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Research of the month: the MMR vaccine does not cause autism

Lucy Goodchild van Hilten, 24th April 2019

In another of our monthly blog post written by Science Wordsmith Lucy Goodchild, we explore the findings and attention around a piece of research published in the previous month that caught the public’s attention. Listen to the accompanying podcast here.

Why an Annals of Internal Medicinestudy replicating previous results hit the headlines

When Dr. Anders Hviid published his latest study, he didn’t expect it to get the attention it did – after all, he had done a similar study 17 years earlier with the very same results. But given the current momentum of the antivaxx movement, any new study showing there’s no link between the MMR vaccine and autism is likely to spark discussion.

Read the study: “Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study

It’s an old story, he says. More than two decades ago, Andrew Wakefield published a study in The Lancetin which he linked the measles, mumps and rubella (MMR) vaccine with autism. The paper was found to be fraudulent and was retracted, and Wakefield has been struck off the medical register in the UK. Yet his initial claim that has grown and fueled anti-vaccine sentiment despite repeated studies to the contrary – including one Dr. Hviid published in 2002.

“Even though we did that study more than 17 years ago, we have seen that the anti-vaccine movement has just grown stronger,” said Dr. Hviid, a senior investigator at Statens Serum Institut in Copenhagen, Denmark – a communicable diseases institute similar to the CDC in the US. “In the last couple of years we’ve seen some really concerning returns of a number of childhood infectious diseases that the childhood vaccination programs are supposed to control and actually eliminate.”

Dr. Anders Hviid, Senior Investigator in the Departmentof Epidemiology Research at Statens Serum Institutin Denmark

Ever since Edward Jenner pioneered the first vaccine against smallpox in the late 18th century, there has always been an anti-vaccine movement. But with the support of social media and a generous amount of airtime in the mainstream media, vaccine hesitancy has become a major global health issue; World Health Organization has even named it one of the top 10 threats to global health in 2019.

With the pervasiveness of online antivaxx groups, Dr. Hviid warns that we need to be vigilant and respond with good quality observational research.

Local data with a global message

Being based in Denmark means Dr. Hviid and his colleagues have access to an unusual dataset: everyone who lives in the country has a unique personal identifier which is used in all national registers. This produces comparable demographic and health information that let them compare groups of people – for example, to examine the incidence of autism among vaccinated and unvaccinated children.

“We have access to demographic information, we know who your mother and father are, we know where you live, we know how much money you make, we know when you go to the hospital and what kind of diagnosis you get, and we know when you go to the GP and you get your vaccinations,” he said. “That’s really a wonderful resource for doing research on epidemiology and disease and health.”

Using that data, Dr. Hviid and his colleagues carried out a study of more than 650,000 children. They looked at the registers to see when the children were vaccinated and who was diagnosed with autism, and they compared the results. What they found was that there is no difference in the rates of autism between the two groups, showing once again that there is no link between the MMR vaccine and autism.

The study was published in the Annals of Internal Medicine, which worked with the Statens Serum Institut to issue a press release and reach out to journalists with the story – promotion is one of the benefits of publishing in a major medical journal, Dr. Hviid says. The outreach had a major impact: more than 200 news articles and blog posts have been published since the paper came out, resulting in an Altmetric attention score of over 8,300.

Discover the coverage:

Having worked on vaccine safety studies for nearly two decades, Dr. Hviid is well versed in dealing with media attention, even if it had been somewhat unexpected. “Perhaps it wasn’t the most novel study, but it hit a really key time where a lot of stuff was happening in the US and here in Europe, both in relation to these measles outbreaks and different legislative issues,” he said.

He’s still getting requests – the study has already become part of the public narrative on the topic, with nearly 10,000 tweets, 29 blogs and 49 Facebook pages mentioning the paper. “That’s wonderful, because scientifically it’s not the most novel finding, but it’s a finding that needs to get a lot of attention so that, in particular, parents who are concerned about vaccine safety hear about this.”

It’s not all supportive coverage – Dr. Hviid has had his share of threats and name-calling – but that’s something he’s used to, and attributes in part to the past behavior of the press. “I think the press has played a role in giving the anti-vaccine movement too much room and not being critical enough of it,” he explained.

But he also believes that the tide is turning now – in Denmark he has noticed a shift towards good science in the press coverage, with stories pointing out that vaccines are actually beneficial but need a high level of coverage to be effective. “I hope our study and our research in general can play a part in supplying some good, solid science to support these efforts,” he said.

Dr. Hviid’s top tip for promoting research

“We have been quite privileged – the fact that many of the studies that we do have often been published in the big medical journals because they can really only be done here in Denmark and because they are globally important. That means you get a lot of exposure automatically. So my top tip is really to publish in the big journals, but of course, not everybody can do that. I also see colleagues promoting their own work on social media and getting some exposure. There’s more and more research, so you have to do something to not be forgotten immediately after you publish.”

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