Is There A Link Between The MMR Vaccine And Autism?

My essay is going to be based on, the ongoing controversial debate as to whether there is a link between the Measles Mumps and Rubella (MMR) vaccine in causing autism. I have chosen a media headline story that is related to this subject, and I will back it up with credible sources from journal articles.

The MMR vaccine introduced in 1988 ‘is a safe and effective combined vaccine that protects against 3 separate illnesses – measles, mumps and rubella - in a single injection’ (NHS, 2018: online). ‘The MMR vaccine is a weakened live virus vaccine, meaning after the vaccine is injected the viruses may cause an infection in the body, before they are eradicated from the body. Your immune system will then fight the infection caused by the weakened viruses and immunity to MMR will develop’ (NHS, 2018: online). The link between the MMR vaccine and autism came in 1998, when Wakefield carried out a study that suggested the vaccine was causing children who had the vaccination to develop autism, ‘In 1998, respected medical journal The Lancet carried the results of a small-scale study (12 children) that claimed a link between the Measles Mumps Rubella (MMR) combined vaccine and autism…’ (Knapton,2019: online).

The World Health Organisations (WHO) target, for the MMR vaccine being given to children, is 95% (World Health Organisation, 2018: online). WHO have very clear beliefs about the MMR vaccine and autism and have said, ‘Available epidemiological data are conclusive that there is no evidence of a causal association between measles, mumps and rubella vaccine, and ASD [autism spectrum disorder].Previous studies suggesting a causal link were found to be filled with methodological flaws’ (World Health Organisation, 2018: online).

Nuffield Trust and Health Foundation, 2019 have produced data to show the number of children being vaccinated with the MMR vaccine;

From 1994-1997 there was a good percentage of children being vaccinated with the MMR vaccine, around 91%. In 1998 a study by Wakefield hit the public stating that the vaccine was causing autism. Uptake decreased significantly due to Wakefield’s allegations and by 2003-2004 only 80% of children were vaccinated. In 2010 Wakefield’s study was fully retracted and the % of children being vaccinated started to increase, in 2010 this was 89%. The percentage of children carried on increasing to 93% in 2014, only two per cent of the WHO target.

This research was originally found by Public Health England, giving a good level of validity to the study due to the quantitative data. This is why it is important to have evidence-based practice in providing effective care delivery, without it people won’t trust health care professionals or treatment options as has happened with the MMR vaccine. Parents stopped getting their children vaccinated and an MMR outbreak occurred. The argument about the MMR vaccine is important to nurses due it being their job to reassure the public that the vaccine is safe, and their children will not develop autism. They will need the knowledge and statistics of the vaccine to pass down to patients, being able to do this will ensure effective care delivery.

My media story comes from The Telegraph newspaper, the headline reports ‘No link between the MMR vaccine and autism, biggest ever study shows’ (Knapton, 2019). The article discusses how there is no link between the MMR vaccination and autism and in fact Danish researchers have now found that children who do have the vaccine are ‘…seven per cent less likely to be autistic than those who missed the injection’ (Knapton,2019). The study was done by Danish researchers from the Staten’s Serum Institute and the University of Copenhagen in Denmark’s and Stanford University School of Medicine in the US, giving it a high level of credibility, due to all researchers being educated to a high standard. They used a ‘population wide cohort study in Denmark that aimed to investigate the now discredited link between the MMR vaccine and autism’ (Bazian, NHS,2019: online). The study followed 657,461 children born between 1999 and 2010 to see if a link could be found between autism and the MMR vaccine. They found that just under one per cent were diagnosed with autism during the study between 1999 and 2010, but the chance of getting autism was slightly higher for those who had not had the jab. The article then goes on to talk about Wakefield’s study.

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On the 8th January 2011 the British Medical Journal (BMJ) published an article that stated, ‘Wakefield's article linking MMR vaccine and autism was fraudulent: Clear evidence of falsification of data should now close the door on this damaging vaccine scare’ (Godlee et al, 2011:64), this backs up Knapton’s article and the Danish researchers study. The article backs up that there is no evidence between the MMR vaccine and autism by explaining how Wakefield’s study was flawed, ‘…critics quickly pointed out that the paper was a small case series with no controls, linked three common conditions, and relied on parental recall and beliefs. Over the following decade, epidemiological studies consistently found no evidence of a link between the MMR vaccine and autism’ (Godlee et al, 2011:64). The article also gives me a study that was carried out that proves Wakefield’s study was fraudulent; Godlee et al (2011:64-65) provides the study from Deer that took place in 2004

…Drawing on interviews, documents, and data made public at the GMC hearings, Deer shows how Wakefield altered numerous facts about the patients' medical histories in order to support his claim to have identified a new syndrome; how his institution, the Royal Free Hospital and Medical School in London, supported him as he sought to exploit the ensuing MMR scare for financial gain; and how key players failed to investigate thoroughly in the public interest when Deer first raised his concerns. This uncovered the possibility of research fraud, unethical treatment of children, and Wakefield's conflict of interest through his involvement with a lawsuit against manufacturers of the MMR vaccine. Deer unearthed clear evidence of falsification. He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled…

This article is credible, it comes from an academic source, it has referenced all of its information, so I’m able to go back and check the information given is reliable and valid. The text is supported by other sources such as Deer’s research. The article is transparent as it tells me who has written the article so I can find their background such as, I know that Fiona Godlee has a degree in medicine from the University of Cambridge and therefore I can rely on her articles because she has clinical experience and is an expert in her field. It also tells us when the article was written and when the primary and secondary data was collected.

Annals of Internal Medicine in 2019 published an article which provides me with evidence of the safety of the MMR vaccine. The article written by Saad B. Omer, MBBS, MD, PhD and Inci Yildirim, MD, PhD, MSc both have medical degrees and have a known interest in vaccines such as MMR, meaning it’s a credible source for information which is able to back up my newspaper article. The article talks about the Danish study that is taking place in the newspaper article, and again states no link between the vaccine and autism. ‘In one of the largest studies to date, Madsen and colleagues (2) conducted a retrospective analysis of 537 303 children born in Denmark between 1991 and 1998, representing 2 129 864 person-years, to assess a potential link between autism and receipt of MMR vaccine. They concluded that MMR vaccine wasn’t associated with development of autism and that the risk for autism in the group of vaccinated children was the same as that in unvaccinated children’ (Omer and Yildirim, 2019:567).

My third article explains what has caused parents to not want their children to be vaccinated with the MMR vaccine, and why there’s been an MMR outbreak in the UK. Cambridge University Press published a study into ‘Reasons for measles cases not being vaccinated with MMR: investigation into parents’ and carers’ views following a large measles outbreak’ (McHale et al. 2015) carried out by P. McHale, A. Keenan and S. Ghebrehewt. This article has been peer reviewed, this is important as it means there will be no bias in the article and the transparency of the research process and the scrutiny of the peer reviewers ensures that the article is independent, also the anonymity of the peer reviewer allows them to provide independent feedback, without influence from the authors status. The article provides me with evidence in the form of quantitative and qualitative, of why parents don’t want to get their children vaccinated and it is still because of Wakefield’s study.

The government website backs up what is said in the Telegraph by Knapton that the vaccine does not cause autism and is very safe for children to be vaccinated with, ‘The link to autism … was pure speculation’ ‘ The possible links to autism … were investigated by Public Health England (PHE), and have been proved wrong’ ‘The MMR vaccine remains the most effective and safest way of protecting children against these dangerous diseases. We urge parents to make sure their children have the MMR vaccine’ (Department of Health and Social Care, 2014).

In conclusion I believe the MMR vaccine is one of the most important vaccines that children can have as it protects from three serious illnesses, it’s important that the UK is immune to these diseases which is why the WHO aim is to have 95% of children are vaccinated. Ensuring the adequate uptake of vaccines being given helps to also protect the community, healthcare workers and our hospitals.