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Joint and limb symptoms in children after immunisation with measles, mumps, and rubella vaccine
C M Benjamin1, G C Chew, A J Silman
1Arthritis and Rheumatism Council Epidemiology Research Unit, University of Manchester.
Insights
The combined measles, mumps, and rubella vaccine is linked to a higher risk of joint and limb symptoms in young children, particularly girls and those under five. Most cases were mild and resolved on their own.
Area of Science:
- Pediatric Vaccinology
- Immunology
- Public Health
Background:
- The measles, mumps, and rubella (MMR) vaccine is a cornerstone of childhood immunization programs.
- Concerns have been raised regarding potential side effects of childhood vaccines, including joint and limb symptoms.
Purpose of the Study:
- To investigate the association between the combined measles, mumps, and rubella (MMR) vaccine and the incidence of joint and limb symptoms in young children.
Main Methods:
- A comparative study design was employed, analyzing recalled symptom incidence over six weeks.
- Two groups were compared: children who received the MMR vaccine and a control group of eligible but unvaccinated children.
- Data were collected via postal questionnaires and confirmed with clinical follow-up.
Main Results:
- The MMR-vaccinated group showed an increased incidence of new joint and limb episodes (relative risk 1.6).
- This increased risk was more pronounced in girls and children under five years old.
- While most episodes were mild and self-limiting, three vaccinated children required hospitalization.
Conclusions:
- The MMR vaccine is associated with an elevated risk of joint and limb symptom episodes, particularly in specific demographic groups.
- The observed risk of arthritis following MMR vaccination is considerably lower than that associated with wild rubella infection.
Objective:
To assess whether the combined measles, mumps, and rubella vaccine increases the incidence of joint and limb symptoms in young children.
Design:
Comparison of six week recalled incidence of symptoms in two groups of children: children who had been immunised at the start of the six weeks, and children eligible for immunisation but who had not received it.
Setting:
South Manchester Health Authority.
Subjects:
2658 children immunised during July 1989-February 1990 and 2359 not yet immunised. Questionnaires were returned for 1846 immunised children and 1075 not immunised.
Main Outcome Measure:
Recalled rate of joint and limb episodes determined by postal questionnaire and later by clinical follow up.
Results:
Compared with non-immunised children the immunised group had an increased incidence of new episodes (relative risk 1.6 (95% confidence interval (1.2 to 2.1)) and first ever episodes, though this was not significant (1.7 (0.3 to 3.5)). The risk of first episodes was increased in girls (3.5 (1.1 to 12.2)) but not in boys (1.0 (0.4 to 2.6)). Similarly, an increased risk was seen in children aged under 5 (12.0 (1.6 to 92.3)) but not in older children (0.7 (0.3 to 1.5)). Most episodes were mild and self limiting, but three immunised children required hospital referral.
Conclusion:
Measles, mumps, and rubella vaccine is associated with an increased risk of episodes of joint and limb symptoms, especially in girls and children under 5. The risk of frank arthritis is substantially less than after wild rubella infection.