Should I Vaccinate for Measles, Mumps and Rubella

Post by Cliff Harvey ND

The Question “Should I vaccinate my child” seems to come up frequently in my role as a clinical naturopath and nutritionist. 
This question is one that should always be answered in consultation with your GP and/or paediatrician. But there seems to be so much information on social media and on the net that it can be hard to see any clarity on the issue. 

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I don’t tell my patients to vaccinate or not, I believe making a definitive recommendation is more the role of the GP or paediatric specialist, but I do seek to explore the topic and provide solid evidence around the pros and cons of vaccination. 

It is hard to deny that vaccinations have played a valuable role in securing greater public health over the last century. For example by the time smallpox was practically eliminated (due to vaccination) it had already killed around 500 million people in the 20th century. Many other illnesses have been greatly reduced due to the use of vaccines, and mortality (especially amongst children and the poor) has been significantly reduced in vaccine preventable illnesses. 

Does the Mumps, Measles, Rubella vaccination cause autism?
Opponents of vaccination often cite the supposed link between the measles, mumps, rubella (MMR) vaccine and autism. The original research upon which this link was initially suggested by Andrew Wakefield and others has since been highlighted as fradulent and thus withdrawn by the Lancet (1). Further; systematic reviews of the literature published in the Journal of the American Medical Association, Canadian Journal of Neurological Sciences and Pediatrics suggest no causal association between the Measles-Mumps-Rubella vaccine and autism (2; 3) and population based studies in such disparate populations as Denmark (4), Japan (5) and the United Kingdom (6; 7) have found no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder. There also appears to be no evidence for the contention that there is a ‘new variant’ autism related to the MMR vaccine (8). Furthermore there appears to be no link between the MMR vaccine and neurological disorders (encephalitis and menignitis) (6)

What about Thimerosol?
The MMR and other National Schedule vaccines in New Zealand do not contain thimerosal (9) and so this is a ‘non-issue’ (notwithstanding thimerosol has not been shown to cause harm.)

What is the Impact of Vaccination Risk Versus Disease Risk?
Measles has a mortality rate in developed nations like the United States of around three per 1000 cases, although in under-developed areas this can be as high as 28% (10). 
In the pre-vaccine era there were around 11000 deaths per year from vaccine preventable illnesses. That amount had fallen by the year 2004 to 31 deaths (11).
Mumps and rubella are seldom fatal, although mumps does have a mortality rate of around 3 per million. However mumps cause sterility in males, hearing loss, meningitis and encephalitis (the primary causes of the deaths mentioned above). Rubella likewise is seldom fatal however it can cause Congenital Rubella Syndrome (CRS) if passed from mother to foetus. This condition can result in permanent and severe health effects including: heart disease, eye abnormalities, deafness and a host of other developmental and neural problems. This condition was relatively common in the pre-vaccination era, especially during outbreaks of illness. In the global rubella epidemic of 1962-1965 over 20,000 children in the United States were born with CRS. 

What Damage do Vaccines Cause?
Most deaths and adverse effects that have been related to vaccines are due to reported health conditions acquired in a time period after vaccination. This cannot be adequately equated to causation, and there appear to be sociological factors contributing to what people erroneously consider a link between vaccines and health conditions (12). Mortality is lower amongst vaccinated people than non-vaccinated, and there is no difference between causes of death (13), so there seems to be a lack of evidence of any large-scale damage caused by vaccines, but there is definitive harm caused by vaccine preventable illnesses. 
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References
1. Dyer, C. (2010). Lancet retracts Wakefield’s MMR paper (Vol. 340).

2. Doja, A., & Roberts, W. (2006). Immunizations and autism: a review of the literature. Can J Neurol Sci, 33(4), 341-346. 

3. 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), 628-634. doi: 10.1001/archpedi.157.7.628

4. Madsen, K. M., 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. New England Journal of Medicine, 347(19), 1477-1482. doi: doi:10.1056/NEJMoa021134

5. Honda, H., Shimizu, Y., & Rutter, M. (2005). No effect of MMR withdrawal on the incidence of autism: a total population study. Journal of Child Psychology and Psychiatry, 46(6), 572-579. doi: 10.1111/j.1469-7610.2005.01425.x

6. Mäkelä, A., Nuorti, J. P., & Peltola, H. (2002). Neurologic Disorders After Measles-Mumps-Rubella Vaccination. Pediatrics, 110(5), 957-963. doi: 10.1542/peds.110.5.957

7. Taylor, B., Miller, E., Farrington, C., Petropoulos, M.-C., Favot-Mayaud, I., Li, J., & Waight, P. A. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. The Lancet, 353(9169), 2026-2029. doi: 10.1016/S0140-6736(99)01239-8

8. Taylor, B., Miller, E., Lingam, R., Andrews, N., Simmons, A., & Stowe, J. (2002). Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study (Vol. 324).

9. Immune Advisory Centre. (2012). Does the MMR Vaccine Contain Thiomersal.   Retrieved 10/1/2015, 2015, from http://www.immune.org.nz/category/tags/thimerosal

10. Perry, R. T., & Halsey, N. A. (2004). The clinical significance of measles: a review. J Infect Dis, 189 Suppl 1, S4-16. doi: 10.1086/377712

11. Roush, S. W., Murphy, T. V., & Vaccine-Preventable Disease Table Working Group, a. (2007). HIstorical comparisons of morbidity and mortality for vaccine-preventable diseases in the united states. JAMA, 298(18), 2155-2163. doi: 10.1001/jama.298.18.2155

12. Leask, J., Chapman, S., & Cooper Robbins, S. C. (2010). "All manner of ills": The features of serious diseases attributed to vaccination. Vaccine, 28(17), 3066-3070. doi: 10.1016/j.vaccine.2009.10.042

13. McCarthy, N. L., Weintraub, E., Vellozzi, C., Duffy, J., Gee, J., Donahue, J. G., . . . DeStefano, F. (2013). Mortality rates and cause-of-death patterns in a vaccinated population. Am J Prev Med, 45(1), 91-97. doi: 10.1016/j.amepre.2013.02.020