| Peer-Reviewed

Neurological Disorders Associated with Measles-Mumps-Rubella Vaccination- a Review

Received: 6 December 2014    Accepted: 11 January 2015    Published: 28 January 2015
Views:       Downloads:
Abstract

Background: The safety of the measles-mumps-rubella (MMR) vaccine has always been doubtful due to its side effects reported over time. Current criticism revolves around the fact that the trials were too small and did not follow up on children involved in the study for long enough periods to determine if there would be any potential hazards involved. Objective: To assess the risks of seizures and other neurological events following MMR immunization in children up to 16 years of age. Methodology: The data was collected from retrospective and prospective cohort studies carried out worldwide on around 8 million children who received MMR immunization up to their 16 years of life. About 110 published articles (from 1991 to 2014), satisfied the inclusion criteria and 38 of them were included in the review. Main Results: MMR immunization was associated with consistent increase in febrile seizures in the 7- through 14-day interval. Delaying MMR vaccine past 15 months of age resulted in a higher risk of seizures. The long-term rate of epilepsy was not increased in children who had febrile seizures following vaccination compared with children who had febrile seizures of a different etiology. The reports on other neurological disorders included the rare adverse events of aseptic meningitis associated with a form of the MMR vaccine containing the Urabe mumps strain, and very few cases of encephalitis, convulsions, Guillain-Barre syndrome and subacute sclerosing panencephalitis. The most commonly occurring adverse reaction was syncopal fit. Conclusion: Measles, mumps, and rubella are all very serious illnesses and can have complications leading to lifetime disability or even death. The long-term effects of the MMR vaccine are still in question, but on comparing its risks and benefits, the benefits far outweigh the incidence of serious adverse events associated with immunization. Changes in the vaccine formulation may help to reduce side-effects, and further advances may help make current vaccines even safer.

Published in Science Journal of Public Health (Volume 3, Issue 1)
DOI 10.11648/j.sjph.20150301.24
Page(s) 81-86
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Immunization, MMR, Neurological Disorders

References
[1] Offit, P. A., Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases. Washington, DC: Smithsonian, 2007.
[2] "MMR vaccine questions and answers". Centers for Disease Control and Prevention. 2004. Retrieved 2008-05-28.
[3] Banatvala, J. E. and Brown, D. W., "Rubella". Lancet, 2004, 363 (9415): 1127–1137.
[4] "Case 4: Discussion- Appropriate Vaccinations - Initial Evaluation - HIV Web Study".
[5] "Measles, Mumps, and Rubella -- Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP)"
[6] Griffin, M. R., Ray, W. A., Mortimer, E. A., Fenichel, G. M. and Schaffner, W. Risk of seizures after measles-mumps-rubella immunization. Pediatrics, 1991, 88(5):881-885.
[7] Harnden, A. and Shakespeare, J., 10-minute consultation: MMR immunization. BMJ, 2001, 323 (7303): 32.
[8] Schattner, A., Consequence or coincidence? The occurrence, pathogenesis and significance of autoimmune manifestations after viral vaccines. Vaccine, 2005, 23 (30): 3876–3886.
[9] Carapetis, J. R., Curtis, N. and Royle, J.). MMR immunisation. True anaphylaxis to MMR vaccine is extremely rare. BMJ, 2001, 323 (7317): 7869.
[10] Fox, A. and Lack, G., Egg allergy and MMR vaccination. Br. J. Gen. Pract., 2003, 53 (495): 801–802.
[11] "M-M-R II (measles, mumps, and rubella virus vaccine live)". Merck. 2007.
[12] Institute of Medicine (1994). Measles and mumps vaccines. Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Causality. National Academy Press.
[13] Colville, A., Pugh, S., Miller, E., Schmitt, H. J., Just, M. and Neiss, A., Withdrawal of a mumps vaccine. Eur. J. Pediatr., 1994, 153 (6): 467-468.
[14] Fullerton, K. E. and Reef, S. E., Commentary: Ongoing debate over the safety of the different mumps vaccine strains impacts mumps disease control. Int. J. Epidemiol., 2002, 31 (5): 983-984.
[15] Miller, E. The new measles campaign: immunization should prevent an epidemic predicted by modelling. BMJ, 1994, 309:1102-1103.
[16] D'Souza, R. M., Campbell-Lloyd, S., Isaacs, D., Gold, M., Burgess, M., Turnbull, F. and O'Brien, E., Adverse events following immunisation associated with the 1998 Australian Measles Control Campaign. Commun. Dis. Intell., 2000, 24(2):27-33.
[17] Barlow, W. E., Davis, R. L., Glasser, J. W., Rhodes, P. H., Thompson, R. S., Mullooly, J. P., Black, S. B., Shinefield, H. R., Ward, J. I., Marcy, S. M., DeStefano, F., Chen, R. T., Immanuel, V., Pearson, J. A., Vadheim, C. M., Rebolledo, V., Christakis, D., Benson, P. J. and Lewis, N., Centers for Disease Control and Prevention Vaccine Safety Datalink Working Group. The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. N. Engl. J. Med., 2001, 345(9):656-661.
[18] Davis, R. L. and Barlow, W. Placing the risk of seizures with pediatric vaccines in a clinical context. Paediatr Drugs, 2003, 5(11):717-722.
[19] Jefferson, T., Price, D., Demicheli, V. and Bianco, E., European Research Program for Improved Vaccine Safety Surveillance (EUSAFEVAC) Project. Unintended events following immunization with MMR: a systematic review. Vaccine, 2003, 21(25-26): 3954-3960.
[20] Vestergaard, M., Hviid, A., Madsen, K. M., Wohlfahrt, J., Thorsen, P., Schendel, D., Melbye, M. and Olsen, J., MMR vaccination and febrile seizures: evaluation of susceptible subgroups and long-term prognosis. JAMA, 2004, 292(3):351-357.
[21] Miller, E., Andrews, N., Stowe, J., Grant, A., Waight, P. and Taylor, B., Risks of convulsion and aseptic meningitis following measles-mumps-rubella vaccination in the United Kingdom. Am. J. Epidemiol., 2007, 165(6):704-709.
[22] Esteghamati, A., Keshtkar, A., Heshmat, R., Gouya, M.M, Salar Amoli, M, Armin, S. and Mahoney, F., Adverse reactions following immunization with MMR vaccine in children at selected provinces of Iran. Arch. Iran Med., 2011, 14(2):91-95.
[23] Wilson, K., Hawken, S., Kwong, J.C., Deeks, S., Crowcroft, N.S., Van Walraven, C., Potter, B.K., Chakraborty, P., Keelan, J., Pluscauskas, M. and Manuel, D. Adverse events following 12 and 18 month vaccinations: a population-based, self-controlled case series analysis. PLoS One, 2011, 6(12):e27897.
[24] Knuf, M., Faber, J., Barth, I. and Habermehl, P. A combination vaccine against measles, mumps, rubella and varicella. Drugs Today, 2008, 44(4):279-292.
[25] Klein, N.P., Fireman, B., Yih, W.K., Lewis, E., Kulldorff, M., Ray, P., Baxter, R., Hambidge, S., Nordin, J., Naleway, A., Belongia, E.A., Lieu, T., Baggs, J. and Weintraub, E. Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures. Pediatrics, 2010, 126(1):1-8.
[26] O'Leary, S.T., Suh, C.A. and Marin, M. Febrile seizures and measles-mumps-rubella- varicella (MMRV) vaccine: What do primary care physicians think? Vaccine, 2012, 30(48):6731-6733.
[27] Ackerson, B.K., Li, B.H., Sy, L.S., Cheetham, T.C. and Jacobsen, S.J. Association of the use of MMRV in infants by pediatric infectious disease specialists with that of other affiliated providers. Vaccine, 2014, 32(16):1863-1868.
[28] Hanf, M., Quantin, C., Farrington, P., Benzenine, E., Hocine, N.M., Velten, M., Tubert-Bitter, P. and Escolano S. Validation of the French national health insurance information system as a tool in vaccine safety assessment: application to febrile convulsions after pediatric measles/mumps/rubella immunization. Vaccine, 2013, 31(49):5856-5862.
[29] Pruna, D, Balestri, P., Zamponi, N., Grosso, S., Gobbi, G., Romeo, A., Franzoni, E., Osti, M., Capovilla, G., Longhi, R. and Verrotti, A. Epilepsy and vaccinations: Italian guidelines. Epilepsia, 2013, 54 Suppl. 7:13-22.
[30] Hambidge, S.J., Newcomer, S.R., Narwaney, K.J., Glanz, J.M., Daley, M.F., Xu, S., Shoup, J.A., Rowhani-Rahbar, A., Klein, N.P., Lee, G.M., Nelson, J.C., Lugg, M., Naleway, A.L., Nordin, J.D., Weintraub, E. and DeStefano, F. Timely versus delayed early childhood vaccination and seizures. Pediatrics, 2014, 133(6):e1492-1499.
[31] Feenstra, B., Pasternak, B., Geller, F., Carstensen, L., Wang, T., Huang, F., Eitson, J.L., Hollegaard, M.V., Svanström, H., Vestergaard, M., Hougaard, D.M., Schoggins, J.W., Jan, L.Y., Melbye, M. and Hviid, A. Common variants associated with general and MMR vaccine-related febrile seizures. Nat. Genet., 2014, 46(12):1274-1282.
[32] Maglione, M.A., Das, L., Raaen, L., Smith, A., Chari, R., Newberry, S., Shanman, R., Perry, T., Goetz, M.B. and Gidengil, C. Safety of vaccines used for routine immunization of U.S. children: a systematic review. Pediatrics, 2014, 134(2):325-337.
[33] Stratton, K.R., Howe, C.J. and Johnston, R.B. Jr, eds. Adverse Events Associated With Childhood Vaccines: Evidence Bearing on Causality. Washington, DC: National Academy Press; 1993.
[34] Fujinaga, T., Motegi, Y., Tamura, H. and Kuroume, T. A prefecture-wide survey of mumps meningitis associated with measles, mumps and rubella vaccine. The Pediatric Infectious Disease Journal, 1991, 10:204-209.
[35] Ueda, K., Miyazaki, C., Hidaka, Y., Okada, K., Kusuhara, K. and Kadoya, R. Aseptic meningitis caused by measles-mumps-rubella vaccine in Japan. Lancet, 1995, 346:701-702.
[36] Dourado, I., Cunha, S., Teixeira, M.G., Farrington, C.P., Melo, A., Lucena, R. and Barreto, M.L. Outbreak of aseptic meningitis associated with mass vaccination with a Urabe-containing measles-mumps-rubella vaccine: implications for immunization programs. American Journal of Epidemiology, 2000, 151:524-530.
[37] Makela, A., Nuorti, J.P. and Peltola, H. Neurologic disorders after measles-mumps-rubella vaccination. Pediatrics, 2003, 110(5):957-963.
[38] El-Amin, A.N., Parra, M.T., Kim-Farley, R. and Fielding, J.E. Ethical issues concerning vaccination requirements. Public Health Reviews, 2012, 34(1):1-20.
Cite This Article
  • APA Style

    Neetu Batra. (2015). Neurological Disorders Associated with Measles-Mumps-Rubella Vaccination- a Review. Science Journal of Public Health, 3(1), 81-86. https://doi.org/10.11648/j.sjph.20150301.24

    Copy | Download

    ACS Style

    Neetu Batra. Neurological Disorders Associated with Measles-Mumps-Rubella Vaccination- a Review. Sci. J. Public Health 2015, 3(1), 81-86. doi: 10.11648/j.sjph.20150301.24

    Copy | Download

    AMA Style

    Neetu Batra. Neurological Disorders Associated with Measles-Mumps-Rubella Vaccination- a Review. Sci J Public Health. 2015;3(1):81-86. doi: 10.11648/j.sjph.20150301.24

    Copy | Download

  • @article{10.11648/j.sjph.20150301.24,
      author = {Neetu Batra},
      title = {Neurological Disorders Associated with Measles-Mumps-Rubella Vaccination- a Review},
      journal = {Science Journal of Public Health},
      volume = {3},
      number = {1},
      pages = {81-86},
      doi = {10.11648/j.sjph.20150301.24},
      url = {https://doi.org/10.11648/j.sjph.20150301.24},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20150301.24},
      abstract = {Background: The safety of the measles-mumps-rubella (MMR) vaccine has always been doubtful due to its side effects reported over time. Current criticism revolves around the fact that the trials were too small and did not follow up on children involved in the study for long enough periods to determine if there would be any potential hazards involved. Objective: To assess the risks of seizures and other neurological events following MMR immunization in children up to 16 years of age. Methodology: The data was collected from retrospective and prospective cohort studies carried out worldwide on around 8 million children who received MMR immunization up to their 16 years of life. About 110 published articles (from 1991 to 2014), satisfied the inclusion criteria and 38 of them were included in the review. Main Results: MMR immunization was associated with consistent increase in febrile seizures in the 7- through 14-day interval. Delaying MMR vaccine past 15 months of age resulted in a higher risk of seizures. The long-term rate of epilepsy was not increased in children who had febrile seizures following vaccination compared with children who had febrile seizures of a different etiology. The reports on other neurological disorders included the rare adverse events of aseptic meningitis associated with a form of the MMR vaccine containing the Urabe mumps strain, and very few cases of encephalitis, convulsions, Guillain-Barre syndrome and subacute sclerosing panencephalitis. The most commonly occurring adverse reaction was syncopal fit. Conclusion: Measles, mumps, and rubella are all very serious illnesses and can have complications leading to lifetime disability or even death. The long-term effects of the MMR vaccine are still in question, but on comparing its risks and benefits, the benefits far outweigh the incidence of serious adverse events associated with immunization. Changes in the vaccine formulation may help to reduce side-effects, and further advances may help make current vaccines even safer.},
     year = {2015}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Neurological Disorders Associated with Measles-Mumps-Rubella Vaccination- a Review
    AU  - Neetu Batra
    Y1  - 2015/01/28
    PY  - 2015
    N1  - https://doi.org/10.11648/j.sjph.20150301.24
    DO  - 10.11648/j.sjph.20150301.24
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 81
    EP  - 86
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20150301.24
    AB  - Background: The safety of the measles-mumps-rubella (MMR) vaccine has always been doubtful due to its side effects reported over time. Current criticism revolves around the fact that the trials were too small and did not follow up on children involved in the study for long enough periods to determine if there would be any potential hazards involved. Objective: To assess the risks of seizures and other neurological events following MMR immunization in children up to 16 years of age. Methodology: The data was collected from retrospective and prospective cohort studies carried out worldwide on around 8 million children who received MMR immunization up to their 16 years of life. About 110 published articles (from 1991 to 2014), satisfied the inclusion criteria and 38 of them were included in the review. Main Results: MMR immunization was associated with consistent increase in febrile seizures in the 7- through 14-day interval. Delaying MMR vaccine past 15 months of age resulted in a higher risk of seizures. The long-term rate of epilepsy was not increased in children who had febrile seizures following vaccination compared with children who had febrile seizures of a different etiology. The reports on other neurological disorders included the rare adverse events of aseptic meningitis associated with a form of the MMR vaccine containing the Urabe mumps strain, and very few cases of encephalitis, convulsions, Guillain-Barre syndrome and subacute sclerosing panencephalitis. The most commonly occurring adverse reaction was syncopal fit. Conclusion: Measles, mumps, and rubella are all very serious illnesses and can have complications leading to lifetime disability or even death. The long-term effects of the MMR vaccine are still in question, but on comparing its risks and benefits, the benefits far outweigh the incidence of serious adverse events associated with immunization. Changes in the vaccine formulation may help to reduce side-effects, and further advances may help make current vaccines even safer.
    VL  - 3
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Department of Zoology, MCM DAV College for Women, Sector 36-A, Affiliated to Panjab University, Chandigarh, India

  • Sections