Objective: To test the hypothesis that measles vaccination was involved in the pathogenesis of autism spectrum disorders (ASD) as evidenced by signs of a persistent measles infection or abnormally persistent immune response shown by circulating measles virus or raised antibody titres in children with ASD who had been vaccinated against measles, mumps and rubella (MMR) compared with controls.
Design: Case–control study, community based.
Methods: A community sample of vaccinated children aged 10–12 years in the UK with ASD (n = 98) and two control groups of similar age, one with special educational needs but no ASD (n = 52) and one typically developing group (n = 90), were tested for measles virus and antibody response to measles in the serum.
Results: No difference was found between cases and controls for measles antibody response. There was no dose–response relationship between autism symptoms and antibody concentrations. Measles virus nucleic acid was amplified by reverse transcriptase-PCR in peripheral blood mononuclear cells from one patient with autism and two typically developing children. There was no evidence of a differential response to measles virus or the measles component of the MMR in children with ASD, with or without regression, and controls who had either one or two doses of MMR. Only one child from the control group had clinical symptoms of possible enterocolitis.
Conclusion: No association between measles vaccination and ASD was shown.
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GB, ES, TC and DB obtained funding. DB, MA, BT and LJ were responsible for the laboratory tests. TL, SC and DM collected data and samples. PS was responsible for gastrointestinal assessment. AP had overall responsibility for the statistical analysis. All authors contributed to the paper.
Funding: The study was funded by the Department of Health, the Wellcome Trust, the National Alliance for Autism Research (NAAR) and Remedi. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. The corresponding author had full access to all the data in the study and final responsibility for the decision to submit for publication.
Competing interests: MA and DB have given unpaid advice to lawyers in MMR and MR litigation. GB has acted as an occasional expert witness for the diagnosis of autism. AP receives royalties from SCQ and ADOS-G instruments. PBS has acted as an expert witness in the matter of MMR/MR vaccine litigation. All other authors have no conflicts of interest.
Ethics approval: South Thames MREC 00/1/50; Kent & Medway LREC WK153/8/02.