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Strong Evidence for the Safety of MMR and DPT Vaccines

Summary and Comment |
October 4, 2006

Strong Evidence for the Safety of MMR and DPT Vaccines

  1. Robert S. Baltimore, MD

In a large case-control study, researchers found no risk for encephalitis or encephalopathy from MMR or DPT vaccination.

  1. Robert S. Baltimore, MD

Both the diphtheria-tetanus-pertussis (DTP) and the measles-mumps-rubella (MMR) vaccines have been suspected of increasing the risk for encephalopathy or encephalitis. Such suspicions led to decreased vaccination rates in some countries during the 1970s. Although many countries now use DTaP vaccines, in which the pertussis component is an acellular product rather than a killed whole-cell preparation, concern has continued because DTP is still widely used in developing areas. Previous studies either have produced indeterminate results or have failed to prove an association. Because these neurologic outcomes are rare, the studies lacked sufficient power to satisfy many experts who evaluated the data.

Now, in a retrospective case-control study conducted at four health maintenance organizations in the western U.S., researchers have examined the risks following receipt of the original DTP preparation or MMR in a larger cohort. Examination of medical records for 1981 through 1995 identified 452 children aged ≤6 years (among the 2,197,000 eligible for inclusion) who were hospitalized with encephalopathy or related conditions during this period. Three controls were matched to each case. Cases were no more likely than controls to have received either vaccine ≤90 days before disease onset. No distinct pattern of symptoms was seen in the children who developed encephalitis/encephalopathy ≤14 days after DTP vaccination, or ≤30 days after MMR vaccination.

Comment

Vaccination has proved effective in controlling certain severe infectious diseases, including pertussis and measles. These findings provide no evidence for a relationship between DTP or MMR vaccination and encephalopathies. Although DTaP is less reactogenic than DTP, DTP is easier and less expensive to manufacture and is the preferred pertussis vaccine in most developing countries.

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