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Serious adverse events after measles-mumps-rubella vaccination during a fourteen-year prospective follow-up

PATJA, ANNAMARI MD; DAVIDKIN, IRJA MSC, PhD; KURKI, TAPIO MD, PhD; KALLIO, MARKKU J. T. MD; VALLE, MARTTI MD, PhD; PELTOLA, HEIKKI MD, PhD

The Pediatric Infectious Disease Journal: December 2000 - Volume 19 - Issue 12 - p 1127-1134
Original Studies
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Background. Several disorders have been attributed to measles-mumps-rubella (MMR) vaccination during the past decade. The aim of this prospective follow-up study was to identify serious adverse events causally related to MMR vaccination.

Methods. When the MMR vaccination program was launched in Finland in 1982, a countrywide surveillance system was set up to detect serious adverse events associated with MMR. To obtain detailed case histories vaccinees’ clinical charts were reviewed. Serum samples were analyzed to trace concurrent infections.

Setting. All hospitals and health centers in Finland from 1982 through 1996.

Results. Immunization of 1.8 million individuals and consumption of almost 3 million vaccine doses by the end of 1996 gave rise to 173 potentially serious reactions claimed to have been caused by MMR vaccination. In all, 77 neurologic, 73 allergic and 22 miscellaneous reactions and 1 death were reported, febrile seizure being the most common event. However, 45% of these events proved to be probably caused or contributed by some other factor, giving an incidence of serious adverse events with possible or indeterminate causal relation with MMR vaccination of 5.3 per 100 000 vaccinees or 3.2 per 100 000 vaccine doses.

Conclusions. Causality between immunization and a subsequent untoward event cannot be estimated solely on the basis of a temporal relation. Comprehensive analysis of the reported adverse reactions established that serious events causally related to MMR vaccine are rare and greatly outweighed by the risks of natural MMR diseases.

From the Hospital for Children and Adolescents, Helsinki University Central Hospital (AP, MJTK, HP), the National Public Health Institute (ID, MV) and the Department of Obstetrics and Gynecology, Helsinki University Central Hospital (TK), Helsinki, Finland.

Accepted for publication July 24, 2000.

Address for reprints: Annamari Patja, M.D., Hospital for Children and Adolescents, Helsinki University Central Hospital, Lastenlinnantie 11 C 22, PL 280 00029 Hyks, Finland. Fax 358-9-471 80288; E-mail annamari.patja@hus.fi.

© 2000 Lippincott Williams & Wilkins, Inc.