{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T14:00:48Z","timestamp":1792245648073,"version":"4.4.0"},"reference-count":48,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,2,1]]},"abstract":"<jats:p>Objective. To compare ages at first measles-mumps-rubella (MMR) vaccination between children with autism and children who did not have autism in the total population and in selected subgroups, including children with regression in development.<\/jats:p>\n               <jats:p>Methods. A case-control study was conducted in metropolitan Atlanta. Case children (N = 624) were identified from multiple sources and matched to control children (N = 1824) on age, gender, and school. Vaccination data were abstracted from immunization forms required for school entry. Records of children who were born in Georgia were linked to Georgia birth certificates for information on maternal and birth factors. Conditional logistic regression was used to estimate odds ratios (ORs).<\/jats:p>\n               <jats:p>Results. The overall distribution of ages at MMR vaccination among children with autism was similar to that of matched control children; most case (70.5%) and control children (67.5%) were vaccinated between 12 and 17 months of age. Similar proportions of case and control children had been vaccinated before 18 or before 24 months. No significant associations for either of these age cutoffs were found for specific case subgroups, including those with evidence of developmental regression. More case (93.4%) than control children (90.6%) were vaccinated before 36 months (OR: 1.49; 95% confidence interval: 1.04\u20132.14 in the total sample; OR: 1.23; 95% confidence interval: 0.64\u20132.36 in the birth certificate sample). This association was strongest in the 3- to 5-year age group.<\/jats:p>\n               <jats:p>Conclusions. Similar proportions of case and control children were vaccinated by the recommended age or shortly after (ie, before 18 months) and before the age by which atypical development is usually recognized in children with autism (ie, 24 months). Vaccination before 36 months was more common among case children than control children, especially among children 3 to 5 years of age, likely reflecting immunization requirements for enrollment in early intervention programs.<\/jats:p>","DOI":"10.1542\/peds.113.2.259","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:53:04Z","timestamp":1092444784000},"page":"259-266","source":"Crossref","is-referenced-by-count":100,"title":["Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta"],"prefix":"10.1542","volume":"113","author":[{"given":"Frank","family":"DeStefano","sequence":"first","affiliation":[{"name":"National Immunization Program, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya Karapurkar","family":"Bhasin","sequence":"additional","affiliation":[{"name":"Battelle Memorial Institute, Centers for Public Health Research and Evaluation, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"Thompson","sequence":"additional","affiliation":[{"name":"National Immunization Program, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marshalyn","family":"Yeargin-Allsopp","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coleen","family":"Boyle","sequence":"additional","affiliation":[{"name":"National Immunization Program, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2004,2,1]]},"reference":[{"key":"2021121011014889900_R1","unstructured":"American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994"},{"key":"2021121011014889900_R2","doi-asserted-by":"crossref","unstructured":"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\u2013702","DOI":"10.1097\/00004583-200006000-00007"},{"key":"2021121011014889900_R3","doi-asserted-by":"crossref","unstructured":"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\u20131161","DOI":"10.1542\/peds.108.5.1155"},{"key":"2021121011014889900_R4","doi-asserted-by":"crossref","unstructured":"Chakrabarti S, Fombonne E. Pervasive developmental disorders in preschool children. JAMA.2001;285:303\u2013309","DOI":"10.1001\/jama.285.24.3093"},{"key":"2021121011014889900_R5","doi-asserted-by":"crossref","unstructured":"Yeargin-Allsopp M, Rice C, Karapurkar T, Doernberg N, Boyle C, Murphy C. The prevalence of autism: Metropolitan Atlanta. JAMA.2003;289:49\u201355","DOI":"10.1001\/jama.289.1.49"},{"key":"2021121011014889900_R6","unstructured":"Bohman M, Bohman I, Bjorck P, et al. Childhood psychosis in a northern Swedish county: some preliminary findings from an epidemiological survey. In: Schmidt M, Remschmidt H, eds. Epidemiological Approaches in Child Psychiatry: II. New York, NY: Thieme-Stratton; 1983:164\u2013173"},{"key":"2021121011014889900_R7","unstructured":"McCarthy P, Fitzgerald M, Smith M. Prevalence of childhood autism in Ireland. Irish Med J.1984;77:129\u2013130"},{"key":"2021121011014889900_R8","doi-asserted-by":"crossref","unstructured":"Gillberg C. Infantile autism and other childhood psychoses in a Swedish urban region: epidemiological aspects. J Child Psychol Psychiatry.1984;25:45\u201343","DOI":"10.1111\/j.1469-7610.1984.tb01717.x"},{"key":"2021121011014889900_R9","doi-asserted-by":"crossref","unstructured":"Steinhausen H, Gobel D, Breinlinger M, et al. A community survey of infantile autism. J Am Acad Child Psychiatry.1986;25:186\u2013189","DOI":"10.1016\/S0002-7138(09)60225-9"},{"key":"2021121011014889900_R10","doi-asserted-by":"crossref","unstructured":"Fombonne E. Epidemiological trends in rates of autism. Mol Psychiatry.2002;7:S4\u2013S6","DOI":"10.1038\/sj.mp.4001162"},{"key":"2021121011014889900_R11","unstructured":"US Department of Education, Office of Special Education Programs, Data Analysis System (DANS). Number of Children Served Under IDEA by Disability and Age Group, During the 1989\u201390 Through 1998\u20131999 School Years. Twenty-Second Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act. Washington, DC: US Department of Education; 2000:II-20"},{"key":"2021121011014889900_R12","unstructured":"California Health and Human Services Agency, Department of Developmental Services. Changes in the Population of Persons With Autism and Pervasive Developmental Disorders in California\u2019s Developmental Services System: 1987 Through 1998: A Report to the Legislature, March 1, 1999. Sacramento, CA: California Health and Human Services Agency; 1999"},{"key":"2021121011014889900_R13","doi-asserted-by":"crossref","unstructured":"Croen L, Grether J, Hoogstrate J, Selvin S. The changing prevalence of autism in California. J Autism Dev Dis.2002;32:207\u2013215","DOI":"10.1023\/A:1015453830880"},{"key":"2021121011014889900_R14","unstructured":"Byrd RS. Report to the legislature on the principal findings from the epidemiology of autism in California: a comprehensive pilot study. Davis, CA: M.I.N.D. Institute, University of California, Davis; 2002. Available at: mindinstitute.ucdmc.ucdavis.edu\/news\/study_final.pdf"},{"key":"2021121011014889900_R15","doi-asserted-by":"crossref","unstructured":"Wakefield AJ, Murch S, Anthony A, et al. Ileal lymphoid nodular hyperplasia, non-specific colitis, and regressive developmental disorder in children. Lancet.1998;351:637\u2013641","DOI":"10.1016\/S0140-6736(97)11096-0"},{"key":"2021121011014889900_R16","doi-asserted-by":"crossref","unstructured":"Wakefield AJ, Anthony A, Murch S, et al. Enterocolitis in children with developmental disorders. Am J Gastroenterol.2000;95:2285\u20132295","DOI":"10.1111\/j.1572-0241.2000.03248.x"},{"key":"2021121011014889900_R17","unstructured":"Kawashimi H, Takayuki M, Kashiwagi Y, Takekuma K, Akinori H, Wakefield A. Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism. Dig Dis Sci.2000;45:723\u2013729"},{"key":"2021121011014889900_R18","doi-asserted-by":"crossref","unstructured":"Uhlmann V, Martin CM, Sheils O, et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Mol Pathol.2002;55:34\u201390","DOI":"10.1136\/mp.55.2.84"},{"key":"2021121011014889900_R19","doi-asserted-by":"crossref","unstructured":"Dales L, Hammer SJ, Smith NJ. Time trends in autism and in MMR immunization coverage in California. JAMA.2001;285:1183\u20131185","DOI":"10.1001\/jama.285.9.1183"},{"key":"2021121011014889900_R20","doi-asserted-by":"crossref","unstructured":"Farrington CP, Miller E, Taylor B. MMR and autism: further evidence against a causal association. Vaccine.2001;19:3632\u20133635","DOI":"10.1016\/S0264-410X(01)00097-4"},{"key":"2021121011014889900_R21","doi-asserted-by":"crossref","unstructured":"Gillberg C, Heijbel H. MMR and autism. Autism.1998;2:423\u2013424","DOI":"10.1177\/1362361398024007"},{"key":"2021121011014889900_R22","doi-asserted-by":"crossref","unstructured":"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. Br Med J.2001;322:460\u2013463","DOI":"10.1136\/bmj.322.7284.460"},{"key":"2021121011014889900_R23","doi-asserted-by":"crossref","unstructured":"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\u20132029","DOI":"10.1016\/S0140-6736(99)01239-8"},{"key":"2021121011014889900_R24","doi-asserted-by":"crossref","unstructured":"Madsen KM, Hviid A, Vestergaard M, et al. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med.2002;347:1477\u20131482","DOI":"10.1056\/NEJMoa021134"},{"key":"2021121011014889900_R25","unstructured":"Stratton K, Gable A, McCormick M, eds. Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism. Washington, DC: National Academy Press; 2001"},{"key":"2021121011014889900_R26","unstructured":"Yeargin-Allsopp M, Murphy C, Oakley G, Sikes K. A multiple-source method for studying the prevalence of developmental disabilities in children: the Metropolitan Atlanta Developmental Disabilities Study. Pediatrics.1992;89:624\u2013630"},{"key":"2021121011014889900_R27","doi-asserted-by":"crossref","unstructured":"Edmonds LD, Layde PM, James LM, Flynt JW, Erickson JD, Oakley JP Jr. Congenital malformations surveillance: two American systems. J Epidemiol.1981;10:247\u2013252","DOI":"10.1093\/ije\/10.3.247"},{"key":"2021121011014889900_R28","unstructured":"Watson JC, Hadler SC, Dykewicz CA, Reef S, Phillips L. Measles, mumps, and rubella\u2014vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep.1998;47(RR-8):1\u201357"},{"key":"2021121011014889900_R29","doi-asserted-by":"crossref","unstructured":"Fombonne E. Is there an epidemic of autism?Pediatrics.2001;107:411\u2013412","DOI":"10.1542\/peds.107.2.411"},{"key":"2021121011014889900_R30","doi-asserted-by":"crossref","unstructured":"Short AB, Schopler E. Factors relating to age of onset in autism. J Autism Dev Dis.1988;18:207\u2013216","DOI":"10.1007\/BF02211947"},{"key":"2021121011014889900_R31","doi-asserted-by":"crossref","unstructured":"De Giacomo A, Fombonne E. Parental recognition of developmental abnormalities in autism. Eur Child Adolesc Psychiatry.1998;7:131\u2013136","DOI":"10.1007\/s007870050058"},{"key":"2021121011014889900_R32","doi-asserted-by":"crossref","unstructured":"Volkmar FR, Stier DM, Cohen DJ. Age of recognition of pervasive developmental disorder. Am J Psychiatry.1985;142:1450\u20131452","DOI":"10.1176\/ajp.142.12.1450"},{"key":"2021121011014889900_R33","doi-asserted-by":"crossref","unstructured":"Maldonado G, Greenland S. Simulation study of confounder-selection strategies. Am J Epidemiol.1993;138:923\u2013936","DOI":"10.1093\/oxfordjournals.aje.a116813"},{"key":"2021121011014889900_R34","doi-asserted-by":"crossref","unstructured":"Rodier PM, Hyman SL. Early environmental factors in autism. Ment Retard Dev Dis Res Rev.1998;4:121\u2013128","DOI":"10.1002\/(SICI)1098-2779(1998)4:2<121::AID-MRDD9>3.0.CO;2-S"},{"key":"2021121011014889900_R35","doi-asserted-by":"crossref","unstructured":"Kemper TL, Bauman M. Neuropathology of infantile autism. J Neuropathol Exp Neurol.1998;57:645\u2013652","DOI":"10.1097\/00005072-199807000-00001"},{"key":"2021121011014889900_R36","doi-asserted-by":"crossref","unstructured":"Nelson KB, Grether JK, Croen LA, et al. Neuropeptides and neurotrophins in neonatal blood of children with autism or mental retardation. Ann Neurol.2001;49:597\u2013606","DOI":"10.1002\/ana.1024"},{"key":"2021121011014889900_R37","doi-asserted-by":"crossref","unstructured":"Osterling J, Dawson G. Early recognition of children with autism: a study of first birthday home videotapes. J Autism Dev Dis.1994;24:247\u2013257","DOI":"10.1007\/BF02172225"},{"key":"2021121011014889900_R38","doi-asserted-by":"crossref","unstructured":"Werner E, Dawson G, Osterling J, Dinno N. Recognition of autism spectrum disorder before one year of age: a retrospective study based on home videotapes. J Autism Dev Dis.2000;30:157\u2013162","DOI":"10.1023\/A:1005463707029"},{"key":"2021121011014889900_R39","unstructured":"Filipek PA, Accardo PJ, Ashwal S, et al. The screening and diagnosis of autistic spectrum disorders. J Autism Dev Dis.1999;29:439\u2013484"},{"key":"2021121011014889900_R40","doi-asserted-by":"crossref","unstructured":"Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics.2001;108(4). Available at: www.pediatrics.org\/cgi\/content\/full\/108\/4\/e58","DOI":"10.1542\/peds.108.4.e58"},{"key":"2021121011014889900_R41","doi-asserted-by":"crossref","unstructured":"Lord C. Follow-up of two-year-olds referred for possible autism. J Child Psychol Psychiatry.1995;36:1365\u20131382","DOI":"10.1111\/j.1469-7610.1995.tb01669.x"},{"key":"2021121011014889900_R42","doi-asserted-by":"crossref","unstructured":"Shinnar S, Rapin I, Arnold S, et al. Language regression in childhood. Pediatr Neurol.2001;24:183\u2013189","DOI":"10.1016\/S0887-8994(00)00266-6"},{"key":"2021121011014889900_R43","doi-asserted-by":"crossref","unstructured":"Tuchman RF, Rapin I. Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates. Pediatrics.1997;99:560\u2013566","DOI":"10.1542\/peds.99.4.560"},{"key":"2021121011014889900_R44","unstructured":"Medical Research Council. MRC review of autism research: epidemiology and causes; 2001. Available at: www.mrc.ac.uk\/pdf-autism-report.pdf"},{"key":"2021121011014889900_R45","doi-asserted-by":"crossref","unstructured":"Halsey NA, Hyman SL, the Conference Writing Panel. Measles-mumps-rubella vaccine and autistic spectrum disorder: report from the New Challenges in Childhood Immunization Conference convened in Oak Brook, Illinois June 12\u201313, 2000. Pediatrics.2001;107(5). Available at: www.pediatrics.org\/cgi\/content\/full\/107\/5\/e84","DOI":"10.1542\/peds.107.5.e84"},{"key":"2021121011014889900_R46","doi-asserted-by":"crossref","unstructured":"Taylor B, Miller E, Lingam R, 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\u2013396","DOI":"10.1136\/bmj.324.7334.393"},{"key":"2021121011014889900_R47","doi-asserted-by":"crossref","unstructured":"Black C, Kay JA, Jick H. Relation of childhood gastrointestinal disorders to autism: nested case-control study using data from the UK General Practice Research Database. BMJ.2002;325:419\u2013421","DOI":"10.1136\/bmj.325.7361.419"},{"key":"2021121011014889900_R48","unstructured":"Wakefield AJ, Montgomery SM. Measles, mumps, rubella vaccine: through a glass darkly. Adverse Drug Res.2000;19:1\u201319"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/113\/2\/259\/1011501\/zpe00204000259.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/113\/2\/259\/1011501\/zpe00204000259.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T23:57:10Z","timestamp":1639180630000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/113\/2\/259\/66877\/Age-at-First-Measles-Mumps-Rubella-Vaccination-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,2,1]]},"references-count":48,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2004,2,1]]},"published-print":{"date-parts":[[2004,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.113.2.259","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,2,1]]}}}