Original Article
A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism
N Engl J Med 2002; 347:1477-1482November 7, 2002
- Abstract
Background
It has been suggested that vaccination against measles, mumps, and rubella (MMR) is a cause of autism.
Methods
We conducted a retrospective cohort study of all children born in Denmark from January 1991 through December 1998. The cohort was selected on the basis of data from the Danish Civil Registration System, which assigns a unique identification number to every live-born infant and new resident in Denmark. MMR-vaccination status was obtained from the Danish National Board of Health. Information on the children's autism status was obtained from the Danish Psychiatric Central Register, which contains information on all diagnoses received by patients in psychiatric hospitals and outpatient clinics in Denmark. We obtained information on potential confounders from the Danish Medical Birth Registry, the National Hospital Registry, and Statistics Denmark.
Results
Of the 537,303 children in the cohort (representing 2,129,864 person-years), 440,655 (82.0 percent) had received the MMR vaccine. We identified 316 children with a diagnosis of autistic disorder and 422 with a diagnosis of other autistic-spectrum disorders. After adjustment for potential confounders, the relative risk of autistic disorder in the group of vaccinated children, as compared with the unvaccinated group, was 0.92 (95 percent confidence interval, 0.68 to 1.24), and the relative risk of another autistic-spectrum disorder was 0.83 (95 percent confidence interval, 0.65 to 1.07). There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder.
Conclusions
This study provides strong evidence against the hypothesis that MMR vaccination causes autism.
Media in This Article
Table 1
Characteristics of the 537,303 Children in the Danish Cohort.Table 2
Adjusted Relative Risk of Autistic Disorder and of Other Autistic-Spectrum Disorders in Vaccinated and Unvaccinated Children.Article Activity
- Article
It has been suggested that the measles, mumps, and rubella (MMR) vaccine causes autism.1-4 The widespread use of the MMR vaccine has reportedly coincided with an increase in the incidence of autism in California,5 and there are case reports of children in whom signs of both developmental regression and gastrointestinal symptoms developed shortly after MMR vaccination.1 Measles virus has been found in the terminal ileum in children with developmental disorders and gastrointestinal symptoms but not in developmentally normal children with gastrointestinal symptoms.6 The measles virus used in the MMR vaccine is a live attenuated virus that normally causes no symptoms or only very mild ones. However, wild-type measles can infect the central nervous system and even cause postinfectious encephalomyelitis, probably as a result of an immune-mediated response to myelin proteins.7-9
Studies designed to evaluate the suggested link between MMR vaccination and autism do not support an association, but the evidence is weak and based on case-series, cross-sectional, and ecologic studies. No studies have had sufficient statistical power to detect an association, and none had a population-based cohort design.10-16 The World Health Organization and other organizations have requested further investigation of the hypothetical association between the MMR vaccine and autism.2,17-20 We evaluated the hypothesis in a cohort study that included all children born in Denmark in 1991 through 1998.
Methods
Study Design
We designed a retrospective follow-up study of all children born in Denmark during the period from January 1, 1991, to December 31, 1998. The cohort was established on the basis of data obtained from the Danish Civil Registration System and five other national registries.
All live-born children and new residents in Denmark are assigned a unique personal identification number (a civil-registry number), which is stored in the Danish Civil Registration System together with information on vital status, emigration, disappearance, address, and family members (mother, father, and siblings).21 The registry is updated once a week, and all changes in the stored information are reported to the registry according to established legal procedures. The civil-registry number is used as the link to information at the individual level in all other national registries. This system provides completely accurate linkage of information between registries at the individual level.
We determined MMR-vaccination status on the basis of vaccination data reported to the National Board of Health by general practitioners, who administer all MMR vaccinations in Denmark. The general practitioners are reimbursed by the state on the basis of these reports. We retrieved information on vaccinations from 1991 through 1999. The MMR vaccine was introduced in Denmark in 1987, and the single-antigen measles vaccine has not been used. The MMR vaccine used in Denmark during the study period was identical to that used in the United States and contained the following vaccine strains: Moraten (measles), Jeryl Lynn (mumps), and Wistar RA 27/3 (rubella).
The national vaccination program recommends that children be vaccinated at 15 months of age and again at 12 years. No change was made in the program during the study period. We obtained information on MMR vaccination at 15 months of age, since only this exposure is relevant to the end point under study. Since the vaccination data are transferred to the National Board of Health once a week, we chose Wednesday as the day of vaccination. When the vaccination information was recorded with the child's own civil-registry number, the information was directly linked with other registries. Before 1996, in most cases the vaccination information and the age of the child were recorded with the civil-registry number of the accompanying adult; we used information from the Danish Civil Registration System to identify the link from the accompanying adult to the child. Thus, 98.5 percent of the children were identified with the use of the child's civil-registry number or the civil-registry number of the mother or father and the age of the child at vaccination. The remaining 1.5 percent of children were identified on the basis of additional information from the Danish Civil Registration System on other relatives and information on the address at the time of vaccination.
Information about diagnoses of autism was obtained from the Danish Psychiatric Central Register, which contains information on all diagnoses received by patients in psychiatric hospitals, psychiatric departments, and outpatient clinics in Denmark.22 In our cohort, 93.1 percent of the children were treated only as outpatients, and 6.9 percent were at some point treated as inpatients in a psychiatric department. All diagnoses were based on the International Classification of Diseases, 10th Revision (ICD-10), which is similar to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) with regard to autism.23-26 In Denmark, children are referred to specialists in child psychiatry by general practitioners, schools, and psychologists if autism is suspected. Only specialists in child psychiatry diagnose autism and assign a diagnostic code, and all diagnoses are recorded in the Danish Psychiatric Central Register. We identified all children given a diagnosis of autistic disorder (ICD-10 code F84.0 and DSM-IV code 299.00) or another autistic-spectrum disorder (ICD-10 codes F84.1 through F84.9 and DSM-IV codes 299.10 and 299.80). When a child was given diagnoses of both autistic disorder and one or more other autistic-spectrum disorders, we classified the diagnosis as autistic disorder. Autism is associated with the inherited genetic conditions tuberous sclerosis, Angelman's syndrome, and the fragile X syndrome and with congenital rubella. To maximize the homogeneity of the study population, data for children with these conditions were censored when the diagnosis was made. We obtained information on these conditions from the National Hospital Registry.
We performed an extensive record review for 40 children with autistic disorder (13 percent of all the children with autistic disorder) to validate the diagnosis of autism. A consultant in child psychiatry with expertise in autism examined the medical records. Thirty-seven of the children (92 percent) met the operational criteria for autistic disorder according to a systematic coding scheme developed by the Centers for Disease Control and Prevention for surveillance of autism and used in a prevalence study in Brick Township, New Jersey.27 The three children who did not meet the criteria for autistic disorder were all classified as having other autistic-spectrum disorders. For two of the children, the diagnosis of autistic disorder was questionable because of profound intellectual impairment. For the third child, we did not have information about the onset of symptoms before the age of three years, which is a prerequisite for the diagnosis of autistic disorder.
We obtained information on birth weight and gestational age from the Danish Medical Birth Registry and the National Hospital Registry.28,29 Information on potential confounders, including socioeconomic status (as indicated by the employment status of the head of the household) and mother's education was obtained from Statistics Denmark from the time when the child was 15 months of age.
Statistical Analysis
Follow-up for the diagnosis of autistic disorder or another autistic-spectrum disorder began for all children on the day they reached one year of age and continued until the diagnosis of autism or an associated condition (the fragile X syndrome, Angelman's syndrome, tuberous sclerosis, or congenital rubella), emigration, death, or the end of follow-up, on December 31, 1999, whichever occurred first. The incidence-rate ratios for autistic disorder and other autistic-spectrum disorders in the group of vaccinated children, as compared with the unvaccinated group, were examined in a log-linear Poisson regression model with the use of PROC GENMOD (SAS, version 6.12).30 We treated vaccination as a time-dependent covariate. The children were assigned to the nonvaccinated group until they received the MMR vaccine. From that date, they were followed in the vaccinated group. In additional analyses, the MMR-vaccinated children were grouped according to their age at the time of vaccination, the interval since vaccination, and the calendar period when vaccination was performed.
In reporting the results, we refer to the incidence-rate ratios as relative risks. For all risk estimates, we considered possible confounding by age (1, 2, 3, 4, 5, 6, 7, or 8 to 9 years), sex, calendar period (1992 to 1993, 1994, 1995, 1996, 1997, 1998, or 1999; for other autistic-spectrum disorders, the years 1992, 1993, and 1994 were grouped together), socioeconomic status (six groups), mother's education (five groups), gestational age (≤36, 37 to 41, or ≥42 weeks), and birth weight (≤2499, 2500 to 2999, 3000 to 3499, 3500 to 3999, or ≥4000 g).
Results
A total of 537,303 children were included in the cohort and followed for a total of 2,129,864 person-years. Follow-up of 5811 children was stopped before December 31, 1999, because of a diagnosis of autistic disorder (in 316 children), other autistic-spectrum disorders (in 422), tuberous sclerosis (in 35), congenital rubella (in 2), or the fragile X or Angelman's syndrome (in 8), and because of death or emigration in the cases of 5028 children, whose data were censored. For children who received MMR vaccine, there were 1,647,504 person-years of follow-up, and for children who did not receive the vaccine, there were 482,360 person-years of follow-up.
Table 1Table 1
Characteristics of the 537,303 Children in the Danish Cohort. shows the distribution of the MMR cohort according to vaccination status, sex, birth weight, gestational age, socioeconomic status, mother's education, and age when autism was diagnosed. The mean age at diagnosis was four years and three months for autistic disorder and five years and three months for other autistic-spectrum disorders. The mean age at the time of the MMR vaccination was 17 months, and 98.5 percent of the vaccinated children were vaccinated before 3 years of age. The proportion of children who were vaccinated was the same among boys and girls (82.0 percent).Table 2Table 2
Adjusted Relative Risk of Autistic Disorder and of Other Autistic-Spectrum Disorders in Vaccinated and Unvaccinated Children. shows the association between variables related to MMR vaccination and the risk of autism. We calculated the relative risk with adjustment for age, calendar period, sex, birth weight, gestational age, mother's education, and socioeconomic status. Overall, there was no increase in the risk of autistic disorder or other autistic-spectrum disorders among vaccinated children as compared with unvaccinated children (adjusted relative risk of autistic disorder, 0.92; 95 percent confidence interval, 0.68 to 1.24; adjusted relative risk of other autistic-spectrum disorders, 0.83; 95 percent confidence interval, 0.65 to 1.07). Furthermore, we found no association between the development of autistic disorder and the age at vaccination (P=0.23), the interval since vaccination (P=0.42), or the calendar period at the time of vaccination (P=0.06).Adjustment for potential confounders with the exception of age resulted in similar estimates of risk. Changing the start of follow-up for autistic disorder and other autistic-spectrum disorders to the date of birth or 16 months of age had little effect on the estimates (data not shown). Furthermore, including children with the fragile X syndrome, tuberous sclerosis, congenital rubella, or Angelman's syndrome in the analysis did not change the estimates (data not shown).
Discussion
This study provides three strong arguments against a causal relation between MMR vaccination and autism. First, the risk of autism was similar in vaccinated and unvaccinated children, in both age-adjusted and fully adjusted analyses. Second, there was no temporal clustering of cases of autism at any time after immunization. Third, neither autistic disorder nor other autistic-spectrum disorders were associated with MMR vaccination. Furthermore, the results were derived from a nationwide cohort study with nearly complete follow-up data.
All previous studies of an association between autism and MMR vaccination have been case series,1,14,15 ecologic studies,11,12 or cross-sectional studies,10,13 and the majority have not used optimal data for risk assessment. In a well-conducted, cross-sectional prevalence study, Taylor and colleagues10 found that there was no sharp increase in the prevalence of autism after the introduction of the MMR vaccine. However, it could be argued that a more gradual increase would be expected, since autism is characterized by an insidious onset and a delay in diagnosis. A case-series study by Peltola et al.15 also provides evidence against a causal connection.
One of the main reasons for public concern has been that the widespread use of the MMR vaccine in some regions appeared to coincide with an increase in the incidence of autism. However, this is not a uniform finding. In Denmark, the prevalence of autism (according to the criteria of the International Classification of Diseases, 8th Revision) was less than 2.0 cases per 10,000 children between the ages of five and nine years in the 1980s and the beginning of the 1990s. Since then, the rates have increased in all age groups except for children younger than two years of age, and in 2000, the prevalence of autism (according to the ICD-10 criteria) was higher than 10.0 cases per 10,000 children five to nine years of age (unpublished data). Thus, the increase in autism both in California5 and in Denmark occurred well after the introduction of the MMR vaccine.
Our study was based on individual reports of vaccination and diagnoses of autism in a well-defined geographic area. The exposure data were collected prospectively, independently of parental recall and before the diagnosis of autism. Furthermore, the diagnosis was recorded independently of the recording of MMR vaccination. Thus, there was little possibility of differential misclassification of exposure or outcome measures. Furthermore, our analysis was based on complete follow-up data.
We assume that the data on MMR vaccination are almost complete, since general practitioners in Denmark are reimbursed only after reporting immunization data to the National Board of Health. We had an unvaccinated reference group with almost 500,000 person-years of follow-up, even though the study was numerically imbalanced in favor of the vaccinated group. The power of the study is reflected in the narrow 95 percent confidence intervals.
We had no information on the presence or absence of a family history of autism, which could explain our negative findings only if families with a history of autism avoided MMR vaccination. If so, we would expect to have found high relative risks at the beginning of the study period, before the hypothetical link between vaccination and autism was publicized. This was not the case. We had no information on whether the children with autism had regression, and thus we could not perform a subgroup analysis. However, the fact that the overall relative risk of autism or an autistic-spectrum disorder was less than 1.0 does not support the possibility of a subgroup of vulnerable children.
The Danish vaccination program recommends that children receive the MMR vaccine at 15 months of age and provides the vaccination free of charge. Among the children in our cohort who were born in 1995, the rate of MMR vaccination was lower than the rate of vaccination with the first Haemophilus influenzae type B vaccine (86.9 percent vs. 97.0 percent). However, the rate of MMR vaccination in our study was similar to that in the United States (87.6 percent in 1995) and Belgium (83.0 percent in 1997).31,32 Nevertheless, the main concern is the comparability of vaccinated and nonvaccinated children in relation to the end point under study. In all analyses, when risk estimates were calculated, we controlled for possible confounders (age, sex, calendar period, socioeconomic status, mother's education, gestational age, and birth weight). Except for age, none of these possible confounders changed the estimates. The confounding by age was a function of the time available for follow-up, since much of the follow-up for the unvaccinated group involved young children, in whom autism is often undiagnosed.
We assessed the validity of the diagnosis of autistic disorder in a subgroup of children and found it to be high. This was to be expected, since only specialists in child and adolescent psychiatry are authorized to code the diagnosis of autism in the Danish Psychiatric Central Register. All schools have access to health care personnel as well as psychologists. Because of the comprehensive health care surveillance for children in Denmark, all severe cases of autism are likely to be diagnosed and reported to the registry at some point. Reporting of the other autistic-spectrum disorders is less complete than that for autistic disorder, and some diagnoses are almost certainly missed. However, it is unlikely that this misclassification would be associated with vaccination status. It is very difficult to determine the onset of autism, and many cases are probably due to prenatal factors. Our records did not contain information on when the first autistic symptoms were noted, and we could not adjust for a differential delay in the diagnosis. Again, it is highly unlikely that a delayed diagnosis was associated with MMR vaccination in this study.
There are few published data on the incidence of autism, but the prevalence rates reported in the literature vary widely, from 1.2 cases per 10,000 (according to the criteria of the third edition of the Diagnostic and Statistical Manual of Mental Disorders) to 30.8 per 10,000 (according to the ICD-10 criteria).33,34 The prevalence rates among eight-year-old children in our cohort were 7.7 per 10,000 for autistic disorder and 22.2 per 10,000 for other autistic-spectrum disorders. These rates are similar to the prevalence rates of 5.4 per 10,000 for autistic disorder and 16.3 per 10,000 for other autistic-spectrum disorders in a cohort of 325,347 French children (ICD-10 criteria), reported by Fombonne et al.,35 and the rate of 11 per 10,000 for autistic disorder in a cohort of U.S. children (DSM-IV criteria), reported by Croen and colleagues.36 The DSM-IV classification system used in the United States and the ICD-10 classification system used in many European countries are almost identical with regard to the classification of autistic disorder.23-26 In our validity substudy, we found that 93 percent of cases diagnosed according to the ICD-10 criteria met the DSM-IV operational criteria for the diagnosis of autistic disorder.
Supported by grants from the Danish National Research Foundation; the National Vaccine Program Office and National Immunization Program, Centers for Disease Control and Prevention; and the National Alliance for Autism Research.
We are indebted to Susanne Toft and Meta Jørgensen for the abstraction and review of medical records and to Catherine Rice and Nancy Dornberg for assistance with the validity substudy.
Source Information
From the Danish Epidemiology Science Center, Department of Epidemiology and Social Medicine, Århus, Denmark (K.M.M., M.V., P.T., J.O.); the Danish Epidemiology Science Center, Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (A.H., J.W., M.M.); and the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta (D.S.).
Address reprint requests to Dr. Madsen at the Danish Epidemiology Science Center, Department of Epidemiology and Social Medicine, Vennelyst Blvd. 6, DK-8000, Aarhus C, Denmark, or at kmm@dadlnet.dk.
- References
References
1
Wakefield AJ ,Murch SH ,Anthony A , et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998;351:637-641
CrossRef | Web of Science | Medline2
Stratton K, Gable A, Shetty P, McCormick M, eds. Immunization safety review: measles-mumps-rubella vaccine and autism. Washington, D.C.: National Academy Press, 2001.
3
Wakefield AJ ,Montgomery SM . Measles, mumps, rubella vaccine: through a glass, darkly. Adverse Drug React Toxicol Rev 2000;19:265-283
Medline4
Autism: present challenges, future needs — why the increased rates? Hearing before the Committee of Government Reform, U.S. House of Representatives, 106th Congress, second session, April 6, 2000. Washington, D.C.: Government Printing Office, 2000.
5
Department of Developmental Services. Changes in the population of persons with autism and pervasive developmental disorders in California's Developmental Services System: 1987 through 1998: a report to the Legislature. Sacramento: California Health and Human Services Agency, March 1999.
6
Uhlmann V ,Martin CM ,Sheils O , et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Mol Pathol 2002;55:84-90
CrossRef | Medline7
Griffin DE ,Ward BJ ,Jauregui E ,Johnson RT ,Vaisberg A . Immune activation in measles. N Engl J Med 1989;320:1667-1672
Full Text | Web of Science | Medline8
Singh VK ,Lin SX ,Newell E ,Nelson C . Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism. J Biomed Sci 2002;9:359-364
CrossRef | Web of Science | Medline9
Johnson RT ,Griffin DE ,Hirsch RL , et al. Measles encephalomyelitis -- clinical and immunologic studies. N Engl J Med 1984;310:137-141
Full Text | Web of Science | Medline10
Taylor B ,Miller E ,Farrington CP , et al. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet 1999;353:2026-2029
CrossRef | Web of Science | Medline11
Kaye JA ,del Mar Melero-Montes M ,Jick H . Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. BMJ 2001;322:460-463
CrossRef | Web of Science | Medline12
Dales L ,Hammer SJ ,Smith NJ . Time trends in autism and in MMR immunization coverage in California. JAMA 2001;285:1183-1185
CrossRef | Web of Science | Medline13
Fombonne E ,Chakrabarti S . No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics 2001;108:991-991 abstract.
CrossRef | Web of Science14
Patja A ,Davidkin I ,Kurki T ,Kallio MJ ,Valle M ,Peltola H . Serious adverse events after measles-mumps-rubella vaccination during a fourteen-year prospective follow-up. Pediatr Infect Dis J 2000;19:1127-1134
CrossRef | Web of Science | Medline15
Peltola H ,Patja A ,Leinikki P ,Valle M ,Davidkin I ,Paunio M . No evidence for measles, mumps, and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study. Lancet 1998;351:1327-1328
CrossRef | Web of Science | Medline16
Taylor B ,Miller E ,Lingram L ,Andrews N ,Simmons A ,Stowe J . Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. BMJ 2002;324:393-396
CrossRef | Web of Science | Medline17
Causality assessment of adverse events following immunization. Wkly Epidemiol Rec 2001;76:85-89
Medline18
Smeeth L ,Hall AJ ,Rodrigues LC ,Huang X ,Smith PG ,Fombonne E . Measles, mumps, and rubella (MMR) vaccine and autism: ecological studies cannot answer main question. BMJ 2001;323:163-163
CrossRef | Web of Science | Medline19
Edwardes M ,Baltzan M . MMR immunization and autism. JAMA 2001;285:2852-2853
CrossRef | Web of Science | Medline20
Measles, MMR, and autism: the confusion continues. Lancet 2000;355:1379-1379
CrossRef | Web of Science | Medline21
Malig C. The civil registration system in Denmark. IIVRS technical paper no. 66. Bethesda, Md.: International Institute for Vital Registration and Statistics, 1996.
22
Munk-Jorgensen P ,Mortensen PB . The Danish Psychiatric Central Register. Dan Med Bull 1997;44:82-84
Web of Science | Medline23
The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: World Health Organization, 1993.
24
Filipek PA ,Accardo PJ ,Baranek GT , et al. The screening and diagnosis of autistic spectrum disorders. J Autism Dev Disord 1999;29:439-484[Erratum, J Autism Dev Disord 2000;30:81.]
CrossRef | Web of Science | Medline25
Volkmar FR ,Klin A ,Siegel B , et al. Field trial for autistic disorder in DSM-IV. Am J Psychiatry 1994;151:1361-1367
Web of Science | Medline26
Hill A ,Bolte S ,Petrova G ,Beltcheva D ,Tacheva S ,Poustka F . Stability and interpersonal agreement of the interview-based diagnosis of autism. Psychopathology 2001;34:187-191
CrossRef | Web of Science | Medline27
Bertrand J ,Mars A ,Boyle C ,Bove F ,Yeargin-Allsopp M ,Decoufle P . Prevalence of autism in a United States population: the Brick Township, New Jersey, investigation. Pediatrics 2001;108:1155-1161
CrossRef | Web of Science | Medline28
Knudsen LB ,Olsen J . The Danish Medical Birth Registry. Dan Med Bull 1998;45:320-323
Web of Science | Medline29
Andersen TF ,Madsen M ,Jorgensen J ,Mellemkjoer L ,Olsen JH . The Danish National Hospital Register: a valuable source of data for modern health sciences. Dan Med Bull 1999;46:263-268
Web of Science | Medline30
Clayton D, Hills M. Statistical models in epidemiology. Oxford, England: Oxford University Press, 1993.
31
Vellinga A ,Depoorter AM ,Van Damme P . Vaccination coverage estimates by EPI cluster sampling survey of children (18-24 months) in Flanders, Belgium. Acta Paediatr 2002;91:599-603
CrossRef | Web of Science | Medline32
Epidemiology and prevention of vaccine-preventable diseases. 7th ed. Atlanta: Centers for Disease Control and Prevention, 2002.
33
Burd L ,Fisher W ,Kerbeshian J . A prevalence study of pervasive developmental disorders in North Dakota. J Am Acad Child Adolesc Psychiatry 1987;26:700-703
CrossRef | Web of Science | Medline34
Baird G ,Charman T ,Baron-Cohen S , et al. A screening instrument for autism at 18 months of age: a 6-year follow-up study. J Am Acad Child Adolesc Psychiatry 2000;39:694-702
CrossRef | Web of Science | Medline35
Fombonne E ,Du Mazaubrun C ,Cans C ,Grandjean H . Autism and associated medical disorders in a French epidemiological survey. J Am Acad Child Adolesc Psychiatry 1997;36:1561-1569
CrossRef | Web of Science | Medline36
Croen LA ,Grether JK ,Hoogstrate J ,Selvin S . The changing prevalence of autism in California. J Autism Dev Disord 2002;32:207-215
CrossRef | Web of Science | Medline
- Citing Articles (130)
Citing Articles
1
William J Moss, Diane E Griffin. (2012) Measles. The Lancet 379:9811, 153-164
CrossRef2
Dorothea Matysiak-Klose, Faruque Ahmed, Philippe Duclos, Yngve Falck-Ytter, Frode Forland, Hans Houweling, Piotr Kramarz, Joanne M. Langley, Thomas Mertens, Holger Schünemann, Kamel Senouci, Jonathan Temte, Ole Wichmann. (2011) Report on the 1st international workshop on procedures for the development of evidence-based vaccination recommendations, Berlin, Germany, 22–23 November 2010. Vaccine
CrossRef3
Nick Andrews. (2011) Epidemiological designs for vaccine safety assessment: Methods and pitfalls. Biologicals
CrossRef4
Daniel KL Cheuk, Virginia Wong, Wen Xiong Chen, Daniel KL Cheuk. 2011. Acupuncture for autism spectrum disorders (ASD). .
CrossRef5
Gayle DeLong. (2011) A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population. Journal of Toxicology and Environmental Health, Part A 74:14, 903-916
CrossRef6
Maryam M. Abdullah, Agnes R. Ly, Wendy A. Goldberg, K. Alison Clarke-Stewart, John V. Dudgeon, Christopher G. Mull, Tony J. Chan, Erin E. Kent, Andrew Z. Mason, Jonathon E. Ericson. (2011) Heavy Metal in Children’s Tooth Enamel: Related to Autism and Disruptive Behaviors?. Journal of Autism and Developmental Disorders
CrossRef7
Nick Andrews, Julia Stowe, Elizabeth Miller, Henrik Svanström, Kari Johansen, Jan Bonhoeffer, Anders Hviid. (2011) A collaborative approach to investigating the risk of thrombocytopenic purpura after measles–mumps–rubella vaccination in England and Denmark. Vaccine
CrossRef8
Dan Anderberg, Arnaud Chevalier, Jonathan Wadsworth. (2011) Anatomy of a health scare: Education, income and the MMR controversy in the UK. Journal of Health Economics 30:3, 515-530
CrossRef9
Jouko Miettunen, Jaana Suvisaari, Jari Haukka, Matti Isohanni. 2011. Use of Register Data for Psychiatric Epidemiology in the Nordic Countries. , 117-131.
CrossRef10
Masayoshi Kawai, Kenji J. Tsuchiya, Nori Takei. 2011. Recent Epidemiological Studies of Psychiatric Disorders in Japan. , 559-577.
CrossRef11
Lise Aagaard, Erik Wind Hansen, Ebba Holme Hansen. (2011) Adverse events following immunization in children: retrospective analysis of spontaneous reports over a decade. European Journal of Clinical Pharmacology 67:3, 283-288
CrossRef12
Helen V. Ratajczak. (2011) Theoretical aspects of autism: Causes—A review. Journal of Immunotoxicology 8:1, 68-79
CrossRef13
Brynn E Berger, Ann Navar-Boggan, Saad B Omer. (2011) Congenital rubella syndrome and autism spectrum disorder prevented by rubella vaccination - United States, 2001-2010. BMC Public Health 11:1, 340
CrossRef14
C M Hultman, S Sandin, S Z Levine, P Lichtenstein, A Reichenberg. (2010) Advancing paternal age and risk of autism: new evidence from a population-based study and a meta-analysis of epidemiological studies. Molecular Psychiatry
CrossRef15
Emily Hensley, Leslie Briars. (2010) Closer look at autism and the measles-mumps-rubella vaccine. Journal of the American Pharmacists Association 50:6, 736-741
CrossRef16
Raphael Bernier, Alice Mao, Jennifer Yen. (2010) Psychopathology, Families, and Culture: Autism. Child and Adolescent Psychiatric Clinics of North America 19:4, 855-867
CrossRef17
Jennifer Saracino, Julianne Noseworthy, Mandy Steiman, Lisa Reisinger, Eric Fombonne. (2010) Diagnostic and Assessment Issues in Autism Surveillance and Prevalence. Journal of Developmental and Physical Disabilities 22:4, 317-330
CrossRef18
Michael J. Smith, Gary S. Marshall. (2010) Navigating Parental Vaccine Hesitancy. Pediatric Annals 39:8, 476-482
CrossRef19
Dorota Mrożek-Budzyn, Agnieszka Kiełtyka, Renata Majewska. (2010) Lack of Association Between Measles-Mumps-Rubella Vaccination and Autism in Children. The Pediatric Infectious Disease Journal 29:5, 397-400
CrossRef20
Philip J Landrigan. (2010) What causes autism? Exploring the environmental contribution. Current Opinion in Pediatrics 22:2, 219-225
CrossRef21
Niall F. Davis, Barry B. McGuire, Jackie A. Mahon, Anna E. Smyth, Kiaran J. O’Malley, John M. Fitzpatrick. (2010) The increasing incidence of mumps orchitis: a comprehensive review. BJU International 105:8, 1060-1065
CrossRef22
M. Posserud, Astri J. Lundervold, Stein Atle Lie, Christopher Gillberg. (2010) The prevalence of autism spectrum disorders: impact of diagnostic instrument and non-response bias. Social Psychiatry and Psychiatric Epidemiology 45:3, 319-327
CrossRef23
2010. References. , 529-685.
CrossRef24
Marlene B. Lauritsen, Meta Jørgensen, Kreesten M. Madsen, Sanne Lemcke, Susanne Toft, Jakob Grove, Diana E. Schendel, Poul Thorsen. (2010) Validity of Childhood Autism in the Danish Psychiatric Central Register: Findings from a Cohort Sample Born 1990–1999. Journal of Autism and Developmental Disorders 40:2, 139-148
CrossRef25
G. Ashwell. (2009) Autism and Asperger's syndrome. InnovAiT 2:11, 651-656
CrossRef26
K. Weißer, I. Barth, B. Keller-Stanislawski. (2009) Sicherheit von Impfstoffen. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 52:11, 1053-1064
CrossRef27
Michelle Cheh, Alycia Halladay, Carrie Yochum, Kenneth Reuhl, Marianne Polunas, Xue Ming, George Wagner. 2009. Autism and Oxidative Stress. , 131-152.
CrossRef28
John M. Kelso, James T. Li, Richard A. Nicklas, Joann Blessing-Moore, Linda Cox, David M. Lang, John Oppenheimer, Jay M. Portnoy, Christopher Randolph, Diane E. Schuller, Sheldon L. Spector, Stephen Tilles, Dana Wallace, Zuhair K. Ballas, James R. Baker, Joseph A. Bellanti, Daniel Ein, Leslie C. Grammer. (2009) Adverse reactions to vaccines. Annals of Allergy, Asthma & Immunology 103:4, S1-S14
CrossRef29
S. E. Mouridsen, K-M. Hauschild. (2009) A longitudinal study of autism spectrum disorders in individuals diagnosed with a developmental language disorder as children. Child: Care, Health and Development 35:5, 691-697
CrossRef30
Rebecca Podolsky, Miriam Cremer, Jessica Atrio, Tsivia Hochman, Alan A. Arslan. (2009) HPV Vaccine Acceptability by Latino Parents: A Comparison of U.S. and Salvadoran Populations. Journal of Pediatric and Adolescent Gynecology 22:4, 205-215
CrossRef31
Lisa Miller, Joni Reynolds. (2009) Autism and Vaccination-The Current Evidence. Journal for Specialists in Pediatric Nursing 14:3, 166-172
CrossRef32
ERIC FOMBONNE. (2009) Epidemiology of Pervasive Developmental Disorders. Pediatric Research 65:6, 591-598
CrossRef33
Mogens Vestergaard, Jakob Christensen. (2009) Register-based studies on febrile seizures in Denmark
. Brain and Development 31:5, 372-377
CrossRef34
Jeffrey S. Gerber, Paul A. Offit. (2009) Vaccines and Autism: A Tale of Shifting Hypotheses. Clinical Infectious Diseases 48:4, 456-461
CrossRef35
P. Lenoir, C. Bodier, H. Desombre, J. Malvy, B. Abert, M. Ould Taleb, D. Sauvage. (2009) Sur la prévalence de l’autisme et des troubles envahissants du développement (TED). L'Encéphale 35:1, 36-42
CrossRef36
Georgina Peacock, Marshalyn Yeargin-Allsopp. (2009) Autism Spectrum Disorders: Prevalence and Vaccines. Pediatric Annals 38:1, 22-25
CrossRef37
Gerry A. Stefanatos. (2008) Regression in Autistic Spectrum Disorders. Neuropsychology Review 18:4, 305-319
CrossRef38
Rikke Damkjaer Maimburg, Michael Vaeth, Diana Elizabeth Schendel, Bodil Hammer Bech, Jørn Olsen, Poul Thorsen. (2008) Neonatal jaundice: a risk factor for infantile autism?. Paediatric and Perinatal Epidemiology 22:6, 562-568
CrossRef39
Isabelle Rapin, Roberto F. Tuchman. (2008) Autism: Definition, Neurobiology, Screening, Diagnosis. Pediatric Clinics of North America 55:5, 1129-1146
CrossRef40
Timothy Milewa, Martin Buxton, Stephen Hanney. (2008) Lay involvement in the public funding of medical research: expertise and counter-expertise in empirical and analytical perspective. Critical Public Health 18:3, 357-366
CrossRef41
Maria E Johnson, Cary Sanders, Jeffrey L Rausch. 2008. The Gene-Environment Interaction in Asperger's Disorder. , 205-232.
CrossRef42
Karen Honey. (2008) Attention focuses on autism. Journal of Clinical Investigation 118:5, 1586-1587
CrossRef43
Julie S. Downs, Wändi Bruine de Bruin, Baruch Fischhoff. (2008) Parents’ vaccination comprehension and decisions. Vaccine 26:12, 1595-1607
CrossRef44
D Avdjieva-Tzavella. (2008) Genetic and Non Genetic Aspects of Autism Spectrum Disorders. Balkan Journal of Medical Genetics 11:1, 3-10
CrossRef45
Dan Waisman, Oskar Baenziger, Nachum Gall. 2008. Hyperbaric Oxygen Therapy in Newborn Infants and Pediatric Patients. , 95-116.
CrossRef46
F DeStefano. (2007) Vaccines and Autism: Evidence Does Not Support a Causal Association. Clinical Pharmacology & Therapeutics 82:6, 756-759
CrossRef47
Ashraf Gad, Shetal Shah. (2007) Special Immunization Considerations of the Preterm Infant. Journal of Pediatric Health Care 21:6, 385-391
CrossRef48
Rachel Elizabeth Casiday. (2007) Children's health and the social theory of risk: Insights from the British measles, mumps and rubella (MMR) controversy. Social Science & Medicine 65:5, 1059-1070
CrossRef49
Neil Winterton. (2007) In praise of (some) mavericks?. Clean Technologies and Environmental Policy 9:3, 153-155
CrossRef50
Virginia Hughes. (2007) Mercury rising. Nature Medicine 13:8, 896-897
CrossRef51
Cabot, Richard C.Harris, Nancy Lee, Shepard, Jo-Anne O., Rosenberg, Eric S., Cort, Alice M., Ebeling, Sally H.Peters, Christine C., Duggan, Christopher P., Westra, Sjirk J., Rosenberg, Andrew E., . (2007) Case 23-2007. New England Journal of Medicine 357:4, 392-400
Full Text52
Judith H. Miles, T. Nicole Takahashi. (2007) Lack of association between Rh status, Rh immune globulin in pregnancy and autism. American Journal of Medical Genetics Part A 143A:13, 1397-1407
CrossRef53
Apoorva Mandavilli. (2007) Unreasonable doubt. news@nature
CrossRef54
James E. Carr, Linda A. LeBlanc. (2007) Autism Spectrum Disorders in Early Childhood: An Overview for Practicing Physicians. Primary Care: Clinics in Office Practice 34:2, 343-359
CrossRef55
Natasha J Brown, Samuel F Berkovic, Ingrid E Scheffer. (2007) Vaccination, seizures and ‘vaccine damage’. Current Opinion in Neurology 20:2, 181-187
CrossRef56
Hj??rd??s ??sk Atlad??ttir, Erik T. Parner, Diana Schendel, S??ren Dalsgaard, Per Hove Thomsen, Poul Thorsen. (2007) Variation in Incidence of Neurodevelopmental Disorders With Season of Birth. Epidemiology 18:2, 240-245
CrossRef57
Tokio Uchiyama, Michiko Kurosawa, Yutaka Inaba. (2007) MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan. Journal of Autism and Developmental Disorders 37:2, 210-217
CrossRef58
Jennifer Singh, Joachim Hallmayer, Judy Illes. (2007) Interacting and paradoxical forces in neuroscience and society. Nature Reviews Neuroscience 8:2, 153-160
CrossRef59
Anthony R Cox, Harold Kirkham. (2007) A Case Study of a Graphical Misrepresentation. Drug Safety 30:10, 831-836
CrossRef60
Tom L. Kurt. (2006) ACMT position statement: The Iom report on thimerosal and autism. Journal of Medical Toxicology 2:4, 170-171
CrossRef61
William J. Moss, Diane E. Griffin. (2006) Global measles elimination. Nature Reviews Microbiology 4:12, 900-908
CrossRef62
Nick Andrews. (2006) Vaccine scares. Significance 3:4, 158-161
CrossRef63
Nicholas Wood, Peter McIntyre, Melanie Wong. (2006) Vaccination for the paediatrician. Journal of Paediatrics and Child Health 42:11, 665-673
CrossRef64
C. P. Farrington, H. J. Whitaker. (2006) Semiparametric analysis of case series data. Journal of the Royal Statistical Society: Series C (Applied Statistics) 55:5, 553-594
CrossRef65
Robert T. Brown, Erinn S. Gideons. (2006) Etiology of Developmental Disorders: Good Science, Bad Science, and Pseudoscience. International Journal of Anthropology 21:1, 75-82
CrossRef66
Isabelle Rapin. (2006) Language heterogeneity and regression in the autism spectrum disorders—Overlaps with other childhood language regression syndromes. Clinical Neuroscience Research 6:3-4, 209-218
CrossRef67
R. D. Maimburg, M. Vaeth. (2006) Perinatal risk factors and infantile autism. Acta Psychiatrica Scandinavica 114:4, 257-264
CrossRef68
Anders Hviid. (2006) Postlicensure epidemiology of childhood vaccination: the Danish experience. Expert Review of Vaccines 5:5, 641-649
CrossRef69
B. Taylor. (2006) Vaccines and the changing epidemiology of autism. Child: Care, Health and Development 32:5, 511-519
CrossRef70
Marian Sigman, Sarah J. Spence, A. Ting Wang. (2006) Autism from Developmental and Neuropsychological Perspectives. Annual Review of Clinical Psychology 2:1, 327-355
CrossRef71
J A S Vorstman, W G Staal, E van Daalen, H van Engeland, P F R Hochstenbach, L Franke. (2006) Identification of novel autism candidate regions through analysis of reported cytogenetic abnormalities associated with autism. Molecular Psychiatry 11:1, 18-28
CrossRef72
E. Jane Costello, Debra L. Foley, Adrian Angold. (2006) 10-Year Research Update Review: The Epidemiology of Child and Adolescent Psychiatric Disorders: II. Developmental Epidemiology. Journal of the American Academy of Child & Adolescent Psychiatry 45:1, 8-25
CrossRef73
Rachel E Casiday, Anthony R Cox. (2006) Restoring Confidence in Vaccines by Explaining Vaccine Safety Monitoring. Drug Safety 29:12, 1105-1109
CrossRef74
Eric Fombonne. (2005) The Changing Epidemiology of Autism. Journal of Applied Research in Intellectual Disabilities 18:4, 281-294
CrossRef75
François Simondon, Jacques Vaugelade. (2005) Beneficial and adverse side effects of vaccination: perception in developing countries. Expert Review of Vaccines 4:6, 785-787
CrossRef76
(2005) Register now: validity later. Acta Psychiatrica Scandinavica 112:6, 407-408
CrossRef77
Angus Dawson. (2005) Risk perceptions and ethical public health policy: MMR vaccination in the UK. Poiesis & Praxis 3:4, 229-241
CrossRef78
Lara Stern, Marie-Josée Francoeur, Marie-Noel Primeau, Wendy Sommerville, Eric Fombonne, Bruce D. Mazer. (2005) Immune function in autistic children. Annals of Allergy, Asthma & Immunology 95:6, 558-565
CrossRef79
Guido Fran??ois, Philippe Duclos, Harold Margolis, Daniel Lavanchy, Claire-Anne Siegrist, Andr?? Meheus, Paul-Henri Lambert, Nedret Emiro??lu, Selim Badur, Pierre Van Damme. (2005) Vaccine Safety Controversies and the Future of Vaccination Programs. The Pediatric Infectious Disease Journal 24:11, 953-961
CrossRef80
Vittorio Demicheli, Tom Jefferson, Alessandro Rivetti, Deirdre Price, Vittorio Demicheli. 2005. Vaccines for measles, mumps and rubella in children. .
CrossRef81
Marlene Briciet Lauritsen, Carsten Bocker Pedersen, Preben Bo Mortensen. (2005) Effects of familial risk factors and place of birth on the risk of autism: a nationwide register-based study. Journal of Child Psychology and Psychiatry 46:9, 963-971
CrossRef82
C. T Bauch. (2005) Imitation dynamics predict vaccinating behaviour. Proceedings of the Royal Society B: Biological Sciences 272:1573, 1669-1675
CrossRef83
&NA;. (2005) There is a lack of scientific evidence for a causal association between MMR vaccination and autism. Drugs & Therapy Perspectives 21:7, 22-23
CrossRef84
Hideo Honda, Yasuo Shimizu, Michael Rutter. (2005) No effect of MMR withdrawal on the incidence of autism: a total population study. Journal of Child Psychology and Psychiatry 46:6, 572-579
CrossRef85
Ian Amanna, Mark K. Slifka. (2005) Public Fear of Vaccination: Separating Fact From Fiction. Viral Immunology 18:2, 307-315
CrossRef86
Rhiannon Luyster, Jennifer Richler, Susan Risi, Wan-Ling Hsu, Geraldine Dawson, Raphael Bernier, Michelle Dunn, Susan Hepburn, Susan Hyman, William McMahon, Julie Goudie-Nice, Nancy Minshew, Sally Rogers, Marian Sigman, M. Anne Spence, Wendy Goldberg, Helen Tager-Flusberg, Fred Volkmar, Catherine Lord. (2005) Early Regression in Social Communication in Autism Spectrum Disorders: A CPEA Study. Developmental Neuropsychology 27:3, 311-336
CrossRef87
H. J. Larsson. (2005) Risk Factors for Autism: Perinatal Factors, Parental Psychiatric History, and Socioeconomic Status. American Journal of Epidemiology 161:10, 916-925
CrossRef88
E. Hak, Y. Schönbeck, H. De Melker, G.A. Van Essen, E.A.M. Sanders. (2005) Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vaccination program. Vaccine 23:24, 3103-3107
CrossRef89
ANGUS DAWSON. (2005) THE DETERMINATION OF 'BEST INTERESTS' IN RELATION TO CHILDHOOD VACCINATIONS (published in Bioethics 19(1)). Bioethics 19:2, 187-205
CrossRef90
Jane Libbey, Thayne Sweeten, William McMahon, Robert Fujinami. (2005) Autistic disorder and viral infections. Journal of NeuroVirology 11:1, 1-10
CrossRef91
ANGUS DAWSON. (2005) THE DETERMINATION OF THE BEST INTERESTS IN RELATION TO CHILDHOOD IMMUNISATION*. Bioethics 19:1, 72-89
CrossRef92
Susan L Santangelo, Katherine Tsatsanis. (2005) What is Known About Autism. American Journal of PharmacoGenomics 5:2, 71-92
CrossRef93
M. Rutter. (2005) Incidence of autism spectrum disorders: Changes over time and their meaning*. Acta Paediatrica 94:1, 2
CrossRef94
Barbara Sperner-Unterweger. (2005) Immunological Aetiology of Major Psychiatric Disorders. Drugs 65:11, 1493-1520
CrossRef95
Eva Dannetun, Anders Tegnell, Göran Hermansson, Johan Giesecke. (2005) Parents’ reported reasons for avoiding MMR vaccination. Scandinavian Journal of Primary Health Care 23:3, 149-153
CrossRef96
M. Rutter. (2005) Incidence of autism spectrum disorders: Changes over time and their meaning*. Acta Paediatrica 94:1, 2-15
CrossRef97
Mark Noble. 2004. Neural Precursor Cells and Toxicant Action. , 1-27.
CrossRef98
Arun Chakrabarty, Karl Beutner. (2004) Therapy of other viral infections: herpes to hepatitis. Dermatologic Therapy 17:6, 465-490
CrossRef99
P. I. Folb, E. Bernatowska, R. Chen, J. Clemens, A. N. O. Dodoo, S. S. Ellenberg, C. P. Farrington, T. J. John, P.-H. Lambert, N. E. MacDonald, E. Miller, D. Salisbury, H.-J. Schmitt, C.-A. Siegrist, O. Wimalaratne. (2004) A Global Perspective on Vaccine Safety and Public Health: The Global Advisory Committee on Vaccine Safety. American Journal of Public Health 94:11, 1926-1931
CrossRef100
David B. Huang, Jashin J. Wu, Stephen K. Tyring. (2004) A review of licensed viral vaccines, some of their safety concerns, and the advances in the development of investigational viral vaccines. Journal of Infection 49:3, 179-209
CrossRef101
Liam Smeeth, Claire Cook, Eric Fombonne, Lisa Heavey, Laura C Rodrigues, Peter G Smith, Andrew J Hall. (2004) MMR vaccination and pervasive developmental disorders: a case-control study. The Lancet 364:9438, 963-969
CrossRef102
Shaine A Morris, Henry H Bernstein. (2004) Immunizations, neonatal jaundice, and animal-induced injuries. Current Opinion in Pediatrics 16:4, 450-460
CrossRef103
Jick, Hershel, Kaye, James A., . (2004) Autism and DPT Vaccination in the United Kingdom. New England Journal of Medicine 350:26, 2722-2723
Full Text104
E. J. Woo, R. Ball, A. Bostrom, S. V. Shadomy, L. K. Ball, G. Evans, M. Braun. (2004) Vaccine Risk Perception Among Reporters of Autism After Vaccination: Vaccine Adverse Event Reporting System 1990-2001. American Journal of Public Health 94:6, 990-995
CrossRef105
Hélène Verdoux. (2004) Perinatal risk factors for schizophrenia: How specific are they?. Current Psychiatry Reports 6:3, 162-167
CrossRef106
Tom Jefferson. (2004) Informed choice and balance are victims of the MMR-autism saga. The Lancet Infectious Diseases 4:3, 135-136
CrossRef107
G. La Malfa, S. Lassi, M. Bertelli, R. Salvini, G. F. Placidi. (2004) Autism and intellectual disability: a study of prevalence on a sample of the Italian population. Journal of Intellectual Disability Research 48:3, 262-267
CrossRef108
C. Rice, D. Schendel, C. Cunniff, N. Doernberg. (2004) Public health monitoring of developmental disabilities with a focus on the autism spectrum disorders. American Journal of Medical Genetics 125C:1, 22-27
CrossRef109
Frank DeStefano, William W Thompson. (2004) MMR vaccine and autism: an update of the scientific evidence. Expert Review of Vaccines 3:1, 19-22
CrossRef110
Kreesten M Madsen, Mogens Vestergaard. (2004) MMR Vaccination and Autism. Drug Safety 27:12, 831-840
CrossRef111
Deborah K. Sokol, Mary Edwards-Brown. (2004) Neuroimaging in Autistic Spectrum Disorder (ASD). Journal of Neuroimaging 14:1, 8-15
CrossRef112
Paul A Offit, Susan E Coffin. (2003) Communicating science to the public: MMR vaccine and autism. Vaccine 22:1, 1-6
CrossRef113
S. M. Mackell. (2003) Vaccinations for the Pediatric Traveler. Clinical Infectious Diseases 37:11, 1508-1516
CrossRef114
David C. G. Skegg. (2003) Autism and Measles-Mumps-Rubella (MMR) Vaccination: A Challenge for Pharmacoepidemiology. Pharmacotherapy 23:12, 1521-1523
CrossRef115
Hershel Jick, James A. Kaye. (2003) Epidemiology and Possible Causes of Autism. Pharmacotherapy 23:12, 1524-1530
CrossRef116
Jos
F. Cordero. (2003) A new look at behavioral outcomes and teratogens: A commentary. Birth Defects Research Part A: Clinical and Molecular Teratology 67:11, 900-902
CrossRef117
Glenn F. Rall. (2003) M
EASLES VIRUS 1998–2002: Progress and Controversy*. Annual Review of Microbiology 57:1, 343-367
CrossRef118
Carolyn Gallagher. (2003) ‘Parsimonious’ Versus Patient-Centered Care: Quality Issues in Childhood Immunization. Journal for Healthcare Quality 25:5, 28-35
CrossRef119
Hershel Jick, James A. Kaye, Corri Black. (2003) Changes in Risk of Autism in the U.K. for Birth Cohorts 1990–1998. Epidemiology 14:5, 630-632
CrossRef120
Mikko Paunio, Klaus Hedman, Irja Davidkin, Heikki Peltola. (2003) IgG avidity to distinguish secondary from primary measles vaccination failures: prospects for a more effective global measles elimination strategy. Expert Opinion on Pharmacotherapy 4:8, 1215-1225
CrossRef121
Gary E. Marchant. (2003) From General Policy to Legal Rule: Aspirations and Limitations of the Precautionary Principle. Environmental Health Perspectives 111:14, 1799-1803
CrossRef122
Thea Kuddo, Karin B. Nelson. (2003) How common are gastrointestinal disorders in children with autism?. Current Opinion in Pediatrics 15:3, 339-343
CrossRef123
Mike M Pütz, Fabienne B Bouche, Rik L de Swart, Claude P Muller. (2003) Experimental vaccines against measles in a world of changing epidemiology. International Journal for Parasitology 33:5-6, 525-545
CrossRef124
(2003) Current Awareness: Pharmacoepidemiology and Drug Safety. Pharmacoepidemiology and Drug Safety 12:3, 253-268
CrossRef125
(2003) Measles, Mumps, and Rubella Vaccination and Autism. New England Journal of Medicine 348:10, 951-954
Full Text126
P D Griffiths. (2003) Vaccines: back to the future. Reviews in Medical Virology 13:2, 69-70
CrossRef127
Paul A Offit. (2003) The power of ‘box a’. Expert Review of Vaccines 2:1, 1-3
CrossRef128
Keri Wellington, Karen L Goa. (2003) Measles, Mumps, Rubella Vaccine (Priorix???; GSK-MMR). Drugs 63:19, 2107-2126
CrossRef129
Campion, Edward W., . (2002) Suspicions about the Safety of Vaccines. New England Journal of Medicine 347:19, 1474-1475
Full Text130
&NA;. (2002) MMR vaccine not associated with autism. Reactions Weekly &NA;:928, 3
CrossRef
- Letters
