Cited by 76Virology and Viral DiseasesPharmacovigilance and Adverse Drug ReactionsBacterial Infections and Vaccines

Risks of convulsion and aseptic meningitis following measles-mumps-rubella vaccination in the United Kingdom

Miller, E, Andrews, N, Stowe, J, Grant, A, Waight, P, Taylor, B·2007·American Journal of Epidemiology

Abstract

Measles-mumps-rubella (MMR) vaccines containing the Urabe strain of mumps were withdrawn in the United Kingdom in 1992 following demonstration of an increased risk of aseptic meningitis 15-35 days after vaccination. Following introduction of a replacement MMR vaccine (Priorix; GlaxoSmithKline, London, United Kingdom) in 1998, active surveillance of aseptic meningitis and convulsion was established to evaluate the risk associated with the new vaccine. No laboratory-confirmed cases of mumps meningitis were detected among children aged 12-23 months after administration of 1.6 million doses of Priorix (upper 95% confidence limit of risk: 1:437,000) in England and Wales. The upper 95% confidence limit excluded the risk found for mumps meningitis with Urabe vaccines (1:143,000 doses). No cases of aseptic meningitis were detected among children aged 12-23 months, who had received over 99,000 doses of Priorix (upper 95% confidence limit of risk: 1:27,000), in a regional database of hospital-admitted cases. This compares with an observed risk of 1:12,400 for Urabe vaccines. An elevated relative incidence of convulsion was found in the 6- to 11-day period after receipt of Priorix (relative incidence = 6.26, 95% confidence interval: 3.85, 10.18)-consistent with the known effects of the measles component of MMR vaccine-but not in the 15- to 35-day period (relative incidence = 1.48, 95% confidence interval: 0.88, 2.50) as occurred with Urabe-containing vaccines. This study demonstrates the power of active postmarketing surveillance to identify or exclude events too rare to be detected in prelicensure trials.

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Crossref · 10.1093/aje/kwk045

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17 of 17 references verified0 citation errors · 0 not checkable

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  • Considering all MMR vaccine types, the risk incidence remains higher in the six to 11 days following vaccination (RI 4.27; 95% CI 3.17 to 5.76).

    “Considering all MMR vaccine types, the risk incidence remains higher in the six to 11 days following vaccination (RI 4.27; 95% CI 3.17 to 5.76), whereas the time between 15 to 35 days following vaccination it remains of borderline significance (RI 1.33; 95% CI 1.00 to 1.77).”

    From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Miller 2007

  • During the time between six and 11 days following MMR vaccination (of all types) a significantly higher relative incidence (RI) of febrile convulsion had been observed (RI 4.09; 95% CI 3.1 to 5.33).

    “During the time between six and 11 days following MMR vaccination (of all types) a significantly higher relative incidence (RI) of febrile convulsion had been observed (RI 4.09; 95% CI 3.1 to 5.33).”

    From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Miller 2007

  • The time between 15 to 35 days following vaccination remains of borderline significance for risk incidence of febrile convulsion (RI 1.33; 95% CI 1.00 to 1.77).

    “Considering all MMR vaccine types, the risk incidence remains higher in the six to 11 days following vaccination (RI 4.27; 95% CI 3.17 to 5.76), whereas the time between 15 to 35 days following vaccination it remains of borderline significance (RI 1.33; 95% CI 1.00 to 1.77).”

    From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Miller 2007

  • RI of febrile convulsions did not differ significantly from the background period during the 15 to 35 days following MMR immunisation (RI 1.13; 95% CI 0.87 to 1.48).

    “On the contrary, RI of febrile convulsions did not differ significantly from the background period during the 15 to 35 days following MMR immunisation (RI 1.13; 95% CI 0.87 to 1.48).”

    From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Miller 2007

  • The exclusive use of discharge diagnoses for identification of cases in Miller 2007 could have introduced a noteworthy selection bias.

    “The exclusive use of discharge diagnoses for identification of cases in Miller 2007 could have introduced a noteworthy selection bias.”

    From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Miller 2007

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Authors
Miller, E., Andrews, N., Stowe, J., Grant, A., Waight, P., & Taylor, B.
Affiliations
  • Health Protection Agency (GB)
  • The Royal Free Hospital (GB)
Venue
American Journal of Epidemiology
Published
2007-01-12
Volume
165
Issue
6
Pages
704-709
ISSN
  • 0002-9262 (ISSN-L)
  • 1476-6256
OpenAlex
W2163948056
Cited by
76
References
17
Citations by year
2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 6 · 2016: 4 · 2015: 6 · 2014: 3 · 2013: 10 · 2012: 4
FWCI
3.67
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Keywords
MMR vaccine, Priorix, aseptic meningitis, convulsions, vaccine adverse events, post-marketing surveillance, mumps meningitis, measles vaccine, vaccine safety, United Kingdom
MeSH terms
England, Humans, Infant, Medical Record Linkage, Meningitis, Aseptic, Mumps virus, Patient Admission, Population Surveillance, Product Surveillance, Postmarketing, Risk Factors, Seizures, Vaccination, Wales, Incidence, Medical Records Systems, Computerized, Measles-Mumps-Rubella Vaccine, International Classification of Diseases

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