This eighth and final report of the Immunization Safety Review Committee examines the hypothesis that vaccines, specifically the measles-mumps-rubella (MMR) vaccine and thimerosal-containing vaccines, are causally associated with autism. The committee reviewed the extant published and unpublished epidemiological studies regarding causality and studies of potential biologic mechanisms by which these immunizations might cause autism. The committee concludes that the body of epidemiological evidence favors rejection of a causal relationship between the MMR vaccine and autism. The committee also concludes that the body of epidemiological evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism. The committee further finds that potential biological mechanisms for vaccine-induced autism that have been generated to date are theoretical only.

The committee does not recommend a policy review of the current schedule and recommendations for the administration of either the MMR vaccine or thimerosal-containing vaccines. The committee recommends a public health response that fully supports an array of vaccine safety activities. In addition, the committee recommends that available funding for autism research be channeled to the most promising areas. The committee makes additional recommendations regarding surveillance and epidemiological research, clinical studies, and communication related to these vaccine safety concerns. Please see Box ES-1 for a summary of all conclusions and recommendations.

Contents

• The National Academies
• Immunication Safety Review Committee
• Reviewers
• Foreword
• Acknowledgments
• Executive Summary
  • ABSTRACT
  • SIGNIFICANCE ASSESSMENT
  • RECOMMENDATIONS FOR PUBLIC HEALTH RESPONSE
  • REFERENCES
• Immunization Safety Review: Vaccines and Autism
  • THE CHARGE TO THE COMMITTEE
  • THE STUDY PROCESS
  • THE FRAMEWORK FOR SCIENTIFIC ASSESSMENT
  • UNDER REVIEW: VACCINES AND AUTISM
  • SCIENTIFIC ASSESSMENT
  • SIGNIFICANCE ASSESSMENT
  • RECOMMENDATIONS FOR PUBLIC HEALTH RESPONSE
  • SUMMARY
  • REFERENCES
• Appendixes
  • A Committee Recommendations and Conclusions from Previous Reports
  • B Public Meeting Agenda February 9, 2004
  • C Thimerosal Content in Licensed Vaccines
  • D Chronology of Important Events Regarding Vaccine Safety
  • E Summary of Public Submissions
  • F Acronyms

This study was supported by Contract No. N01-OD-4-2139, Task Order #74 between the National Academy of Sciences and Centers for Disease Control and Prevention and the National Institute of Allergy and Infectious Diseases of the National Institutes of Health. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.