Disproving the Fear Autism Linked Vaccinations

Size: px

Start display at page:

Download "Disproving the Fear Autism Linked Vaccinations"

Aldous Norris
5 years ago
Views:

1 Disproving the Fear Autism Linked Vaccinations Christy Donovan, BBA; Rachel House, BSHP; Alysa Walden, BSHP MSN Clinical Nurse Leader Program, College of Nursing

2 Background Wakefield s publication suggested link between autism and MMR vaccine Wakefield s findings produced fear of vaccinating children Britain's General Medical Council investigation found Wakefield dishonest and irresponsible 82% of parents received advice from media on vaccines (Allan, 2010); (Recame, 2012)

3 2008, CDC 98% of those with measles had no prior vaccinations Survey of 203 parents Fear of side effects number one reason for not vaccinating Lancet medical journal fully retracted Wakefield study Present- 20 higher-quality studies failed to show link between MMR vaccine and autism (Allan, 2010); (Recame, 2012)

4 Purpose This literature review was performed to answer the question, are children who are immunized as infants compared to children who are not immunized as infants at increased risk of developing autism?

5 Literature Search Strategy Databases: Medline and CINAHL Key search terms: Infant through 5 years of age, immunizations OR vaccines, and autistic disorder OR autism Target population: Infant-5 years Inclusion/exclusion criteria: Published from 2008 to present, infancy to 5 years of age, and the MMR vaccine 45 articles found and reviewed, 9 articles used

6 Background Results Level I* evidence, a systemic review, examined 12 studies of evidence for and against alleged association No association found between MMR vaccine and autism Four Level IV* studies concluded no association between autism and vaccination trends nor evidence supporting a causal relationship between the two (See Table 1 for result details) *See Figure I for Evidence Hierarchy (Wilson, 2003)

7 Figure 1. Evidence Hierarchy Level I Systemic Review or Meta-analysis Level II Randomized Control Trial Level III Controlled Trials (not randomized) Level IV Case Control or Cohort Studies Level V Systemic Reviews of Descriptive and Qualitative Studies Level VI Descriptive or Qualitative Study Level VII Opinions of authorities and/or reports of Experts (Melnyk, 2011)

8 Study EH* Design Sample Duration Measures Data Smeeth, L., et al., 2004 Madsen, K., et al., 2002 Taylor, B., et al., 1999 Kaye, J., del Mar Melero- Montes, M., & Jick, H., 2001 Table 1. Summary of Review of Studies IV IV IV IV Matched Case Control Study Retrospecti ve Cohort Study Time- Series analyses Time- Series analyses 1294 autistic and 4469 non-autistic children 500,000 children (440,655 received MMR vacci ne) 498 autistic children 305 children with diagnosis first recorded during January Decembe r year study Birth records after 1979 Children diagnosis records between OR of autism disorder in vaccinated children versus unvaccinated Analyzed link between MMR vaccine and autism through RR Change in incidence when MMR vaccine was received and autism diagnosis Annual and age specific incidence of first recorded diagnosis analyzing cumulative incidence OR for association between MMR and disorder was 0.86 (95% CI, ) RR of autism amongst vaccinated children, compared to unvaccinated was 0.92 (95 % CI, 0.68 to 1.24) Relative incidence compared with control period 0.94 [95% CI, ] and 1.09 [ ] Cumulative incidence for boys ages 2 to 5 years rose almost fourfold in 1993 birth cohort compared with the 1988 birth cohort. Prevalence of MMR vaccination was over 95% Incidence continued to rise when MMR prevalence remained relatively constant. Note.*See Figure 1; OR = Odds Ratio; RR = Relative Risk; CI = Confidence Interval; See Results for findings summary

9 Recommendations for Practice Fully inform parents on most recent research results Provide parents with understandable information on vaccination safety Educate parents on proven risks and benefits of MMR vaccine Advantages of Recommendations: Provides parents with simplistic resources they are unable to obtain themselves Eliminates parent s fears and frustrations (Gardner, 2010); (Hilton, 2007)

10 Limitations Time needed to properly inform parents is limited Parents unwilling to visit healthcare services cannot be informed Parents distrust of the healthcare system may cause barriers Overcoming Limitations: Provide simple informational packets to schools, hospitals, daycares, and nurseries, who, in turn, can distribute this information to the parents

11 Conclusions Based on the most recent evidence found, there is no association between the MMR vaccination and the risk for developing autism Education of parents will aid in increasing vaccination rates among children

12 Madsen, K., Hviid, A., Vestergaard, M., Schendel, D., Wohlfahrt, J., Thorsen, P., &... Melbye, M. (2002). A population-based study of measles, mumps, and rubella vaccination and autism. The New England Journal Of Medicine, 347(19), References Allan, G., & Ivers, N. (2010). The autism-vaccine story: fiction and deception?. Canadian Family Physician Médecin De Famille Canadien, 56(10), Gardner, B., Davies, A., McAteer, J., & Michie, S. (2010). Beliefs underlying UK parents' views towards MMR promotion interventions: a qualitative study. Psychology, Health & Medicine, 15(2), Hilton, S., Hunt, K., & Petticrew, M. (2007). MMR: marginalised, misrepresented and rejected? Autism: a focus group study. Archives Of Disease In Childhood, 92(4), Kaye, J., del Mar Melero-Montes, M., & Jick, H. (2001). Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. BMJ (Clinical Research Ed.), 322(7284),

13 Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare, a guide to best practice. (2 ed., pp. 12). Philadelphia, PA: Wolters Kluwer Health/Lipponcott Williams & Wilkins. Recame, M. A. (2012). The Immunization- Autism Myth Debunked. International Journal Of Childbirth Education, 27(4), Smeeth, L., Cook, C., Fombonne, E., Heavey, L., Rodrigues, L., Smith, P., & Hall, A. (2004). MMR vaccination and pervasive developmental disorders: a case-control study. Lancet, 364(9438), Taylor, B., Miller, E., Farrington, C., Petropoulos, M., Favot-Mayaud, I., Li, J., & Waight, P. (1999). Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet, 353(9169), Wilson, K., Mills, E., Ross, C., McGowan, J., & Jadad, A. (2003). Association of autistic spectrum disorder and the measles, mumps, and rubella vaccine: a systematic review of current epidemiological evidence. Archives Of Pediatrics & Adolescent Medicine, 157(7),

ARTICLE. Association of Autistic Spectrum Disorder and the Measles, Mumps, and Rubella Vaccine

ARTICLE. Association of Autistic Spectrum Disorder and the Measles, Mumps, and Rubella Vaccine ARTICLE Association of Autistic Spectrum Disorder and the Measles, Mumps, and Rubella Vaccine A Systematic Review of Current Epidemiological Evidence Kumanan Wilson, MD, MSc, FRCP(C); Ed Mills, DPH; Cory