Table 4:
Summary of the epidemiologic studies on relationship between MMR vaccine and autoimmune diseases
| Type vaccine | Study design | Patients | Findings: primary effect size estimated (95% CI or p value) | Ref |
|---|---|---|---|---|
| Studies included in the weight of epidemiologic evidence for MMR Vaccine and transient arthralgia in women and children | ||||
| MMR vaccine | Retrospective study | - 485 vaccinated women; | Vaccinated: 4 cases of arthralgia (0.8%). Unvaccinated: 3 cases of arthralgia (0.6%). Differences were not statistically significant | [118] |
| - 493 unvaccinated women | ||||
| Double-blind, randomized controlled trial | -268 vaccinated, | Acute arthralgia or arthritis within 12 months of rubella vaccination: 1.73 (95% CI, 1.17–2.57) | [119] | |
| -275 received placebo | ||||
| Retrospective study | -971 seronegative, vaccinated women, | Vaccinated: 4 patients diagnosed as acute arthralgias cases and 1 as indeterminate, seropositive, unvaccinated. Controls: one acute event |
[120] | |
| -2,421 seropositive, unvaccinated, aged-matched controls; | ||||
| -924 seronegative, unvaccinated, unmatched controls | ||||
| Double-blind, randomized, controlled trial | Presence of Dominican Republic-2 (DR2) virus: | Acute arthralgia or arthritis within 12 months of rubella vaccination in women expressing DR2: 4.8 (95% CI, 1.2–18.8) | [121] | |
| 41 vaccinated; | ||||
| 38 received placebo | ||||
| MMR vaccine | Double-blind, controlled crossover study | 581 twin pairs | Maximum difference rate of arthropathy between MMR vaccine and placebo groups at 7–9 days after vaccination: 0.8% (95% CI, 0.2–1.3%) | [122] |
| Double-blind, controlled crossover study | 581 twin pairs, separated into two age groups: 14–18 months and 6 years of age | Adjusted OR of arthralgia in the 14–18 month age group within 21 days of MMR vaccination: 3.66 (95% CI, 1.74–7.70) | [123] | |
| Double-blind, randomized control trial | 2,216 vaccinated with MMR II, 3,521 unvaccinated | MMR II group: 8 joint reactions (primarily transient arthralgia) within 30 days of vaccination | [124] | |
| Case-control | 125 patients with psoriatic arthritis; 163 patients with psoriasis | OR for psoriatic arthritis after rubella vaccination: 12.4 (95% CI, 1.20–122.14) | [125] | |
| Studies included in the weight of epidemiologic evidence for MMR Vaccine and Type 1 Diabetes | ||||
| MMR vaccine | Case-control | -393 children with type 1 diabetes; | OR for type 1 diabetes diagnosis; any time after MMR vaccination: 0.95 (95% CI, 0.71–1.28) OR for type 1 diabetes diagnosis any time after measles vaccination: 0.74 (95% CI, 0.55–1.00) OR for type 1 diabetes diagnosis any time after mumps vaccination: 1.75 (95% CI, 0.54–5.70). OR for type 1 diabetes diagnosis any time after rubella vaccination: 1.24 (95% CI,0.41–3.73) | [126] |
| -786 controls matched on age, sex, and county | ||||
| Case-control | -136 children with type 1 diabetes; | OR for type 1 diabetes diagnosis any time after MMR vaccination: 0.382 (95% CI, 0.201–0.798) OR for type 1 diabetes diagnosis any time after measles vaccination: 0.777 (95% CI, 0.403–1.498) | [127] | |
| -272 controls matched on age and registration with the same family pediatrician | ||||
| Retrospective cohort | 739,694 children | Rate ratio for type 1 diabetes diagnosis any time after one dose of MMR vaccine compared to the unexposed: 1.14 (95% CI, 0.90–1.45) | [56] | |