Vaccines for measles, mumps, rubella, and varicella in children
- PMID: 34806766
- PMCID: PMC8607336
- DOI: 10.1002/14651858.CD004407.pub5
Vaccines for measles, mumps, rubella, and varicella in children
Abstract
Background: Measles, mumps, rubella, and varicella (chickenpox) are serious diseases that can lead to serious complications, disability, and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness. This is an update of a review published in 2005 and updated in 2012.
Objectives: To assess the effectiveness, safety, and long- and short-term adverse effects associated with the trivalent vaccine, containing measles, rubella, mumps strains (MMR), or concurrent administration of MMR vaccine and varicella vaccine (MMR+V), or tetravalent vaccine containing measles, rubella, mumps, and varicella strains (MMRV), given to children aged up to 15 years.
Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 5), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 2 May 2019), Embase (1974 to 2 May 2019), the WHO International Clinical Trials Registry Platform (2 May 2019), and ClinicalTrials.gov (2 May 2019).
Selection criteria: We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), prospective and retrospective cohort studies (PCS/RCS), case-control studies (CCS), interrupted time-series (ITS) studies, case cross-over (CCO) studies, case-only ecological method (COEM) studies, self-controlled case series (SCCS) studies, person-time cohort (PTC) studies, and case-coverage design/screening methods (CCD/SM) studies, assessing any combined MMR or MMRV / MMR+V vaccine given in any dose, preparation or time schedule compared with no intervention or placebo, on healthy children up to 15 years of age.
Data collection and analysis: Two review authors independently extracted data and assessed the methodological quality of the included studies. We grouped studies for quantitative analysis according to study design, vaccine type (MMR, MMRV, MMR+V), virus strain, and study settings. Outcomes of interest were cases of measles, mumps, rubella, and varicella, and harms. Certainty of evidence of was rated using GRADE.
Main results: We included 138 studies (23,480,668 participants). Fifty-one studies (10,248,159 children) assessed vaccine effectiveness and 87 studies (13,232,509 children) assessed the association between vaccines and a variety of harms. We included 74 new studies to this 2019 version of the review. Effectiveness Vaccine effectiveness in preventing measles was 95% after one dose (relative risk (RR) 0.05, 95% CI 0.02 to 0.13; 7 cohort studies; 12,039 children; moderate certainty evidence) and 96% after two doses (RR 0.04, 95% CI 0.01 to 0.28; 5 cohort studies; 21,604 children; moderate certainty evidence). The effectiveness in preventing cases among household contacts or preventing transmission to others the children were in contact with after one dose was 81% (RR 0.19, 95% CI 0.04 to 0.89; 3 cohort studies; 151 children; low certainty evidence), after two doses 85% (RR 0.15, 95% CI 0.03 to 0.75; 3 cohort studies; 378 children; low certainty evidence), and after three doses was 96% (RR 0.04, 95% CI 0.01 to 0.23; 2 cohort studies; 151 children; low certainty evidence). The effectiveness (at least one dose) in preventing measles after exposure (post-exposure prophylaxis) was 74% (RR 0.26, 95% CI 0.14 to 0.50; 2 cohort studies; 283 children; low certainty evidence). The effectiveness of Jeryl Lynn containing MMR vaccine in preventing mumps was 72% after one dose (RR 0.24, 95% CI 0.08 to 0.76; 6 cohort studies; 9915 children; moderate certainty evidence), 86% after two doses (RR 0.12, 95% CI 0.04 to 0.35; 5 cohort studies; 7792 children; moderate certainty evidence). Effectiveness in preventing cases among household contacts was 74% (RR 0.26, 95% CI 0.13 to 0.49; 3 cohort studies; 1036 children; moderate certainty evidence). Vaccine effectiveness against rubella, using a vaccine with the BRD2 strain which is only used in China, is 89% (RR 0.11, 95% CI 0.03 to 0.42; 1 cohort study; 1621 children; moderate certainty evidence). Vaccine effectiveness against varicella (any severity) after two doses in children aged 11 to 22 months is 95% in a 10 years follow-up (rate ratio (rr) 0.05, 95% CI 0.03 to 0.08; 1 RCT; 2279 children; high certainty evidence). Safety There is evidence supporting an association between aseptic meningitis and MMR vaccines containing Urabe and Leningrad-Zagreb mumps strains, but no evidence supporting this association for MMR vaccines containing Jeryl Lynn mumps strains (rr 1.30, 95% CI 0.66 to 2.56; low certainty evidence). The analyses provide evidence supporting an association between MMR/MMR+V/MMRV vaccines (Jeryl Lynn strain) and febrile seizures. Febrile seizures normally occur in 2% to 4% of healthy children at least once before the age of 5. The attributable risk febrile seizures vaccine-induced is estimated to be from 1 per 1700 to 1 per 1150 administered doses. The analyses provide evidence supporting an association between MMR vaccination and idiopathic thrombocytopaenic purpura (ITP). However, the risk of ITP after vaccination is smaller than after natural infection with these viruses. Natural infection of ITP occur in 5 cases per 100,000 (1 case per 20,000) per year. The attributable risk is estimated about 1 case of ITP per 40,000 administered MMR doses. There is no evidence of an association between MMR immunisation and encephalitis or encephalopathy (rate ratio 0.90, 95% CI 0.50 to 1.61; 2 observational studies; 1,071,088 children; low certainty evidence), and autistic spectrum disorders (rate ratio 0.93, 95% CI 0.85 to 1.01; 2 observational studies; 1,194,764 children; moderate certainty). There is insufficient evidence to determine the association between MMR immunisation and inflammatory bowel disease (odds ratio 1.42, 95% CI 0.93 to 2.16; 3 observational studies; 409 cases and 1416 controls; moderate certainty evidence). Additionally, there is no evidence supporting an association between MMR immunisation and cognitive delay, type 1 diabetes, asthma, dermatitis/eczema, hay fever, leukaemia, multiple sclerosis, gait disturbance, and bacterial or viral infections. AUTHORS' CONCLUSIONS: Existing evidence on the safety and effectiveness of MMR/MMRV vaccines support their use for mass immunisation. Campaigns aimed at global eradication should assess epidemiological and socioeconomic situations of the countries as well as the capacity to achieve high vaccination coverage. More evidence is needed to assess whether the protective effect of MMR/MMRV could wane with time since immunisation.
Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Conflict of interest statement
Carlo Di Pietrantonj: none known Alessandro Rivetti: none known Pasquale Marchione: none known Maria Grazia Debalini: none known Vittorio Demicheli: none known
Figures
Update of
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Vaccines for measles, mumps, rubella, and varicella in children.Cochrane Database Syst Rev. 2020 Apr 20;4(4):CD004407. doi: 10.1002/14651858.CD004407.pub4. Cochrane Database Syst Rev. 2020. Update in: Cochrane Database Syst Rev. 2021 Nov 22;11:CD004407. doi: 10.1002/14651858.CD004407.pub5. PMID: 32309885 Free PMC article. Updated.
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cb‐Jacobsen 2009 {published data only}
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- Jacobsen SJ, Ackerson BK, Sy LS, Tran TN, Jones TL, Yao JF, et al. Observational safety study of febrile convulsion following first dose MMRV vaccination in a managed care setting. Vaccine 2009;27(34):4656-61. [PMID: ] - PubMed
cb‐Jain 2015 {published data only}
-
- Jain A, Marshall J, Buikema A, Bancroft T, Kelly JP, Newschaffer CJ. Autism occurrence by MMR vaccine status among US children with older siblings with and without autism. JAMA 2015;313(15):1534-40. - PubMed
cb‐Klein 2010 {published data only}
-
- Klein NP. Measles-mumps-rubella-varicella combination vaccine increases risk of febrile seizure. Pediatrics 2011;126(1):170. - PubMed
cb‐Klein 2012 {published data only}
-
- Klein NP, Lewis E, Baxter R, Weintraub E, Glanz J, Naleway A, et al. Measles-containing vaccines and febrile seizures in children age 4 to 6 years. Pediatrics 2012;129(5):809-14. [PMID: ] - PubMed
cb‐Klein 2017 {published data only}
-
- Klein NP, Lewis E, McDonald J, Fireman B, Naleway A, Glanz J, et al. Risk factors and familial clustering for fever 7-10 days after the first dose of measles vaccines. Vaccine 2017;35(12):1615-21. - PubMed
cb‐Madsen 2002 {published data only}
-
- Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, et al. A population-based study of measles, mumps, and rubella vaccination and autism. New England Journal of Medicine 2002;347(19):1477-82. - PubMed
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- Noble KK, Miyasaka K. Measles, mumps, and rubella vaccination and autism. New England Journal of Medicine 2003;348(10):951-4; author reply 951-4. - PubMed
cb‐Makino 1990 {published data only}
-
- Makino S, Sasaki K, Nakayama T, Oka S, Urano T, Kimura M, et al. A new combined trivalent live measles (AIK-C strain), mumps (Hoshino strain), and rubella (Takahashi strain) vaccine. Findings in clinical and laboratory studies. American Journal of Diseases in Children 1990;144(8):905-10. - PubMed
cb‐McKeever 2004 {published data only}
cb‐Miller 1989 {published data only}
-
- Miller C, Miller E, Rowe K, Bowie C, Judd M, Walker D. Surveillance of symptoms following MMR vaccine in children. Practitioner 1989;233(1461):69-73. - PubMed
cb‐Mrozek‐Budzyn 2013 {published data only}
cb‐Robertson 1988 {published data only}
cb‐Rowhani‐Rahbar 2013 {published data only}
-
- Rowhani-Rahbar A, Fireman B, Lewis E, Nordin J, Naleway A, Jacobsen SJ, et al. Effect of age on the risk of fever and seizures following immunization with measles-containing vaccines in children. JAMA Pediatrics 2013;167(12):1111-7. [PMID: ] - PubMed
cb‐Schink 2014 {published data only}
-
- Gvozdenovic E, Vetter V, Willame C, Rosillon D. Impact of history of febrile convulsions on the risk difference of febrile convulsions with the tetravalent measles-mumps-rubella-varicella vaccine: post-hoc exploratory analysis of results from a matched-cohort study. Vaccine 2018;36(39):5803-6. - PubMed
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- Schink T, Holstiege J, Kowalzik F, Zepp F, Garbe E. Risk of febrile convulsions after MMRV vaccination in comparison to MMR or MMR+V vaccination. Vaccine 2014;32(6):645-50. [PMID: ] - PubMed
cb‐Sharma 2010 {published data only}
-
- Sharma HJ, Oun SA, Bakr SS, Kapre SV, Jadhav SS, Dhere RM, et al. No demonstrable association between the Leningrad-Zagreb mumps vaccine strain and aseptic meningitis in a large clinical trial in Egypt. Clinical Microbiology and Infection 2010;16(4):347-52. - PubMed
cb‐Stokes 1971 {published data only}
-
- Stokes JJ, Weibel RE, Villarejos VM, Arguedas JA, Buynak EB, Hilleman MR. Trivalent combined measles-mumps-rubella vaccine. Findings in clinical-laboratory studies. JAMA 1971;218(1):57-61. - PubMed
cb‐Swartz 1974 {published data only}
-
- Swartz TA, Klingberg W, Klingberg MA. Combined trivalent and bivalent measles, mumps and rubella virus vaccination. A controlled trial. Infection 1974;2(3):115-7. - PubMed
cb‐Timmermann 2015 {published data only}
cb‐Uchiyama 2007 {published data only}
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- Uchiyama T, Kurosawa M, Inaba Y. MMR-vaccine and regression in autism spectrum disorders: negative results presented from Japan. Journal of Autism and Developmental Disorders 2007;37(2):210-7. - PubMed
cb‐Vestergaard 2004 {published data only}
-
- Vestergaard M, Hviid A, Madsen KM, Wohlfahrt J, Thorsen P, Schendel D, et al. MMR vaccination and febrile seizures: evaluation of susceptible subgroups and long-term prognosis. JAMA 2004;292(3):351-7. - PubMed
cb‐Weibel 1980 {published data only}
-
- Weibel RE, Carlson AJ Jr, Villarejos VM, Buynak EB, McLean AA, Hilleman MR. Clinical and laboratory studies of combined live measles, mumps, and rubella vaccines using the RA 27/3 rubella virus. Proceedings of the Society for Experimental Biology and Medicine 1980;165(2):323-6. - PubMed
db‐Andrews 2012 {published data only}
-
- Andrews N, Stoweb J, Miller E, Svanström H, Johansen K, Bonhoeffer J, et al, VAESCO consortium. A collaborative approach to investigating the risk of thrombocytopenic purpura after measles–mumps–rubella vaccination in England and Denmark. Vaccine 2012;30:3042-6. [DOI: 10.1016/j.vaccine.2011.06.009] - DOI - PubMed
db‐Dourado 2000 {published data only}
-
- Dourado I, Cunha S, Teixeira MG, Farrington CP, Melo A, Lucena R, et al. 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(5):524-30. - PubMed
db‐Farrington 1995 {published data only}
-
- Farrington CP, Miller E, Taylor B. MMR and autism: further evidence against a causal association. Vaccine 2001;19(27):3632-5. - PubMed
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- Farrington CP, Nash J, Miller E. Case series analysis of adverse reactions to vaccines: a comparative evaluation. American Journal of Epidemiology 1996;143(11):1165-73. - PubMed
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- Farrington P, Pugh S, Colville A, Flower A, Nash J, Morgan-Capner P, et al. A new method for active surveillance of adverse events from diphtheria/tetanus/pertussis and measles/mumps/rubella vaccines. Lancet 1995;345(8949):567-9. - PubMed
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- Miller E. MMR vaccine: review of benefits and risks. Journal of Infection 2002;44(1):1-6. - PubMed
db‐France 2008 {published data only}
-
- France EK, Glanz J, Xu S, Hambidge S, Yamasaki K, Black SB, et al. Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children. Pediatrics 2008;121(3):e687-92. - PubMed
db‐Macartney 2017 {published data only}
db‐MacDonald 2014 {published data only}
db‐Makela 2002 {published data only}
-
- Makela A, Nuorti JP, Peltola H. Neurologic disorders after measles-mumps-rubella vaccination. Pediatrics 2002;110(5):957-63. - PubMed
db‐McClure 2019 {published data only}
db‐Miller 2003 {published data only}
db‐Miller 2005 {published data only}
db‐Miller 2007 {published data only}
-
- Miller E, Andrews N, Stowe J, Grant A, Waight P, Taylor B. Risks of convulsion and aseptic meningitis following measles-mumps-rubella vaccination in the United Kingdom. American Journal of Epidemiology 2007;165(6):704-9. - PubMed
db‐O'Leary 2012 {published and unpublished data}
db‐Perez‐Vilar 2018 {published data only}
db‐Stowe 2009 {published data only}
-
- Stowe J, Andrews N, Taylor B, Miller E. No evidence of an increase of bacterial and viral infections following measles, mumps and rubella vaccine. Vaccine 2009;27(9):1422-5. - PubMed
db‐Taylor 1999 {published data only}
-
- Taylor B, Miller E, Farrington CP, Petropoulos MC, Favot-Mayaud I, Li J, et al. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet 1999;353(9169):2026-9. - PubMed
db‐Ward 2007 {published data only}
-
- Ward KN, Bryant NJ, Andrews NJ, Bowley JS, Ohrling A, Verity CM, et al. Risk of serious neurologic disease after immunization of young children in Britain and Ireland. Pediatrics 2007;120(2):314-21. - PubMed
eb‐Ki 2003 {published data only}
eb‐Lafaurie 2018 {published data only}
-
- Lafaurie M, Baricault B, Lapeyre-Mestre M, Sailler L, Moulis G, Sommet A, et al. Risk of vaccine-induced immune thrombocytopenia in children. Nationwide case cross-over and self controlled case series studies in France. Fundamental & Clinical Pharmacology 2018;32:86.
eb‐Park 2004 {published data only}
-
- Park T, Ki M, Yi SG. Statistical analysis of MMR vaccine adverse events on aseptic meningitis using the case cross-over design. Statistics in Medicine 2004;23(12):1871-83. - PubMed
ga‐Boccalini 2015 {published data only}
ga‐Pozza 2011 {published data only}
-
- Pozza F, Piovesan C, Russo F, Bella A, Pezzotti P, Emberti Gialloreti L. Impact of universal vaccination on the epidemiology of varicella in Veneto, Italy. Vaccine 2011;29(51):9480-7. [PMID: ] - PubMed
ga‐Tafuri 2015 {published data only}
gb‐da Cunha 2002 {published data only}
-
- da Cunha SS, Rodrigues LC, Barreto ML, Dourado I. Outbreak of aseptic meningitis and mumps after mass vaccination with MMR vaccine using the Leningrad-Zagreb mumps strain. Vaccine 2002;20(7-8):1106-12. - PubMed
gb‐da Silveira 2002 {published data only}
-
- da Silveira CM, Kmetzsch CI, Mohrdieck R, Sperb AF, Prevots DR. The risk of aseptic meningitis associated with the Leningrad-Zagreb mumps vaccine strain following mass vaccination with measles-mumps-rubella vaccine, Rio Grande do Sul, Brazil, 1997. International Journal of Epidemiology 2002;31(5):978-82. - PubMed
gb‐Fombonne 2001 {published data only}
-
- Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics 2001;108(4):E58. - PubMed
gb‐Fombonne 2006 {published data only}
-
- Fombonne E, Zakarian R, Bennett A, Meng L, McLean-Heywood D. Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations. Pediatrics 2006;118(1):e139-50. - PubMed
gb‐Honda 2005 {published data only}
-
- Honda H, Shimizu Y, Rutter M. No effect of MMR withdrawal on the incidence of autism: a total population study. Journal of Child Psychology and Psychiatry, and Allied Disciplines 2005;46(6):572-9. - PubMed
gb‐Jonville‐Bera 1996 {published data only}
-
- Jonville-Bera AP, Autret E, Galy-Eyraud C, Hessel L. Thrombocytopenic purpura after measles, mumps and rubella vaccination: a retrospective survey by the French Regional Pharmacovigilance Centres and Pasteur-Mérieux Sérums et Vaccins. Pediatric Infectious Disease Journal 1996;15(1):44-8. - PubMed
gb‐Seagroatt 2005 {published data only}
gb‐Taylor 2002 {published data only}
References to studies excluded from this review
Akobeng 1999 {published data only}
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- Akobeng AK, Thomas AG. Inflammatory bowel disease, autism, and the measles, mumps, and rubella vaccine. Journal of Pediatric Gastroenterology and Nutrition 1999;28(3):351-2. - PubMed
Andre 1984 {published data only}
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- Andre FE. Summary of clinical studies with the Oka live varicella vaccine produced by Smith Kline-RIT. Biken Journal 1984;27(2-3):89-98. - PubMed
Anonymous 1982 {published data only}
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- Anonymous. Adverse effects of Virivac. Lakartidningen 1982;79(42):3822. - PubMed
Anonymous 1997 {published data only}
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- Anonymous. Vaccination: news on precautions, contraindications, and adverse reactions. Consultant 1997;37(3):756-60.
Anonymous 1998 {published data only}
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- Anonymous. Field evaluation of the clinical effectiveness of vaccines against pertussis, measles, rubella and mumps. The Benevento and Compobasso Pediatrician's Network for the Control of Vaccine-Preventable Diseases. Vaccine 1998;16(8):818-22. - PubMed
Anonymous 1999 {published data only}
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- Anonymous. Incidence of measles vaccine-associated adverse events is low. Drugs & Therapy Perspectives 1999;14(11):13-6.
Aozasa 1982 {published data only}
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- Aozasa K, Nara H, Kotoh K, Watanabe Y, Sakai S, Honda M. Malignant histiocytosis with slow clinical course. Pathology, Research and Practice 1982;174(1-2):147-58. - PubMed
Asaria 2008 {published data only}
Autret 1996 {published data only}
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- Autret E, Jonville-Bera AP, Galy-Eyraud C, Hessel L. Thrombocytopenic purpura after isolated or combined vaccination against measles, mumps and rubella [Purpura thrombopenique apres vaccination isolee ou associee contre la rougeole, la rubeole et les oreillons]. Therapie 1996;51(6):677-80. - PubMed
Bakker 2001 {published data only}
Balraj 1995 {published data only}
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- Balraj V, Miller E. Complications of mumps vaccines. Reviews in Medical Virology 1995;5(4):219-27.
Bawankule 2017 {published data only}
Beck 1991 {published data only}
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- Beck SA, Williams LW, Shirrell MA, Burks AW. Egg hypersensitivity and measles-mumps-rubella vaccine administration. Pediatrics 1991;88(5):913-7. - PubMed
Bedford 2010 {published data only}
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- Bedford HE, Elliman DA. MMR vaccine and autism. BMJ 2010;340:c655. - PubMed
Beeler 1996 {published data only}
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- Beeler J, Varricchio F, Wise R. Thrombocytopenia after immunization with measles vaccines: review of the vaccine adverse events reporting system (1990 to 1994). Pediatric Infectious Disease Journal 1996;15(1):88-90. - PubMed
Benjamin 1991 {published data only}
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Berger 1988a {published data only}
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Berger 1988b {published data only}
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Berlin 1983 {published data only}
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- Berlin BS. Convulsions after measles immunisation. Lancet 1983;1(8338):1380. - PubMed
Bernsen 2008 {published data only}
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- Bernsen RM, Wouden JC. Measles, mumps and rubella infections and atopic disorders in MMR-unvaccinated and MMR-vaccinated children. Pediatric Allergy and Immunology 2008;19(6):544-51. - PubMed
Bhargava 1995 {published data only}
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- Bhargava I, Chhaparwal BC, Phadke MA, Irani SF, Chhaparwal D, Dhorje S, et al. Immunogenicity and reactogenicity of indigenously produced MMR vaccine. Indian Pediatrics 1995;32(9):983-8. - PubMed
Bonanni 2005 {published data only}
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- Bonanni P, Bechini A, Pesavento G, Boccalini S, Tiscione E, Graziani G, et al. Implementation of the plan for elimination of measles and congenital rubella infection in Tuscany: evidence of progress towards phase II of measles control. Journal of Preventive Medicine and Hygiene 2005;46(3):111-7.
Borchardt 2007 {published data only}
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Borgono 1973 {published data only}
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- Borgono JM, Greiber R, Solari G, Concha F, Carrillo B, Hilleman MR. A field trial of combined measles-mumps-rubella vaccine. Satisfactory immunization with 188 children in Chile. Clinical Pediatrics 1973;12(3):170-2. - PubMed
Boxall 2008 {published data only}
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- Boxall N, Kubinyiova M, Prikazsky V, Benes C, Castkova J. An increase in the number of mumps cases in the Czech Republic, 2005-2006. Euro Surveillance 2008;13(16):18842. - PubMed
Brockhoff 2010 {published data only}
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- Brockhoff HJ, Mollema L, Sonder GJ, Postema CA, Binnendijk RS, Kohl RH, et al. Mumps outbreak in a highly vaccinated student population, The Netherlands, 2004. Vaccine 2010;28(17):2932-6. - PubMed
Brond 2017 {published data only}
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- Brond M, Martins C, Byberg S, Benn C, Whittle H, Garly M, et al. Randomized trial of 2 versus 1 dose of measles vaccine: effect on hospital admission of children after 9 months of age. Journal of the Pediatric Infectious Diseases Society 2017;7(3):226-33. - PubMed
Bruno 1997 {published data only}
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- Bruno G, Grandolfo M, Lucenti P, Novello F, Ridolfi B, Businco L. Measles vaccine in egg allergic children: poor immunogenicity of the Edmoston-Zagreb strain. Pediatric Allergy and Immunology 1997;8(1):17-20. - PubMed
Bulik 2018 {published data only}
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- Bulik NB, Bucsa C, Farcas A, Oniga O. Hexavalent vaccine in Europe: safety data from the randomized clinical trials. Farmacia 2018;66(5):747-57.
Buntain 1976 {published data only}
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- Buntain WL, Missall SR. Letter: Local subcutaneous atrophy following measles, mumps, and rubella vaccination. American Journal of Diseases of Children 1976;130(3):335. - PubMed
Buynak 1969 {published data only}
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- Buynak EB, Weibel RE, Whitman JE Jr, Stokes J Jr, Hilleman MR. Combined live measles, mumps, and rubella virus vaccines. JAMA 1969;207(12):2259-62. - PubMed
Byberg 2017 {published data only}
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- Byberg S, Thysen SM, Rodrigues A, Martins C, Cabral C, Careme M, et al. A general measles vaccination campaign in urban Guinea-Bissau: comparing child mortality among participants and non-participants. Vaccine 2017;35(1):33-9. - PubMed
Cao 2018 {published data only}
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- Cao Z, Chen D, Yang Y, Zhang D. Effectiveness of post-exposure prophylaxis during varicella outbreaks among primary and middle school students in Shanghai: an analysis of three-year surveillance data. Vaccine 2018;36(38):5754-9. - PubMed
Cardenosa 2006 {published data only}
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- Cardenosa N, Dominguez A, Camps N, Martinez A, Torner N, Navas E, et al. Non-preventable mumps outbreaks in schoolchildren in Catalonia. Scandinavian Journal of Infectious Diseases 2006;38(8):671-4. - PubMed
Cashman 2018 {published data only}
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- Cashman P, Moberley S, Durrheim D. MMRV vaccine safety. Vaccine (in press). - PubMed
Chang 1982 {published data only}
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- Chang HH. Immunisation problems in measles, rubella and mumps. Journal of the Korean Medical Association 1982;25(9):801-6.
Chang 2017 {published data only}
Chen 1991 {published data only}
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- Chen RT, Moses JM, Markowitz LE, Orenstein WA. Adverse events following measles-mumps-rubella and measles vaccinations in college students. Vaccine 1991;9(5):297-9. - PubMed
Chen 2000 {published data only}
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- Chen RT, Mootrey G, DeStefano F. Safety of routine childhood vaccinations. An epidemiological review. Paediatric Drugs 2000;2(4):273-90. - PubMed
Cherian 2010 {published data only}
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- Cherian MP, Al-Kanani KA, Al Qahtani SS, Yesurathinam H, Mathew AA, Thomas VS, et al. The rising incidence of type 1 diabetes mellitus and the role of environmental factors - three decade experience in a primary care health center in Saudi Arabia. Journal of Pediatric Endocrinology and Metabolism 2010;23(7):685-95. - PubMed
Chiodo 1992 {published data only}
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- Chiodo F. Effectiveness and security of the trivalent vaccine against measles, parotitis and rubella (MPR). Igiene Moderna 1992;97(Suppl 1):77-86.
Cinquetti 1994 {published data only}
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- Cinquetti S, Tonetto L, Portello A, Chermaz E, Sernagiotto F, De Noni R, et al. Adverse reactions following vaccination with two different types of measles mumps-rubella vaccine [Reazioni indesiderate a due diverse preparazioni di vaccine 'triplo' antimorbillo-parotite-rosolia]. Igiene Moderna 1994;101(6):793-800.
Contardi 1989 {published data only}
-
- Contardi I. Clinical and immunologic valuation of a new triple measles, mumps and rubella vaccine. Giornale di Malattie Infettive e Parassitarie 1989;41(11):1106-7.
Contardi 1992 {published data only}
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- Contardi I, Lusardi C, Cattaneo GG. A comparative study of 3 different types of trivalent measles-mumps-rubella vaccine. Pediatria Medica e Chirurgica 1992;14(4):421-4. - PubMed
Coplan 2000 {published data only}
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- Coplan P, Chiacchierini L, Nikas A, Shea J, Baumritter A, Beutner K, et al. Development and evaluation of a standardized questionnaire for identifying adverse events in vaccine clinical trials. Pharmacoepidemiology and Drug Safety 2000;9(6):457-71. - PubMed
Coronado 2006 {published data only}
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- Coronado F, Musa N, El Tayeb ESA, Haithami S, Dabbagh A, Mahoney F, et al. Retrospective measles outbreak investigation: Sudan, 2004. Journal of Tropical Pediatrics 2006;52(5):329-34. - PubMed
Cox 2009 {published data only}
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- Cox AR, McDowell S. A response to the article on the association between paracetamol/acetaminophen use and autism by Stephen T. Schultz. Autism: the International Journal of Research and Practice 2009;13(1):123-4; author reply 124-5. - PubMed
Curtale 2010 {published data only}
Czajka 2009 {published data only}
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- Czajka H, Schuster V, Zepp F, Esposito S, Douha M, Willems P. A combined measles, mumps, rubella and varicella vaccine (Priorix-Tetra): immunogenicity and safety profile. Vaccine 2009;27(47):6504-11. - PubMed
D'Souza 2000 {published data only}
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- D'Souza RM, Campbell-Lloyd S, Isaacs D, Gold M, Burgess M, Turnbull F, et al. Adverse events following immunisation associated with the 1998 Australian Measles Control Campaign. Communicable Diseases Intelligence 2000;24(2):27-33. - PubMed
Dales 2001 {published data only}
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- Dales L, Hammer SJ, Smith NJ. Time trends in autism and in MMR immunization coverage in California. JAMA 2001;285(9):1183-5. - PubMed
Dallaire 2009 {published data only}
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- Dallaire F, De Serres G, Tremblay FW, Markowski F, Tipples G. Long-lasting measles outbreak affecting several unrelated networks of unvaccinated persons. Journal of Infectious Diseases 2009;200(10):1602-5. - PubMed
Dankova 1995 {published data only}
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- Dankova E, Domorazkova E, Skovrankova J, Vodickova M, Honzonova S, Stehlikova J, et al. Immune reactivity and risk of an undesirable response after vaccination. Ceskoslovenská Pediatrie 1995;50(9):515-9.
Dashefsky 1990 {published data only}
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- Dashefsky B, Wald E, Guerra N, Byers C. Safety, tolerability, and immunogenicity of concurrent administration of Haemophilus influenzae type b conjugate vaccine (meningococcal protein conjugate) with either measles-mumps-rubella vaccine or diphtheria-tetanus-pertussis and oral poliovirus vaccines in 14- to 23-month-old infants. Pediatrics 1990;85(4 Pt 2):682-9. - PubMed
Davis 1997 {published data only}
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- Davis RL, Marcuse E, Black S, Shinefield H, Givens B, Schwalbe J, et al. MMR2 immunization at 4 to 5 years and 10 to 12 years of age: a comparison of adverse clinical events after immunization in the Vaccine Safety Datalink project. The Vaccine Safety Datalink Team. Pediatrics 1997;100(5):767-71. - PubMed
Dayan 2008a {published data only}
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- Dayan GH, Quinlisk MP, Parker AA, Barskey AE, Harris ML, Schwartz JM, et al. Recent resurgence of mumps in the United States. New England Journal of Medicine 2008;358(15):1580-9. - PubMed
Deforest 1986 {published data only}
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- Deforest A, Long SS, Lischner HW. Safety and efficacy of simultaneous administration of measles-mumps-rubella (MMR) with booster doses of diphtheria-tetanus-pertussis (TP) and trivalent oral poliovirus (OPV) vaccines. Developments in Biological Standardization 1986;65:111.
Deforest 1988 {published data only}
-
- Deforest A, Long SS, Lischner HW, Girone JA, Clark JL, Srinivasan R, et al. Simultaneous administration of measles-mumps-rubella vaccine with booster doses of diphtheria-tetanus-pertussis and poliovirus vaccines. Pediatrics 1988;81(2):237-46. - PubMed
De Laval 2010 {published data only}
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- De Laval F, Haus R, Spiegel A, Simon F. Lower long-term immunogenicity of mumps component after MMR vaccine. Pediatric Infectious Disease Journal 2010;29(11):1062-3. - PubMed
DeStefano 2000 {published data only}
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- DeStefano F, Chen RT. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Journal of Pediatrics 2000;136(1):125-6. - PubMed
Diaz‐Ortega 2010 {published data only}
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- Diaz-Ortega JL, Bennett JV, Castaneda D, Vieyra JR, Valdespino-Gomez JL, Castro JF. Successful seroresponses to measles and rubella following aerosolized Triviraten vaccine, but poor response to aerosolized mumps (Rubini) component: comparisons with injected MMR. Vaccine 2010;28(3):692-8. - PubMed
Dobrosavljevic 1999 {published data only}
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- Dobrosavljevic D, Milinkovic MV, Nikolic MM. Toxic epidermal necrolysis following morbilli-parotitis-rubella vaccination. Journal of the European Academy of Dermatology and Venereology 1999;13(1):59-61. - PubMed
Dominguez 2008 {published data only}
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- Dominguez A, Torner N, Barrabeig I, Rovira A, Rius C, Cayla J, et al. Large outbreak of measles in a community with high vaccination coverage: implications for the vaccination schedule. Clinical Infectious Diseases 2008;47(9):1143-9. - PubMed
Doshi 2009 {published data only}
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- Doshi S, Khetsuriani N, Zakhashvili K, Baidoshvili L, Imnadze P, Uzicanin A. Ongoing measles and rubella transmission in Georgia, 2004-05: implications for the national and regional elimination efforts. International Journal of Epidemiology 2009;38(1):182-91. - PubMed
Dos Santos 2002 {published data only}
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- Dos Santos BA, Ranieri TS, Bercini M, Schermann MT, Famer S, Mohrdieck R, et al. An evaluation of the adverse reaction potential of three measles-mumps-rubella combination vaccines. Revista Panamericana de Salud Pública 2002;12(4):240-6. - PubMed
Duderstadt 2012 {published data only}
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- Duderstadt SK, Rose CE Jr, Real TM, Sabatier JF, Stewart B, Ma G, et al. Vaccination and risk of type 1 diabetes mellitus in active component U.S. Military, 2002-2008. Vaccine 2012;30(4):813-9. - PubMed
Dyer 2010a {published data only}
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- Dyer C. Wakefield was dishonest and irresponsible over MMR research, says GMC. BMJ 2010;340:c593. - PubMed
Dyer 2010b {published data only}
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- Dyer C. Lancet retracts Wakefield's MMR paper. BMJ 2010;340:c696. - PubMed
Elphinstone 2000 {published data only}
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- Elphinstone P. The MMR question. Lancet 2000;356(9224):161. - PubMed
Englund 1989 {published data only}
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- Englund JA, Suarez CS, Kelly J, Tate DY, Balfour HH Jr. Placebo-controlled trial of varicella vaccine given with or after measles-mumps-rubella vaccine. Journal of Pediatrics 1989;114(1):37-44. - PubMed
Fitzpatrick 2007 {published data only}
Fletcher 2001 {published data only}
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- Fletcher AP. MMR safety studies. Adverse Drug Reactions and Toxicological Reviews 2001;20(1):57-60. - PubMed
Garrido Lestache 1992 {published data only}
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Kaye 2001 {published data only}
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Ntshoe 2013 {published data only}
O'Brien 1998 {published data only}
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References to studies awaiting assessment
Cardemil 2017 {published data only}
Cohen 2007 {published data only}
Deeks 2011 {published data only}
Dominguez 2010 {published data only}
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