaccine. Although the researchers stated in the paper: "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described.", and an accompanying commentary was heavily critical of any suggestion of such a link,[4] the story attracted much attention in the media. This was largely fuelled by a paragraph in the press release accompanying a press conference - "The majority opinion among the researchers involved in this study supports the continuation of MMR vaccination. Dr Wakefield feels that vaccination against the measles, mumps, and rubella infections should undoubtedly continue but until this issue is resolved by further research there is a case for separating the three vaccines into separate measles, mumps, and rubella components and giving them individually spaced by at least 1 year." [5] Subsequently, public confidence in the vaccine was dented and uptake of the vaccine in England fell to 79%, with some parents seeking the single antigen components. In this article we consider the evidence in relation to the proposed link, the effect the scare has had on the control of measles, mumps and rubella and the current situation.

Keywords: MMR, measles, mumps, rubella, vaccine uptake

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