Measles, Mumps and Rubella Vaccine

Feb 12, 2010

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

One of my favourite TV shows was the X-files. It wasnt just because it came on Sunday nights when I was supposed to be studying. I loved watching FBI Agents Mulder and Scully tracking down UFOs, government conspiracies, ghosts and aliens. There was the Cigarette Smoking Man whose name we never learned but who periodically gave our daring duo tips about the UFO related Black Ops the government was up to. The tag line for the show was The Truth is Out There.

I couldnt help but think that the truth might be out there in Newfoundland recently. Residents of Harbour Mille, Newfoundland reported seeing a UFO flying over their community Monday, January 25, 2010. The UFO pictures I saw were taken by Harbour Mille resident Darlene Stewart. The UFO looked missile-like to me. However the Prime Ministers Office and Department of National Defence denied that any missile was fired. I thought the story felt very X-Files-ish. The problem is that if you are always chasing UFOs and government conspiracies, sometimes you miss the truth that is out there right in front of your nose. One recent conspiracy theory said that the Measles, Mumps, and Rubella or MMR vaccine caused autism. The truth on that conspiracy became even more clear recently and not everyone will be happy.

The MMR vaccine prevents three different viral diseases. Measles, mumps and rubella have no effective treatments once a patient is infected. However, they can be prevented by getting the vaccine before exposure to the virus.

Measles is not a deadly disease in most people. It causes a rash, fever, runny nose and cough that lasts one to two weeks. Why vaccinate against it then? Because large outbreaks of the disease usually happen in children. A small percentage of these children develop meningitis, an inflammation of the brain and spinal cord that can cause headaches, seizures, coma and/or long term brain damage. In rare cases it can even cause death.

Mumps is an uncomfortable condition. It can cause painful, swollen saliva glands (usually in the cheeks) and fever. Painful inflammation of the testicles can occur in 1 out of 4 boys beyond puberty and painful inflammation of the ovaries in about 5% of girls beyond puberty. Again brain lining inflammation (or meningitis) is a rare but serious possibility.

Rubella is an important disease to avoid during pregnancy, as it can damage the unborn baby. Rubella can cause brain damage, an unusually small head, deafness, heart defects, blindness, small eyes, diabetes or death in the unborn child. About 90% of women infected with rubella during the first trimester of pregnancy will give birth to babies with problems. So it is important to try to protect all children at a young age from rubella so they dont contract the disease when they get pregnant later in life or give the disease to a pregnant woman.

The MMR vaccine is very effective. It protects 94% of those immunized verses rubella, 81% verses mumps and 88% verses measles. Measles protection goes up to 99% after two vaccinations. Protection is believed to be lifelong in most people for all three diseases. So where does the MMR vaccine-autism link come from?

Back in 1998 there was a study published in the Lancet by Dr. AJ Wakefield and colleagues. They looked at 12 children that had lost acquired skills like language. These children ranged in age from 3 to 10 years and 11of the 12 were boys. These children could have had Autism Spectrum Disorder, depending on how that condition is defined. Of these 12 children, eight of them had developed autism like symptoms after the MMR vaccine as determined by the parents. So the controversy began.

What was wrong with people questioning MMR vaccine after those reports? Nothing. But the popular media seemed to ignore that the study was only a study of 12 children, not the 1000s of people that we usually like to see in a study. The celebrities who announced MMR causes autism seemed to ignore that since 1998 at least a dozen studies looked for a connection between MMR and autism and found none. Now the original publisher, the Lancet, has actually retracted the original study. On February 2, 2010 the Lancet published a short retraction that said in part Following the judgment of the UK General Medical Councils Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al are incorrectTherefore we fully retract this paper from the published record.

So the system worked, right? The flawed paper was eventually pulled and now everyone knows the MMR vaccine doesnt cause autism. Well, unfortunately due to some celebrity endorsements, I think some people will always believe MMR is a conspiracy to cause autism. The original author, Dr. Wakefield and has said the Panels findings were unjust and and unfounded. But more importantly because fewer parents gave their children the MMR vaccine in the last 12 years, there will be more outbreaks of measles, mumps and rubella.

You dont believe me? Well in 2004-2005 there was a mumps epidemic in the United Kingdom. The highest rate of infection was among those born during 1983-1986. People in England and Wales born before 1987 were generally not eligible for a mumps vaccine. Only 2.4% of confirmed cases of mumps during the 2004-2005 outbreak would have been eligible for the routine 2 doses of MMR vaccine. There were probably other factors involved, but this seems a clear case of people who didnt get a mumps vaccine getting sick more often than would be expected.

So the truth is still out there. However in ten to twenty years the conspiracy might be the autism-MMR scare of the late 1990s, and early 2000s lead to a lot of pain, suffering and possible death due to measles, mumps and rubella.

UFO in Newfoundland link : http://www.cbc.ca/canada/newfoundland-labrador/story/2010/01/28/ufo-newfoundland-pmo.html

Lancet retraction link: http://download.thelancet.com/flatcontentassets/pdfs/S0140673610601754.pdf

As always if you have any questions or concerns about these or other products, ask your pharmacist.

 


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