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Study: Don't delay measles vaccine
May 19th, 2014
02:18 PM ET

Study: Don't delay measles vaccine

There are many myths about vaccinations floating around the Internet, says Dr. Simon Hambidge. One that giving vaccinations too close together is unhealthy  has prompted some parents to request that their children receive vaccines on an alternate schedule, Hambidge told CNN in an e-mail.

Hambidge, an expert in pediatric vaccination with Kaiser Permanente's Institute for Health Research Colorado, is lead author of a new study that examines the association between vaccine timing and seizures.

His team found that in the first year of life, there is no relationship between the recommended vaccine schedule and seizures. But delaying the measles vaccine until after a child is 15 months old may raise his or her seizure risk. The study results were published Monday in the journal Pediatrics.

"A number of people have claimed that a young child’s immune system is not robust enough to be given multiple vaccines, and that it is safer to 'spread out' vaccination," Hambidge said. "There is no scientific evidence for this, and there is evidence that it is safe and effective to follow the current recommended schedule."

Background

Parents who don't comply with recommended guidelines for childhood vaccines are in a sizable minority.

A study using the 2009 National Immunization Survey found that 25.8% of parents delayed the vaccines, 8.2% refused to get their children vaccinated, and 5.8% both delayed and refused, Hambidge said. The rest did not delay or refuse. These data come from parents of children aged 24 to 35 months.

Parents' fears are mostly about autism, Hambidge said, even though no scientific link has been proven between the two.

Methods

For this study, researchers obtained data on more than 300,000 children born between 2004 and 2008. They looked at a variety of different vaccines and their associated seizure risks.

There are two options for vaccinating children against measles: the measles-mumps-rubella (MMR) vaccine plus a separate varicella vaccine, and the measles-mumps-rubella-varicella (MMRV) vaccine. The Centers for Disease Control and Prevention tells parents that while MMRV results in one fewer vaccine, it is associated with a higher risk of seizures.

U.S. health authorities recommend that children receive their first dose of the MMR or MMRV vaccine at 12 to 15 months of age.

Results

The study suggests that children who receive childhood vaccines in the first year of life do not have an associated risk of seizure. But seizure risk may increase in the second year of life with measles vaccines specifically.

The overall risk of seizures in vaccines that contain measles is "real but very low," Hambidge said it's about 1 in 4,000 doses, according to previous research. It appears that the risk of seizures is about 2 in every 4,000 doses for children who receive the first MMR vaccine between 16 and 23 months of age.

"Febrile seizures that occur after MMR vaccine are rare and temporary – these children are not at increased risk of epilepsy," Hambidge said. "The risk of catching measles disease is far more serious, especially as we are seeing increased cases of measles in the U.S."

(A febrile seizure is a convulsion in young children that may be caused by a spike in body temperature, often from an infection.)

Meanwhile, the study found that getting the MMRV vaccine, instead of the MMR and varicella vaccines separately, increases the risk of seizures twofold regardless of whether the vaccine was given on time. The association with seizures was strongest for children who received the MMRV vaccine between 16 and 18 months of age.

The results support a 2010 study that found additional febrile seizure risk from using MMRV instead of MMR plus varicella separately. But the absolute risk remains small: For every 2,300 MMRV doses given in the second year of life, there is one additional febrile seizure in the seven to 10 days following vaccination.

Recommendations

"This study supports the currently recommended vaccination schedule from the CDC as the best choice for protecting children from serious disease and minimizing adverse events from vaccination," Hambidge said.

Bottom line: Do what your doctor says and vaccinate against measles on time. Have a conversation about MMRV versus MMR if you have questions or concerns. The CDC recommends receiving the MMR and varicella injections separately.

"Because the U.S. is seeing the largest increase in measles cases in recent memory due to unvaccinated travelers returning from trips abroad, the risk of not vaccinating a child for measles or for delaying vaccination is that the child is left vulnerable to catching measles, which is a very serious disease," Hambidge said.

Related: Measles cases at highest level in nearly 20 years


soundoff (31 Responses)
  1. wat

    Uh, no. We don't need vaccine that' designed to kill us. NO THANKS! I would take it back in the 70s, but now humans want to evolve into a monster: that's where vaccine comes in.

    May 19, 2014 at 16:12 | Report abuse | Reply
    • Emily

      I have NO idea what you're trying to say.

      May 19, 2014 at 16:30 | Report abuse |
    • DilapidatedEmu

      This is so wrong that it is comical.

      May 19, 2014 at 17:04 | Report abuse |
    • Pete

      ‘What flavor cheese is the Moon made of?’ Well, the answer is zero when the moon is not brie.

      May 19, 2014 at 20:17 | Report abuse |
    • Sulivanthepoop

      Since no vaccines are designed to kill anyone vaccinate.

      May 20, 2014 at 07:53 | Report abuse |
    • Eeyore

      Typical anti-vax nuttiness. Vaccines aren't "designed to kill us." They are the reason children no longer suffer from the complications of measles, which occur FAR more frequently than any reactions to vaccines. I doubt you understand the science behind vaccines. You should read about them.

      May 21, 2014 at 11:20 | Report abuse |
  2. Delmar H. Knudson

    30% of measles cases develop one or more complications, including
    Pneumonia, the most common cause of death in young children who contract measles.
    Ear infections occur in 1 of 10 cases of measles.
    Some of these get permanent hearing loss.
    Diarrhea occurs in 8% of cases.
    These complications are more common in children under 5 years of age.
    As many as 1 in 20 kids who get measles gets pneumonia.
    One in one thousand who get measles will get encephalitis. This can cause convulsions, permanent deafness or mental retardation. For ever thousand kids who gets measles, one dies.
    In the third world where so many have malnutrition and Vitamin A deficiency, measles kills about 1 in 4 people. Measles is the leading cause of blindness among African children. In 2008 there were about 164,000 deaths from measles worldwide.

    May 19, 2014 at 22:53 | Report abuse | Reply
    • TheM0thership

      Did you know they actually did a study on anti-vaxxers? The more you presented real, scientific evidence supporting vaccination, the more they became entrenched in their opinion that vaccinations were evil. I think I read it in Discover magazine. Anyway, that's a great summary of facts even if it won't sway even one crazy anti-vax.

      May 20, 2014 at 06:39 | Report abuse |
  3. SS

    I realize most people dislike this new trend of anti vaccinations, but I think its kind of funny how no one presents the side of ones who are unable to receive vaccines due to serious adverse reactions. This happened to both my sisters and my nephew after receiving both the whooping cough and MMR vaccines. This is obviously a reaction that runs in our family and if I told someone that I would hesitate giving one of these vaccines to my child I'm sure someone would call me crazy and say that I'm putting my children in danger. But why would you after you know that this is something that runs in your blood line? This is just some food for thought for those who are so quick to jump against those who choose to not vaccinate. Everyone's reasons will be different, I'm simply trying to point out that you shouldn't be assuming anything about people as you never know what the real scenario is.

    May 20, 2014 at 08:03 | Report abuse | Reply
    • Sulivanthepoop

      I don't think your crazy for being wary of vaccinating your children if you have a problem in your family, but if it is an allergic reaction, I would try it but make sure that the pediatrician is aware and prepared to keep your child there for 1/2 hour after to be observed in case epinephrine is needed.

      May 20, 2014 at 08:45 | Report abuse |
    • czerenity

      What were the reactions?

      May 20, 2014 at 11:26 | Report abuse |
    • Pippi

      As a child, I personally had a reaction to the measles vaccine at 15 months and came down with measles. I recovered after a month in the hospital without any of the lasting side effects. But my four kids all were vaccinated and none had a reaction. We simply had the pediatrician watch them more closely for any signs of reactions due to the family history. If you're talking about an allergic reaction to the egg protein in the vaccines, they have alternate forms of vaccinations for those allergies. That's not a problem with vaccination in general though – that's an allergy. Some people also react to the nickel metal in syringes, and they can work around that too.

      May 20, 2014 at 11:52 | Report abuse |
    • bepatienz

      "This is obviously a reaction that runs in our family and if I told someone that I would hesitate giving one of these vaccines to my child I'm sure someone would call me crazy and say that I'm putting my children in danger."

      When I think of a bad reaction to a vaccine, I think that the child did not develop an appropriate immune response. Parents who happen to have produced children who have other and sometimes frightening responses may feel differently.

      For example, depending on ethnicity, five to ten per cent of children develop benign febrile seizures (often in response to elevated body temperature associated with an otherwise appropriate response to vaccination–or following natural infection, or hot baths) and other children develop more serious seizure disorders. The evidence shows that such reactions are due to genetics, not vaccination, but that can provide little comfort to parents. (Such mutations cause seizure disorders in unvaccinated laboratory animals, and neurons cultured from induced pluripotent stem cells from the skin of affected individuals are abnormal.)

      Since the vaccines do not cause what parents might consider a "bad" reaction so much as reveal the underlying genetics, it is difficult for parents to decide what to do–but there's a clue:

      MMR vaccination produces encephalitis in one in three million doses–much less frequently than in the natural diseases that MMR prevents:

      –Measles produces encephalitis in about one in one thousand cases.
      –Postnatal rubella infection produces encephalitis in about one in five thousand cases.
      –Mumps produces encephalitis in about one in fifty thousand cases.
      –Measles can kill

      May 21, 2014 at 19:59 | Report abuse |
  4. mom

    It sounds a bit "trendy" in modern society to skip vaccines or give birth at home...but those in the third world would love to have a safe hospital to birth in (instead of having the baby die at home b/c of something silly), or a vaccine that would mean most of the kids would not die before age 5. Let's not go back to the 1800s.
    Grandma had measles and is blind in one eye. We want better for our kids. And we want them to reach adulthood.

    May 20, 2014 at 08:26 | Report abuse | Reply
  5. Melody RN

    This is a great reason to convince a parent to vaccinate their children on time, especially with the MMR/MMRV vaccine. It was very interesting to discover that according to the study, delaying the first measles-mumps-rubella vaccine (MMR) or the first measles-mumps-rubella-varicella vaccine (MMRV) beyond the age of 15 months may more than double a 2-year-old's risk for postvaccination seizures. It's one of many reasons to follow the recommended schedule unless otherwise recommended by a pediatrician.

    Melody RN- Founder of Nurses Who Vaccinate

    May 20, 2014 at 10:29 | Report abuse | Reply
  6. czerenity

    My fourteen month old daughter has had two seizures in the past three months, not vaccine related. A seizure does not do damage to their brains. It's a quick (most often less than a minute and a half, especially in febrile seizures) process that does not cause any sort of damage.

    Is it terrifying for the parent? Heck yes. But I'd still rather her have a one minute seizure than contract measles.

    May 20, 2014 at 11:23 | Report abuse | Reply
  7. bepatienz

    It's been clear for years that seizure disorders become apparent after months or years of apparently normal development due to developmental changes in the expression of pre-existing mutations, not due to vaccinations.

    Cases of alleged vaccine injury that have been repeatedly touted in hundreds or thousands of posts by anti-vaccine activists to support their mistaken notion that "the federal government has been paying court awards to children whose vaccine injuries directly led to the development of autism" (an idea advanced by legal expert Mary Holland and a team with no medical or scientific expertise) are remarkably similar to the many cases of alleged vaccine injury that have been examined by independent researchers who concluded that the alleged vaccine injuries were in fact genetically-determined channelopathies.

    The United States Court of Federal Claims is slowly waking up to this: compensation was rejected in recent cases precisely because the evidence suggested that the alleged vaccine injuries were in fact genetically-determined channelopathies that would have produced the same results with or without vaccination–perhaps as in the case of little Samuel Shattuck, whose regression in Salem, Massachusetts centuries ago was not caused by either vaccines or witches. Given the very high preponderance of already-identified causative mutations in alleged cases of vaccine injury already examined, it seems likely that since the Court has actually ordered genetic testing for channelopathy-producing mutations few of the cases that seem canonical to anti-vaxxers would be compensated today.

    May 21, 2014 at 19:39 | Report abuse | Reply
    • Cynthia

      Really? Then how do you suppose the very real data of a vaccinated child has a 1 in 50 chance of getting autism, while an unvaccinated child has a 1 in 10,000 chance of getting autism? Homefirst reports over 30,000 unvaccinated children with no autism.

      May 22, 2014 at 02:38 | Report abuse |
    • Eeyore

      What "very real data"? From what study? Homefirst is run by a quack and the numbers you're spouting aren't supported by any data at all–only what the quack "doctor" claims. Furthermore, you have no studies to support your statement that the rate of autism in unvaccinated children is different than that of those who are vaccinated. IN FACT, it's the opposite.

      I suspect that you are "cia parker," a known anti-vax activist who misleads others with misinformation and outright falsehoods.

      May 22, 2014 at 06:37 | Report abuse |
    • Artemis MA

      Cynthia, your "data" is not real. And on top of that, signs of autism are now being detected much earlier than the actual behaviors of autism show up.

      May 24, 2014 at 09:14 | Report abuse |
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    May 21, 2014 at 22:19 | Report abuse | Reply
  9. Cynthia

    It doesn't take a science degree to add up the facts: The vaccines are spreading the diseases they are supposed to "prevent" to mostly vaccinated persons. These aren't wild strains, but strains from vaccines. Obviously vaccines don't work and even more obvious are compromising immune systems to make sicker persons, not to mention the brain damage from the neurotoxins added as "fillers." And we wonder why people are doing really bad crimes (like shooting up schools) and have no remorse?

    May 22, 2014 at 02:35 | Report abuse | Reply
    • Eeyore

      Oh, malarkey. You are a typical anti-vax nut-job. You don't understand how vaccines work. You are incapable of discerning the difference between valid, credible studies and statistics and those that are either completely fabricated or fraudulent. Knock it off. Nobody with an ounce of sense thinks vaccines are causing autism.

      May 22, 2014 at 06:34 | Report abuse |
    • Michael

      You have not a clue how vaccines work.
      A.,the virus is dead and can't infect you. It will stimulate your immune system and make you immune
      B. vaccines WILL NOT AFFECT YOU .
      C. The "toxins" are miniscule and have no ill-effect on your body

      May 22, 2014 at 12:11 | Report abuse |
    • Eeyore

      It's a riot reading your posts, Cynthia. Are you really blaming "toxins" in vaccines, which, as Michael says, are used in minuscule amounts that are harmless, for people "shooting up schools?" Wow. Just wow.

      May 22, 2014 at 12:46 | Report abuse |
  10. chrissy

    Spot on @ SS! I am the mother of a 34 yr old son who is severely mentally impaired because of the pertusis portion of the DPT vaccine that children are required to have. And that is simply because we were not told at the time that it could happen to children with specific issues. Im not saying vaccines should or should not be given im saying all the facts should be given first!!

    May 23, 2014 at 13:01 | Report abuse | Reply
    • Eeyore

      What facts were you not told? Was there an informational insert? Did you read it?

      Yes, there are vaccine injuries. Nothing is ever 100% safe for everyone. Nor is anything 100% effective. But the statistics show that vaccines are far safer than the diseases they prevent.

      May 27, 2014 at 10:33 | Report abuse |
  11. Artemis MA

    I would have much rather had the vaccine than the measles. I was seven and the vaccine was still in the late trial stage. I understand it was pretty much touch and go. Unless you have some medical contra-indication, Get the Vaccine!

    May 24, 2014 at 09:06 | Report abuse | Reply
  12. chrissy

    @ Eeyore no back then there were no inserts. In fact they really didnt tell you anything at all about it except that is was required. Plus it was 34 years ago so it was relatively new. Also they didnt ask any medical information that wouldve prevented my sons tragedy after getting the shot. Had they asked then they later told me, he would NOT have been given the pertusis part of the vacine. Because of problems with his birth he had an apnea issue which caused a slight brain hemorage...the pertusis vacine can cause siezures and mental retardation if a child is prone. He was because of the hemorage but since they didnt get a medical history or even mention THAT fact to me, i had no idea. So my thought is information needs to be given AND recieved BEFORE as all children are not the same.

    May 27, 2014 at 15:35 | Report abuse | Reply
    • Nonovyerbeezwax

      While I'm sorry for your son's problems, how do you know that the vaccine was the cause?

      May 29, 2014 at 10:53 | Report abuse |
  13. chrissy

    Also he has had all other vacines without incident as have both my daughters. And ive not ever "blamed" any specific person...that is a negative approach and wouldve changed absolutely nothing. Yes he is severely mentally impaired from it and has alot of seizures but...he is a very happy guy and i wouldnt trade him for nothing! Was part of a bigger picture than i know im sure.

    May 27, 2014 at 15:42 | Report abuse | Reply

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