Re: [balita-anda] MMR dan Autism
sumber : www.cdc.gov [Centers for Disease Control and Prevention] 1. Does the MMR vaccine cause autism? CDC believes that the current scientific evidence does not support the hypothesis that MMR, or any combination of vaccines, cause the development of autism, including regressive forms of autism. A suspected link between MMR vaccine and autism has been suggested by researchers and some parents of children with autism. Often symptoms of autism are first noted by parents as their child begins to have difficulty with delays in speaking after age one. MMR vaccine is first given to children at 12 to 15 months of age. Therefore, children an apparent onset of autism within a few weeks after MMR vaccination may simply be an unrelated chance occurrence. An extensive study of the evidence was recently conducted in the United Kingdom. The British Committee on Safety of Medicines convened a "Working Party on MMR Vaccine" to conduct a systematic review of reports of autism, gastrointestinal disease, and similar disorders after receipt of MMR or measles/rubella vaccine. The National Childhood Encephalopathy Study (NCES) was examined to see if there was any link between measles vaccine and neurological events. The researchers in England found no indication that measles vaccine contributes to the development including educational and behavioral deficits (Miller et al 1997). A more recent epidemiological study also found no association between MMR vaccine and autism (Taylor et al. 1999). This study compared rates of autism between children who received the MMR vaccine and children who did not. The results found no difference in rates of autism between the two groups. 2. What about the study by Dr. Andrew Wakefield, of the Royal Free Hospital in the United Kingdom? Current scientific evidence does not support the hypothesis that the MMR vaccine, or any combination of vaccines, causes the development of autism, including regressive forms of autism. This includes the research conducted by Dr. Wakefield. The Wakefield Study This study was conducted in 1998 and looked at whether the existence of the measles virus from the MMR vaccine could cause bowel disease and, in turn, cause autism. The authors reviewed reports of 12 children with bowel disease and regressive developmental disorders, mostly autism. In 9 of the cases, the child's parents or pediatrician speculated that the MMR vaccine had contributed to the behavioral problems of the children in the study. This study was reviewed by an expert committee from the UK Medical Research Council (MRC). The Council concluded there is no evidence to link the MMR vaccine with autism. On April 3, 2000 the MRC issued a new report confirming its earlier conclusion; MMR has not been linked with inflammatory bowel disease in autism. A copy of this research report can be found in the appendix and is also available at the MRC web site, http://www.mrc.ac.uk Limitations of Dr. Wakefield's Study 1. The study used too few cases to make any generalizations about the causes of autism; only 12 children were included in the study. Further, the cases were selected by researchers and may not be representative of many cases of autism. 2. There were inadequate groups of control children. As a result, it is difficult to determine whether the bowel changes were similar to changes in normal children, or to determine if the rate of vaccination in autistic children was higher than in the general population. 3. The study did not identify the time period during which the cases were identified. 4. In at least 4 of the 12 cases behavioral problems appeared before the onset of symptoms of bowel disease; that is, the effect preceded the proposed cause. It is unlikely, therefore, that bowel disease or the MMR vaccine triggered the autism. 3. Would it be safer to separate the MMR vaccine into its individual components--in other words, give children three separate shots, at different times (e.g., six months or one year apart), instead of one combined shot? Why do we have to use the combined vaccine? There is no scientific research or data to indicate that there is any benefit to separating the MMR vaccine into its individual components. This idea is not based on any published evaluation of the effect(s) it may have on children. In fact, splitting the MMR vaccine into three separate doses may be harmful because it would expose children unnecessarily to potentially serious diseases. For instance, if rubella vaccine were delayed, 4 million children would be susceptible to rubella for an additional six to 12 months. This would potentially allow otherwise preventable cases of congenital rubella syndrome (CRS) to occur. Infection of pregnant woman with "wild" rubella virus is one of the few known causes of autism. Thus, by preventing infection of pregnant women, rubella vaccine also prevents autism. 4. Should a younger sibling, or a child of someone who suffered autism be vaccinated with MMR or other
Re: [balita-anda] MMR dan Autism
sorry, sumbernya waktu itu lupa saya catat... Kayaknya sih dari CDC juga. - Frequently Asked Questions about Measles, Mumps, and Rubella, and MMR Vaccine [Q.]Are measles, mumps, and rubella still a problem in the United States? All three diseases are currently at or near their lowest point ever reported in the United States. In 1995, a provisional total of 288 measles cases (lowest ever), 840 cases of mumps (lowest ever), and 200 cases of rubella (third lowest) were reported. [Q.]If the chance of the diseases is so low, why do we still give the vaccine? Measles, mumps, and rubella are all still very common in other parts of the world, and can be easily imported into the United States. A reduction in our vaccination efforts would lead to a rapid increase in the number of susceptible children, which could lead to an outbreak. [Q.]What kind of vaccine is MMR? MMR is a attenuated live virus vaccine. After injection, the viruses replicate (grow), and cause a subclinical or asymptomatic infection in the vaccinated person. The person's immune system fights the infection caused by these weakened viruses, and immunity develops. [Q.]How effective is MMR vaccine? From 95 percent to 98 percent of persons who receive a single dose of MMR will develop immunity to all three viruses. [Q.]Why is MMR vaccine given after the first birthday? Most infants born in the United States will receive passive protection against measles, mumps, and rubella in the form of maternal antibody. These antibodies can destroy the vaccine virus if they are present when the vaccine is administered. By 12 months of age, almost all infants have lost this passive protection, so the vaccine viruses can replicate and produce infection with interference. [Q.]If a single dose of MMR vaccine is so effective, why do we give a second dose? The second dose is to provide another chance to develop measles immunity for persons who did not respond to the first dose. About 2 percent to 5 percent of persons do not develop measles immunity after the first dose of vaccine. [Q.]What is the best age to give the second dose of MMR vaccine? The second dose of MMR can be given anytime, as long as the child is at least 12 months old and it has been at least a month since the first dose. However, the second dose is usually administered before the child begins kindergarten or first grade (4-5 years of age) or before entry to middle school (11-12 years of age). The age at which the second dose is required is generally mandated by state school entry requirements. [Q.]Can I give a PPD (tuberculin skin test) on the same day as a dose of MMR vaccine? Live measles vaccine can reduce the reactivity of a PPD because of mild suppression of the immune system. A PPD can be done before or at the same time as measles vaccine is given. However, if measles vaccine is given first, the PPD should be delayed for at least one month. [Q.]What is the most common adverse event following MMR vaccine? Low grade fever and a mild rash, which occur in 5 percent to 10 percent of recipients. [Q.]For years our clinic has given MMR intramuscularly (IM) rather than subcutaneously (SC). Is it less effective IM? If MMR has been given IM instead of SC should it be repeated? All live injected vaccines (MMR, varicella, and yellow fever) are recommended to be given subcutaneously. Intramuscular administration is not likely to decrease immunogenicity, and doses given IM do not need to be repeated. [Q.]Why are people born before 1957 exempt to receiving MMR vaccine? Persons born in 1957 and before lived through several years of epidemic measles before the first measles vaccine was licensed. As a result, these people are very likely to have had measles disease. Serologic surveys suggest that 95%-98% of persons born before 1957 are immune to measles. The "1957 rule" applies only to measles and mumps, and does NOT apply to rubella. [Q.]How long after a blood transfusion can a person be given MMR vaccine? MMR should not be given for 6 months following a transfusion of whole blood. Different blood products require different waiting periods before giving measles vaccine. Table 8 in the General Recommendations on Immunization gives a complete listing of these intervals. [Q.]Rubella is a very mild disease. Why do we even bother to vaccinate against it? Rubella disease in childhood is usually a mild illness. The major public health importance of rubella is the impact the virus may have on a developing fetus. If a woman is infected with rubella virus during the first trimester of pregnancy, the fetus may be stillborn, or may be born with severe birth defects, such as blindness, deafness, or mental retardation. These defects in a newborn of a woman who has rubella during pregnancy are collectively known as congenital rubella syndrome. [Q.]How common is arthritis following rubella vaccine? Joint pain is reported by 25
