Risks of convulsion and aseptic meningitis following measles-mumps-rubella vaccination in the United Kingdom
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Measles-mumps-rubella (MMR) vaccines containing the Urabe strain of mumps were withdrawn in the United Kingdom in 1992 following demonstration of an increased risk of aseptic meningitis 15-35 days after vaccination.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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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
- Publisher
- Oxford University Press (OUP)
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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