News
Vaccines and Autism:
An Institute of Medicine (IOM) Report
Immunization
Safety Review: Vaccines and Autism
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Background
In 2000, the
Centers for Disease Control and Prevention
(CDC) and the National Institutes of Health
(NIH) asked the Institute of Medicine (IOM)
to establish an independent expert committee
(the Immunization Safety Review Committee)
to evaluate evidence regarding whether vaccines
cause certain health problems, and to report
their conclusions and recommendations.
In its first
two reports (published in 2001), the committee
examined evidence related to: 1) the theory
that MMR (measles-mumps-rubella) vaccine
causes autism and 2) the theory that vaccines
containing the preservative thimerosal cause
neurodevelopmental disorders, including autism,
attention deficit hyperactivity disorder
(ADHD), and speech or language delay. In
the May 2004 report, the committee updates
its conclusions and recommendations regarding
vaccines and autism based on the significant
number of studies that have been done on
these topics since 2001.
CDC and NIH
welcome this IOM report as a helpful contribution
to the complex scientific issues related
to autism.
Key
Conclusions
The IOM Immunization
Safety Review Committee’s most notable
conclusions were:
- neither
thimerosal-containing vaccines or MMR vaccine
are associated with autism.
-
the hypotheses regarding a link between
autism and MMR vaccine and thimerosal-containing
vaccines lack supporting evidence and are
only theoretical.
-
future research to find the cause of autism
should be directed toward other promising
lines of inquiry that are supported by
current knowledge and evidence and offer
more promise for providing an answer.
The committee’s
conclusion that MMR vaccine is not associated
with autism is consistent with their previous
report on the topic. The committee’s
conclusion in the 2004 report that thimerosal-containing
vaccines are not associated with autism differs
from their conclusion in 2001. At that time,
the committee determined that there was not
enough evidence to determine whether thimerosal
was associated with neurodevelopmental disorders
such as autism. The 2004 report explains
that in 2001 there were no published epidemiological
studies examining the potential association
between thimerosal-containing vaccines and
neurodevelopmental disorders. Since 2001,
several studies have been published which
the committee states “consistently
provided evidence of no association."
Key
Recommendations
The committee
made a number of recommendations in the areas
of policy, surveillance, and epidemiologic
research, clinical studies, and communication,
including:
- The committee
does not recommend a policy review of the
licensure of MMR vaccine or of the current
schedule and recommendations for giving
the MMR vaccine to children.
- The committee
does not recommend a policy review of the
current schedule and recommendations for
the administration of routine childhood
vaccines based on hypotheses regarding
thimerosal and autism.
-
The committee recommends that cost-benefit
assessments regarding the use of thimerosal-containing
versus thimerosal-free vaccines and other
biological or pharmaceutical products,
whether in the United States or other countries,
should not include autism as a potential
risk.
-
The committee recommends developing programs
to increase public participation in vaccine
safety research and policy decisions and
to enhance the skills and willingness of
scientists and government officials to
engage in constructive dialogue with the
public about research findings and their
implications for policy development.
Next
Steps
The Committee
has made helpful recommendations about
policy and research in the areas of vaccine
safety and autism. These are being considered
in depth by the Department of Health and
Human Services agencies, including CDC
and their advisory bodies. At this
time, CDC has no plans to change to the
current childhood
immunization schedule and recommendations
based on hypothetical associations regarding
vaccines and autism.
Autism research
and monitoring will continue to be high
priorities for CDC. Such efforts will
be essential in answering key questions
about whether autism is increasing over
time, determining the cause(s) of this
condition, and ultimately developing
prevention strategies. In addition to
these critical efforts, we also realize
the need to act on existing science to
improve the lives of children already
living with this condition by promoting
developmental screening and intervention.
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