How we know that vaccines are safe & effective for children & teens
Here’s a round-up of studies published in peer-reviewed, science publications for parents to review on the safety of vaccines.
Note: This is not an exhaustive list—vaccine safety studies are constantly being conducted and published and may not be reflected here. Experts closely evaluated the methods and data analyses that produced the results described before accepting these studies for publication in scientific journals.
Safety of Vaccines Used for Routine Immunization in the United States: An Update |
Agency for Healthcare Research and Quality (AHRQ) Publication No. 21-EHC024 (2021)
This 2021 report is an update to a 2014 report from the Agency for Healthcare Research and Quality (AHRQ). The 2021 update found no new evidence of increased risk since the 2014 report for rare adverse events (severe allergy, seizures caused by fever and blood clotting issues) following administration of routine recommended childhood vaccinations. The AHRQ serves to produce evidence to make health care safer, higher quality, more accessible, equitable and affordable. |
Association Between Estimated Cumulative Vaccine Antigen Exposure Through the First 23 Months of Life and Non–Vaccine-Targeted Infections From 24 Through 47 Months of Age |
Glanz JM, et al. JAMA. 2018;319:906-913
In a study of 994 children ages 24-47 months who had an emergency department (ED) or inpatient visit, 193 children were seen for an infectious disease for which there is no vaccine. Study authors counted how many antigens the children were exposed to through vaccines. They compared the group of 193 children with the remaining 801 children who were seen for a different reason. . There was no significant difference in the two groups of children related to their exposure to multiple vaccines through the first 23 months of life and their risk for infections not targeted by vaccines. |
Vaccines are not associated with conditions like infertility or diabetes.
No Association between HPV [human papillomavirus] Vaccination and Infertility in U.S. Females 18–33 Years Old |
Schmuhl NB et al. Vaccine. 2020. 19;38:4038–4043
Authors found that women who had never been pregnant or who were pregnant before they received human papillomavirus (HPV) vaccination were less likely to report infertility. No other associations between HPV and infertility were found. |
Childhood vaccination schedule and type 1 diabetes |
Glanz JM, et al. Pediatrics. 2021;148:e2021051910
Researchers studied medical records from 584,171 children to learn whether there was an association between receiving on-time vaccination (according to the recommended immunization schedule) and children developing type 1 diabetes. The recommended schedule was not positively associated with T1DM in children. These results support the safety of the recommended childhood immunization schedule. |
Vaccines are not associated with autism or developmental delays.
There is Strong Evidence that the MMR Vaccine Does Not Cause Autism
Kreesten M M, et al. NEJM. 2002; 347:1477-1482
In Denmark from January 1991 through December 1998, 537,303 children were followed after receiving the MMR vaccine. The researchers concluded there was not difference in the incidence of Autism between vaccination and unvaccinated children.
Vaccines Are Not Associated With Autism: An Evidence-Based Meta-Analysis of Case-Control and Cohort Studies |
Taylor L, et al. Vaccine. 2014;32:3623-3629
Authors of a meta-analysis review of 10 studies (5 cohort and 5 case-control involving over 1.25 million children looked at autism spectrum disorders (ASD), vaccines, the ingredient thimerosal (mercury) and the measles-mumps-rubella (MMR) vaccine. No causal association was found between vaccinations and ASD or between ASD and the MMR vaccine, specifically. In addition, no causal association was found between ASD and thimerosal (mercury). |
Increasing Exposure to Antibody-Stimulating Proteins and Polysaccharides in Vaccines is Not Associated with Risk of Autism |
DeStefano F, et al. J Peds. 2013;163:561-567
Researchers studied 321 children with diagnosis of autism spectrum disorder (ASD), autistic disorder (AD) or ASD with regression and 752 children not diagnosed with these conditions. They compared the number of components used in vaccines (antibody-stimulating proteins and polysaccharides) that each group of children had received through vaccines at these ages: birth to 3 months, birth to 7 months and birth to 2 years. The comparisons were to determine if children with a diagnosis of ASD, AD or ASD with regression had received more vaccine components. Having a diagnosis of ASD, AD, or ASD with regression was not associated with exposure to antibody-stimulating proteins and polysaccharides from vaccines in the first 2 years of life. An ASD, AD or ASD with regression diagnosis was not associated with exposure to these vaccine components at any of the studied time periods (birth to 3 months, birth to 7 months, birth to 2 years), or when comparing a how many vaccine components a child received in one day. |
On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes |
Smith M, Woods C. Pediatrics. 2010;125:1134-1141
Researchers looked for any association between vaccines in the first year of a child’s life and neuropsychological outcomes 7-10 years later. The study involved more than 1,000 children born between 1993-1997. On-time vaccination in the first year was compared with delayed or incomplete vaccination in the first year. The researchers found no adverse effect on long-term neuropsychological outcomes in 42 tests related to speech and language, verbal memory, achievement, fine motor coordination, visuospatial ability, attention and executive-functioning tasks, behavior regulation, tics and general intellectual functioning. In fact, timely vaccination was associated with better performance on numerous outcomes. |
Measles-containing vaccines are safe.
Measles-Containing Vaccines and Febrile Seizures in Children Age 4-6 Years |
Klein N, et al, Pediatrics. 2012;129:809-814
A cohort study included 715,484 children age 48-83 months. The children received one of these vaccine combinations:
Researchers set out to determine risk of post-vaccination seizure for each group. Results showed more fevers and seizures in children who received the MMRV vaccine compared with children in the other three groups, but the finding was not statistically significant. Four febrile seizures were seen in the 7-10 days post-vaccination for children receiving the MMRV vaccine. Only one febrile seizure could be confirmed. Authors concluded that the rate of febrile seizure after MMRV was 1 in 86,750 doses. There was no increased risk of febrile seizures in any of the study groups within 6 weeks of vaccination. |
Autism Occurrence by MMR Vaccine Status Among U.S. Children With Older Siblings With and Without Autism |
Jain A, et al. JAMA. 2015;313:1534-1540
The study looked at MMR vaccine status in children with and without autism spectrum disorder (ASD) with older siblings with and without ASD. Relative risk was calculated for a child receiving an ASD diagnosis at ages 2 years, 3 years or 4 years based on 0 doses or 1 dose of MMR vaccine and whether the child had a sibling with ASD or a sibling without ASD. Relative risk also was calculated any child who got an ASD diagnosis at age 5 years based on 1) whether they’d received 0 doses, 1 dose or 2 doses of MMR vaccine, and 2) whether the child had a sibling with ASD or a sibling without ASD. No harmful association was found between MMR vaccination and ASD risk. In addition, no causal association was found between receipt of 1 or 2 doses of MMR vaccine and having a higher risk of ASD for children with an older sibling with ASD. |
No Evidence for Measles, Mumps and Rubella Vaccine-Associated Inflammatory Bowel Disease or Autism in a 14-Year Prospective Study |
Peltola H, et al., Lancet. 1998;351:1327-1328
This 14-year prospective study of 3 million adverse events tracked subjects who developed gastrointestinal symptoms or signs lasting 24 hours or more starting one hour after MMR vaccination. Researchers also checked hospital and health center records or interviewed local public health nurses. No evidence was found for MMR vaccine-associated inflammatory bowel disease or autism. |
Autism and Measles, Mumps and Rubella Vaccine: No Epidemiological Evidence for a Causal Association |
Taylor B, et al. Lancet. 1999;353:2026-2029
Researchers looked for any change in number or age of children diagnosed with autism associated with the MMR vaccine being introduced in the United Kingdom in 1988. The study identified 498 cases of autism (261 “core” autism; 166 “atypical” autism; 71 “Asperger syndrome”) in children born in the UK since 1979. There was a steady increase in autism cases by year of birth with no sudden change after the MMR vaccine was introduced. There was no difference in age at diagnosis between the cases vaccinated before or after 18 months of age and those never vaccinated. There was no causal association between onset of autism within 1 or 2 years after vaccination with MMR. Developmental regression was not clustered in the months after vaccination. |
Mumps, Measles and Rubella Vaccine and the Incidence of Autism Recorded by General Practitioners: A Time Trend Analysis |
Kaye JA, et al. BMJ. 2001; 322:460-463
A UK study compared MMR vaccination of children and rising prevalence of autism diagnoses in children. The study included 96 children with a pervasive developmental disorder born between 1992 and 1995 who received the MMR vaccine to those who did not receive the vaccine. No correlation was found between the prevalence of MMR vaccination and increase in risk of autism over time. |
Measles-Mumps-Rubella and Other Measles-Containing Vaccines Do Not Increase the Risk for Inflammatory Bowel Disease: A Case-Control Study From the Vaccine Safety Datalink Project |
Davis RL, et al. Arch Pediatr Adolesc Med. 2001;155:354-359
The study looked at measles-containing vaccine (MCV) and risk of Crohn’s disease, ulcerative colitis or irritable bowel disease (IBD). Neither past vaccination nor age at vaccination with MCV was associated with increased risk for Crohn’s disease, ulcerative colitis, or IBD. Vaccination with MMR or other MCV, or the timing of vaccination early in life, did not increase the risk for IBD. |
No Effect of MMR Withdrawal on the Incidence of Autism: A Total Population Study |
Honda H, et al. J Child Psychol Psychiatry. 2005;46:572-579
In a study of all children born between 1988 and 1996 in Yokohama, Japan, the number of new cases of autism spectrum disorder (ASD) increased significantly even though MMR vaccination decreased and ended in 1993.. In addition, there was a steep increase in ASD that started with the 1993 birth cohort. Authors concluded that the withdrawal of MMR vaccine cannot be expected to lead to a reduction in the incidence of ASD and the vaccine cannot explain the rise over time in the incidence of ASD. |
Measles, Mumps and Rubella Vaccination and Bowel Problems or Developmental Regression in Children With Autism: Population Study |
Taylor B, et al. BMJ. 2002;324:393
This study looked at a population of children born between 1979-1998, including 473 with autism. It found no evidence to link MMR vaccine and a “new variant form” of autism with bowel problems or developmental regression. |
Neurologic Disorders After Measles-Mumps-Rubella Vaccination |
Mäkelä A et al. Pediatrics. 2002;110:957–963
In a study of 535,544 children aged 1-7 years who were vaccinated between November 1982 and June 1986 in Finland, no association was found between MMR vaccination and encephalitis, aseptic meningitis or autism. |
A Population-Based Study of Measles, Mumps and Rubella Vaccination and Autism |
Madsen KM et al. NEJM. 2002;347:1477-1482
No link was found between autism and age at receipt of MMR vaccination, time since MMR vaccination, or date of MMR vaccination in a population-based study of 537,303 children born between 1991 and 1998. This study was conducted in Denmark. |
Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta |
DeStefano F et al. Pediatrics. 2004;113:259-266
There were similar proportions in case and control groups of children who received their first MMR vaccination by the recommended age or shortly after, and before age 24 months. That’s the age when atypical development is recognized in children with autism. |
Immunization Safety Review: Vaccines and Autism (2004) |
Institute of Medicine, The National Academies Press: 2004
An independent review committee rejected a causal relationship between MMR vaccine and autism. The Institutes of Medicine Immunization Safety Review on vaccines and autism involved input from 15 committee members with expertise in pediatrics, internal medicine, immunology, neurology, infectious diseases, epidemiology, biostatistics, public health, risk perception, decision analysis, nursing, genetics, ethics and health communications. The committee analyzed more than 200 relevant studies. The group also rejected a causal relationship between thimerosal-containing vaccines and autism. |
Relationship Between MMR Vaccine and Autism |
Klein KC, Diehl EB. Ann Pharmacother. 2004;38:1297-1300
Ten articles on autism and MMR vaccine were identified and evaluated. No causal relationship was found. |
Is There A ‘Regressive Phenotype’ of Autism Spectrum Disorder Associated With the Measles-Mumps-Rubella Vaccine? A CPEA Study |
Richler J, et al., J Autism Dev Disord. 2006;36:299-316
Authors found no evidence of an observable loss of skills (regressive phenotype) of autism spectrum disorder (ASD) associated with the MMR vaccine . This multi-site study used caregiver interviews to describe loss of social-communication milestones. In addition, caregivers reported that the children with ASD had atypical development before the observable loss of skills. |
Immunizations and Autism: A Review of the Literature |
Doja A, Roberts W. Can J Neurol Sci. 2006;33:341-346
In a review of literature on immunizations and autism, an overwhelming majority of studies concluded that there is no causal association between the MMR vaccine and autism. Also, no convincing evidence was found to support an association between the vaccine preservative thimerosal and autism. In addition, no evidence was found to support the use of chelation therapy in autism. |
MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan |
Uchiyama T, et al. J Autism Dev Disord. 2007;37:210-217
MMR vaccine and regression in autism spectrum disorders (ASDs) were not linked in a study of 904 patients with ASD in Japan. No significant difference was found in the incidence of regression between MMR-vaccinated children and non-vaccinated children. |
Measles Vaccination and Antibody Response in Autism Spectrum Disorders |
Baird G, et al. Arch Dis Child. 2008;93:832-837
Researchers studied 98 vaccinated children aged 10-12 years in the UK with ASD and two control groups of similar age: 52 children with special educational needs but no ASD and 90 children in the “typically developing” group. There was no dose-response relationship between autism symptoms and antibody concentrations. |
Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study |
Hornig M, et al. PLoS One. 2008;3:e3140
Autism was not associated with traces of measles virus in the gastrointestinal tract after recovery from infection or MMR vaccination. In this study, researchers looked for measles virus in the guts of 25 children with both autism and gastrointestinal disorders, and another 13 children with the same gastrointestinal disorders but no autism. The virus was detected in one child from each group. Continued on next page.Source: Healthy Children at https://www.healthychildren.org/english/safety-prevention/immunizations/pages/vaccine-studies-examine-the-evidence.aspx |